Results help

[emmylou71]

Please can somebody help with these results.

B12 253 (170-730)

Ferritin 46 (10-290)

Feeling really tired right now.

[holehead]

Hi Emmylou

Understand your problem, your results show border line b12 deficiency however each person is different and you can show symptoms in the 400s but it would be useful if you could provide any other blood results you may have including folate as this works with the other 2.

Your ferritin although not at optimum levels is vital to the process. Do you know if this level in your ferritin and your b12 shows a downward trend?

What about vit D as well. There are people who can help with the knowledge of your bloods

Mark

[emmylou71 in reply to holehead]

Thanks for your help. This is the first time my b12 has been tested. They didn't test folate or vit d. I've got underactive thyroid so we're mainly testing for that.

[holehead]

Hi with a B12 level in your range you really need a few blood results to make any definite diagnosis especially folate as the 2 work together. Also your blood distribution width which could point to macrocitic anemia. If you get a full blood count then understanding your possible b12 diagnosis will be clearer as it could be you are deficient or it could be you cannot absorb b12 which could point to pernicious anemia. Hope you get sorted

Mark

[emmylou71]

Going back to the doc next week as feeling dizzy and aching. They did a full blood count last time. Can't see anything about blood width tho. Is there any tests in particular I need to ask for apart from folate?

[Sleepybunny]

Hi,

Copies of blood tests

Do you get copies of all your blood tests? There can be useful clues on Full Blood Count (FBC) as to whether an iron deficiency, folate deficiency or B12 deficiency is a possibility.

b12deficiency.info/b12-test...

labtestsonline.org.uk/under...

patient.info/doctor/macrocy...

Low iron can lead to small red blood cells (microcytosis). Low b12 and /or low folate cna lead to enlarged red blood cells (macrocytosis). A person with both low iron and low B12/low folate may appear to have a normal MCV on FBC because effects of low iron on red blood cells can mask effect of low folate/low B12.

Are you in UK?

In UK, people who are symptomatic for B12 deficiency are supposed to have an IFA (Intrinsic Factor Antibody) test and start initial b12 treatment. This applies whether B12 is low or within range. See next links.

bmj.com/content/349/bmj.g5226

stichtingb12tekort.nl/weten...

b-s-h.org.uk/guidelines/gui...

Are you symptomatic for B12 deficiency?

pernicious-anaemia-society.... see PAS symptoms checklist

b12deficiency.info/signs-an...

b12d.org/admin/healthcheck/...

Have you had an IFA test? This can help to diagnose PA (pernicious anaemia) but test is not always reliable and it is possible to have pA even if IFA result is negative (called Antibody Negative PA)

Neurological Symptoms?

In UK, people with b12 deficiency with neuro symptoms are supposed to have more intensive B12 treatment. Untreated or inadequately treated b12 deficiency can lead to permanent neurological damage.

See BNF link below for details of UK B12 treatment.

evidence.nhs.uk/formulary/b...

Info on UK treatment is also in BSH Cobalamin and Folate guidelines.

Who gets PA and B12 deficiency?

b12deficiency.info/what-are...

b12deficiency.info/who-is-a...

pernicious-anaemia-society....

What to do next?

b12deficiency.info/what-to-...

b12deficiency.info/b12-writ...

Interesting blog on B12 Deficiency Info website. Person who runs website can be contacted by e-mail.

Other b12 info

1) Pinned posts on this forum

2) PAS website

pernicious-anaemia-society....

PAS tel no [phone]

Martyn Hooper's blog

martynhooper.com/

3) book "What You Need to Know About Pernicious Anaemia and Vitamin B12 Deficiency" by Martyn Hooper

4) book "Could it Be B12" by Sally Pacholok and JJ. Stuart (USA authors)

very comprehensive book about b12 deficiency

I was very symptomatic for B12 deficiency for many years but the majority of test results were negative or normal range so it was very difficult to convince doctors that B12 deficiency was a possibility.

Some people can have Functional B12 deficiency. There is plenty in the blood but not enough gets into the cells of the body.

nhs.uk/Conditions/Anaemia-v...

ncbi.nlm.nih.gov/pubmed/191...

I would suggest reading up on B12 in case GPs are not aware of latest guidelines.

I am not a medic just a perosn who has struggled for years to get a diagnosis.

[emmylou71]

Hi Sleepybunny. Thanks for that. I've attached a photo of my latest blood test results. Could you have a look at them to see if all look ok. Sick of feeling like this. Thought it was my thyroid at first but will talk them about this as well. TIA.