Serum albumin

[Lizreds1]

Hello everybody, can anybody help with this reading on my blood test please?

Normal range (34-51). My reading was 54?

Is there any need to be concerned?

As always doctor said it was ok

[Foggyme Administrator]

Hi Lizreds1. The most common cause of a slightly raised serum albumin is dehydration - and yours is only slightly raised 😀.

Think if there was anything to worry about the levels would be much much higher...and your GP would have considered this result alongside any other blood tests done (for instance liver/kidney functions tests, inflammatory markers etc).

As always, if you have 'new' or different symptoms to those you usually experience, or you're at all worried, perhaps you could discuss this further with your GP....if only for your peace of mind 😉.

👍

[Lizreds1 in reply to Foggyme]

Thank you so much for your reply, I did manage to speak to the doctor today and she said the same! It was only slightly higher than normal! Guess I'm clutching at straws as to why I feel so ill.

[Foggyme Administrator in reply to Lizreds1]

Hi Lizreds. I've just had a look through your past posts and oh dear, looks like the fact that you've been injecting with B12 and taking sublinguals has pushed your serum B12 level up to the point where your GP (perhaps mistakenly) thinks that B12 can't be the problem.

The fact that you had symptom relief when you were injecting B12 and that symptoms returned when you stopped injecting is a sure indicator that B12 may be the problem.

And once injections have started, serum B12 levels are no longer reliable (if they ever are) as an indicator of B12 status and potential deficency. Your GP should be treating your symptoms (which you certainly have) and not your B12 levels. Not many GP's know that 😖.

And a family history of PA means that you are more likely to also suffer from PA (which you can still have even if your IF test is negative - test returns 50% false negative results).

I'm going to copy some links below that will give you more information about B12 deficency, it's diagnosis and treatment, and some myth busting information (since many GP's approach B12 deficency from a position at can often be described as mythical 😖). In particular, look at the links about the u reliability of serum B12 testing as the sole marker of deficency...and also look for information about the neurological regime of injections (every other day until no further improvement)...again, many GP's have not heard of this.

Hopefully, you'll be able to use the information as evidence to support a further request for treatment...good idea to print the information in the links, highlight what's relevant to your case, and take along for discussion with your GP. Some find that it's more beneficial,to,put their concerns and request for treatment in a letter to the GP before the appointment so that the GP has time to review first.

Your could also include information about subacute combined degeneration of the spinal cord - a neurological condition that can occur due to lack or under treatment of B12 deficiency (available from the PAS website or from the Internet). I'm not suggesting you have this or will get it. Rather, many Gp's are completely unaware of the neurological havoc that B12 deficency (from whatever cause) can wreak on the body...ask your GP to confirm that you are not being exposed to is potential risk...might sharpen her/his mind a little.

Also - if you feel brave enough - if treatment is still refused, ask for the reasons for is to be put in writing, together with medical evidence to support that decision (they won't be able to do this because there is t any 😀).

Putting this in writing is often effective because then it becomes a part of your medical record...and the GP is accountable for the decisions he/she makes, especially if this is to your detriment.

The fact that B12 injections have previously proven to be effective (whether self-injected or not) should be taken into account by your GP...if taken as a therapeutic trail that WORKED, then goodness only knows why this can't be continued - because it makes you well...and with a family history of PA... 😖😀.

Anyway, here's the links...looks like a lot but don't be daunted...most are only one page long and the I fora tigon will certainly help you to approach your GP.

Good luck and post again if you need more help:

b12researchgroup.wordpress.... (Serious Caution Note about the use of Oral and Sublingual B12 Supplements)

evidence.nhs.uk/formulary/b... (BNF B12 Deficiency: Hydroxocobalamin Treatment Regimes)

pernicious-anaemia-society.... (PAS Symptom Checklist)

stichtingb12tekort.nl/weten... (BSH B12 Deficiency / PA Diagnostic Flowchart)

onlinelibrary.wiley.com/doi... (British Society Haematology (BSH) Guidelines: Treatment of B12 Deficiency and Folate Disorders)

cks.nice.org.uk/anaemia-b12... (NICE Guidelines Treatment of B12 / Folate Deficiencies)

onlinelibrary.wiley.com/doi... (UKNEQAS B12 Treatment Alert, Neurological Symptoms and Risk of Subacute Combined Degeneration of the Spinal Cord)

stichtingb12tekort.nl/weten... (Problems with Serum B12 Test)

stichtingb12tekort.nl/weten... (Testing B12 During Treatment)

stichtingb12tekort.nl/weten... (Misconceptions About B12 Deficiency – Good to Know Before Seeing GP)

stichtingb12tekort.nl/weten... (B12 Treatment Safety / Long Term Treatment for neurological symptoms)

stichtingb12tekort.nl/weten... (B12 Deficiency: Neurological Symptoms Can Present Even When B12 is ‘In-Range’ and Without Macrocytosis (large red blood cells) or confirmed PA Diagnosis)

stichtingb12tekort.nl/weten.... (B12 and Intrinsic Factor)

gov.uk/drug-safety-update/n... (B12 & Nitrous Oxide Contraindicated)

stichtingb12tekort.nl/weten... (Methylmalonic Acid – MMA)

stichtingb12tekort.nl/weten... (B12 Deficiency and Neuropsychiatric Symptoms)

👍

P.s. Sorry for the delay in responding...busy few days and struggling with energy levels...

