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Pernicious Anaemia Society
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B12/Folate/Iron deficiencies

Hey guys

My mum's thyroid tests came back hypo and she started levo and is autoimmune. I'm trying to get my mums health sorted properly rather than leaving it to docs as she has never eaten much at all so got her some extra tests done at medichecks that you can see below. I have had multiple autoimmune issues and deficiencies throughout my life most of which reversed/improved after going GF although thyroid is already long dead lol. Myself and my daughter are both diagnosed with Non Coliac Gluten Sensitivity as was proven to cause systemic inflammation and autoimmunity in my case even though I test negative for coeliacs. They also stated was likely genetic so got my mum to go gluten free also a month or so ago and she's had a lot of improvements in her appetite and has started eating better.

She's obviously Folate deficient and Vit D deficient so will make sure she's treated adequately for these but I don't think for one minute that she can't be iron and B12 deficient due to her historic malnutrition so wanted your expert opinion.

The B12 is low in range anyway and would have supplemented anyway but she had taken 1000mcg methylcobalamin the day before the test. I told her not too but she did anyway as was more tired than usual - she hasn't taken any since. How much do you think that one off B12 would have effected her blood test result a day later? I don't think the docs will treat where it's showing in range so should I treat B12 anyway or should I get a retest to see if will show deficient and get her treated properly by docs with injections? If a retest, how long should it be left for that 1000mcg to clear?

Levels are kind of expected with the lack of eating but I will test for PA at some point when have the rest sorted and more money to pay for extra tests but am assuming intrinsic factor antibodies will show neg/pos regardless of B12 treatment and therefore okay to leave for a while?

In regards to Iron, I don't see how she could ever have eaten enough to not be deficient in everything regardless of ferritin result so am wondering if the B12/iron are counteracting each other somewhat? Her HB, RBC and MPV are low in range and MCV, MCH and RDW are all high in range with MCHC and HCT more mid range- all in range though. What do you guys think, should I get an iron panel?


VITAMIN B12 177 pmol/L 140.00 - 724.00

FOLATE (SERUM) *2.2 ug/L 2.91 - 50.0025

OH VITAMIN D *20.89 nmol/L 50.00 - 200.00

Iron Status FERRITIN 111 ug/L 13.00 - 150.00

Many thanks in advance for any advice :-)

8 Replies

B12 is actually stored in the liver in quite good quantities and the daily requirement is quite low so can take years for stores to be depleted.

Given the folate deficiency the changes in MCH and MCV could be due to folate deficiency so not evidence of B12 deficiency.

If your mother has an absorption problem then not much will have got through from the tablet - but it could still be a couple of times RDA. If she doesn't have an absorption problem then it will have been a really big dose. If you think she is B12 deficient for dietary reasons then tablets that are a few times RDA should be sufficent to correct the problem ... and they probably won't have any impact on testing in future.


Thanks Gambit62

I'm not sure she'd have ever stored any to be honest, she never ate much since being a kid - she lost weight when she was pregnant with me and that was nearly fourty years ago. That's why I'm sooo surprised at the ferritin - unless chocolate contains a lot lol. I have been forcing her to eat last 2-3 months so hopefully making a difference.

She literally moves in slow motion like a sloth so I think her body put her in some form of semi-hibernation to protect her from herself lol! She has a shocking memory too but always has.

Was just a little worried in case she's like me as my levels are dropping lower and lower even though I get far more than needed in my diet and all my other vit levels have improved since I sorted stomach issues.

Okay will just supplement for a while to get levels up a little higher and she how she gets on after that :-)


There are two good websites, b12deficiency.info and b12d.org and a Facebook page New beginnings b12 deficiency information and support group. There are information files on there too.


THanks, will read through :-)


I was put on injections for low B12 when my level was 176. My GP told me it ought to be at least 200, and in some countries it's treated when it's below 500. My VitD was low too. Does your Mum have any symptoms of B12 deficiency? Try the Pernicious Anaemia Society website for a full symptom list. If you can tick any of those for your Mum, then return to the doctor with the list, and hope he will begin treatment. He ought to do an intrinsic factor test, but they are notoriously unreliable.


THanks :-) Yes, I would have supplemented with a high dose regardless at that level. She certainly does have symptoms of B12 deficiency I suppose but then she's always had these symptoms so a little hard to gauge but she is also likely to have been deficient for a long long time lol. Her walking has become more shuffly lately. What I do know is that some of her results have changed quite a lot since she's been on levo the past month or so for no reason and maybe not good to have done this without addressing the other issues as I suppose it's forcing her out of purposefully slowed metabolism when she's not ready - just speculation lol. For example ferritin has gone from 61 to 111. I suppose on the plus side her extremely puffy eyes have reduced which is why I finally managed to persuade to get all these tests done in the first place and she is finally doing something about all this after me nagging for years lol :-)

Actually, we spoke to a different GP that she hasn't seen before at her surgery today and unexpectedly she agrees with me and because it is still low and because of the supplement she took, she wants to do her own tests and she's going to retest in two weeks along with her thyroid and see where's she's truly at to get properly medicated. It's annoying to have to wait two weeks but she wanted them done at the same time as her repeat thyroid tests. She also unexpectedly apologised and admitted these tests should have been done already before we had to pay for them so I think we'll stick with her.

Thanks again :-)

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I also have an underactive thyroid condition, and have discovered that getting the low B12 sorted has helped the thyroid too. Wishing you and your Mum well. Hope the doctor will be able to get everything in balance again. ( by the way, my balance was awful when my B12 was low!)


I'm not so sure she move fast enough to lose her balance :-/ Thanks :-)


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