Low but within range B12

[Joanne-M]

Hi, recent blood test results indicate that although I am low (Serum B12 - 219) GP has said it's within range. (April it was 220)

I have recently been prescribed Folic acid for 3 x months however this has now stopped again. I do frequently require folic acid!

I have UAT & have currently had levothyroxine increased from 125 to 150.

Could someone please advise....thanks

[Sleepybunny]

Hi,

Are you in UK?

If yes, I'd recommend reading the whole "BSH Cobalamin and Folate guidelines" document.

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

Flowchart from BSH Cobalamin guidelines

stichtingb12tekort.nl/weten...

Flowchart makes it clear that in UK, people who are symptomatic for B12 deficiency should have an IFA (Intrinsic Factor Antibody) test and start initial b12 treatment. This applies whether B12 is low or within range.

Are you symptomatic for B12 deficiency?

pernicious-anaemia-society.... I gave a copy of PAS checklist with all my symptoms ticked, to my GPs.

b12deficiency.info/signs-an...

b12d.org/admin/healthcheck/...

IFA test is not always reliable and it is possible to still have PA (Pernicious Anaemia) even if IFA test result is negative (called Antibody Negative Pernicious Anaemia).

Who gets PA and B12 deficiency?

pernicious-anaemia-society....

b12deficiency.info/what-are...

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

You mention having folate treatment. I have read that if a person is having folate treatment, it is important to treat any co-existing B12 deficiency.

See Management section in next link for more details (and also BSH Cobalamin and Folate Guidelines).

patient.info/doctor/folate-...

I am not a medic just a person who has struggled to get a diagnosis.

[Joanne-M in reply to Sleepybunny]

Yes...in UK...thanks & will do 😊

[Sleepybunny in reply to Joanne-M]

More B12 info

1) Pinned posts on this forum. I found fbirder 's summary of mainly UK B12 documents useful to read.

2) BMJ B12 article

bmj.com/content/349/bmj.g5226

3) BNF (British National Formulary) Chapter 9 Section 1.2

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

4) PAS (Pernicious Anaemia Society) website

pernicious-anaemia-society....

PAS tel no [phone] answerphone so messages can be left

Martyn Hooper's blog about PA and B12 Deficiency issues

martynhooper.com/

5) B12 Deficiency Info website

lots of b12 info and an interesting blog

b12deficiency.info/

Person who runs website can be contacted by e-mail.

6) B12d.org

b12d.org

7) Book "What You Need to Know About Pernicious Anaemia and Vitamin B12 Deficiency" by Martyn Hooper. Book is up to date with UK B12 guidelines. He has written two other books about PA and B12 deficiency.

I found "Living with Pernicious Anaemia and Vitamin B12 Deficiency " helpful as well due to case histories in it.

8) Book "Could it Be b12:An Epidemic of Misdiagnoses" by Sally Pacholok and JJ. Stuart (USA authors)

Very comprehensive book about B12 deficiency and lots of case histories.

[Joanne-M]

Thanks 😊