[Lizreds1 in reply to Foggyme]

Thank you so much for your help, have read through all your links. I have decided to stop taking all b12 and other supplements! I am quite happy to self medicate for the rest of my life if need be, but I have been battling medical staff for 6 long long years, if I have pa which I would say was a definite, I want a diagnosis, so fed up of everybody telling me I'm just depressed, or you need to get out more, you need to make more effort, or the most common is you just plain lazy! Really my pa symptoms are secondary to the chronic migraines, 6 days out of 7 I spent last week with migraine as I came off the b12, I get so tired that it triggers the migraines, I have spent nearly 6 years trawling the internet trying to find an answer to why I was so fatigued (fatigued huh! , stupid word doesn't even come close to how we must all feel) some days just stare out my window thinking how much I would love to even be a tiny bit of how I used to be! Why the doctors refused to try and help me! I used to be so assertive and nothing would bother me, the doctors would resort me to tears on lots of occasions, being told your swinging the led!! I was going to give it two weeks off b12 then I was going to periodically get some private active b12 blood tests done, what do you think? I fully understand that my blood tests were skewed, gp said it wouldn't make a difference! Wish I would have known what I was doing before taking the b12. I feel like I'm a prisoner in my own body, do you feel like that?

[Foggyme Administrator in reply to Lizreds1]

Hi Lizreds1. Anybody who reads your reply will know exactly how you feel about being a prisoner in your own body...a body that is t really your own anymore since it won't do anything you want it to! That's no way to live your life...or rather to exist in your life, since living, as most people experience it, is something that almost ceases to exist. And yes, I've been there too 😖.

And let me be quite clear about this...I don't think you're lazy or 'swinging the lead'. If your GP told you this, my response would be...if I was lazy, I'd be at home enjoying my laziness. I'm not. I'm here, asking for your help! Rather, I think your GP is the one who is being lazy.

If he/she knew anything about B12 deficency they would view your self treatment with B12 as a successful therapeutic trail (as I've said above) and prescribe regular B12 injections to see if further improvement and ongoing repair can be achieved and maintained.

Unfortunately, giving up B12 for two weeks will not be sufficient time for B12 levels to drop enough so you can get a diagnosis of B12 deficiency. Once injections have taken place, it can be several months...or even up to a year (depending on how efficient your body is at excreting B12) for levels to become low enough to get that diagnosis. And the active B12 test will give no more information than the serum B12 test - both only tell you how much B12 is in your blood - they give no indication of what is happening at a cell level (how much B12 is getting into the cells where it is needed).

An MMA test can sometimes clarify further (the levels of MMA will be raised if a deficiency is present). However, this test will also be skewed due to the B12 injections since MMA returns to normal quite quickly following an influx of B12.

It's not always easy to get a diagnosis for PA since there is no 'gold standard' test which is 100% accurate - you could test negative for the IF test and still have PA.

What's really important is that the B12 deficency that PA causes is treated, especially if you have neurological symptoms. And B12 deficiency can have other causes too.

Have you thought about changing your GP...another GP practise perhaps? There are no guarantees that a new GP would be any better but at least a new GP would listen with new ears, and hopefully want to helplyou get to the bottom of your health issues.

If your health worsens again now you've stopped the B12 injections it's highly likely that B12 is what you need. And if you have neurological symptoms, then delaying treatment can result in potentially irreversible neurological damage.

So...please do not give up. You know that there is something wrong and that that you're not lazy. And you have a family medical history that makes it more likley that you do have PA...or another underlying autoimmune condition (hypothyroidism, diabetes etc.).

Any GP should want to investigate thoroughly to rule out all potential causes for your ill health.

Many here have had success by writing to their GP's and providing evidence to support a B12 treatment request (using information from the links above). A letter with evidence becomes part of your medical record and your GP cannot ignore it.

You could focus on the family history of PA, your on going symptoms, the fact that serum B12 levels alone are an unrealiable marker of deficency (especially once supplementation has taken place), and that you are concerned that failing to treat may leave you exposed to developing subacute degeneration of the spinal cord (the neurological damage that occurs as a consequence of untreated or under treated B12 deficency). Also point out at you have been seeking and been refused treatment for six years and that following a successful therapeutic trial of B12 (undertaken by yourself in line with current guidelines) you feel that continued treatment with B12 injections will be not only beneficial, but essential to you regaining and maintains your health.

Conclude the letter by saying that if they are not prepared to prescribe the treatment, please can they put that decision in writing and provide medical evidence to support that decision (they won't be able to, there isn't any). Quite the opposite, in fact 😀.

Finally Lizreds1, I think if it was me, I'd get another GP. You most certainly deserve better care than you're currently getting.

If you decide to self treat - which many here are eventually forced to do - then please do post again if you need any support with this.

Good luck and let us know how you get on 👍x

P.s. Sorry for the delay in responding - not been too hot for the last week - but picking up again now (antibiotics kicking in, at last 😀).

Take care x