Summoned due to test results

[topazrat]

I've had a phone call to go to the Doc to discuss my blood results. Apart from the high B12 (jab 2 weeks before) and the high Folate (was high on previous test too), I can't see anything out of range, unless I'm missing something obvious, unless they are worried about the Folate. Normal Doc is off sick, so I've got an appointment with a different one. Can anyone see anything I've missed?

Serum ferritin level 48 ug/L [30.0 - 300.0]

SERUM B12 AND FOLATE

Serum vitamin B12 level > 1500 ng/L [180.0 - 915.0]

Above high reference limit

Serum folate level > 24.0 ug/L [4.0 - 20.0]

Above high reference limit

SERUM FOLATE COMMENT Please note new reference range due to

restandardisation to World Health Organisation

(WHO)International Standard 03/178

Normal 4.0-19.9

Borderline 3.1-4.0

Low < 3.1

Serum C reactive protein level 1.8 mg/L [0.0 - 6.0]

Full blood count

Haemoglobin concentration 142 g/L [115.0 - 165.0]

Red blood cell count 4.52 10*12/L [3.8 - 5.8]

PCV 0.414 [0.37 - 0.47]

Mean cell volume 91.0 fL [83.0 - 101.0]

Mean cell haemoglobin level 31.3 pg [27.0 - 32.0]

Mean cell haemoglobin concentration 342 g/L [315.0 - 360.0]

Total white blood count 6.1 10*9/L [4.0 - 10.0]

Neutrophil count 3.97 10*9/L [2.0 - 7.0]

Percentage neutrophil count 65.1

Lymphocyte count 1.13 10*9/L [1.0 - 3.0]

Percentage lymphocyte count 18.5

Monocyte count - observation 0.53 10*9/L [0.2 - 1.0]

Percentage monocyte count 8.7

Eosinophil count - observation 0.37 10*9/L [0.02 - 0.5]

Percentage eosinophil count 6.0

Basophil count 0.10 10*9/L [0.0 - 0.1]

Percentage basophil count 1.7

Platelet count - observation 314 10*9/L [150.0 - 400.0]

Mean platelet volume 9.5 fL

ESTIMATED GFR

Serum creatinine level 71 umol/L [62.0 - 124.0]

Serum TSH level 2.77 U/mL [0.38 - 5.33]

Urea and electrolytes

Serum sodium level 143 mmol/L [135.0 - 145.0]

Serum potassium level 4.17 mmol/L [3.5 - 5.0]

GFR-EPI

GFR calculated abbreviated MDRD 84 mL/min [59.0 - 9999.0]

Serum total protein level 79 g/L [60.0 - 80.0]

Serum albumin level 44 g/L [35.0 - 50.0]

Serum alanine aminotransferase level 22 u/L [5.0 - 45.0]

Serum total bilirubin level 10 umol/L [1.0 - 21.0]

Serum alkaline phosphatase level 97 u/L [30.0 - 170.0]

[Foggyme Administrator]

Hi Topazrat. No, don't think you've missed anything...just the high levels of B12 (expected after B12 injections) and the high folate levels.

Hope your GP (a different one 😣) is not one of those who mistakenly thinks that you don't need B12 because your levels are high, and tries to stop your injections. Just in case (don't know,if,you've seen it) here's some information that might help:

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)

About the high folate - don't know if,you've been supplementing with folic acid but over-supplementation can cause side effects (which resolve quite quickly if folic acid is stopped so that folate levels can fall). Here's some information about that:

mayoclinic.org/folate safety

If you haven't been supplementing with folic acid, your GP may want to investigate the cause of your high folate levels.

Note: folate levels can be high if the body is unable to process B12 at a cell level...it builds up in the blood because it's not being used. Just wondering, are you being treated for B12 deficiency but still suffering symptoms, despite injections?

Good luck with your GP...let us know how you get on 👍

[topazrat in reply to Foggyme]

No, I hadn't been supplementing. I do take a multivitamin and mineral one a day tablet, but I stopped taking that 2 weeks before the bloods, so that it didn't give a false high. It's only 200 u.g of folic acid in it anyways. Yes, I still have symptoms on the jabs, but nowhere near as bad.

She better not say I don't need jabs! An Intrinsic factor and parietal cell was taken too (don't know why, as I've already tested positive in the past) Both were positive again - The I.F level was 30. Anything over 6 is positive, so I'm well positive. Parietal was also positive again.

[Foggyme Administrator in reply to topazrat]

Ah ha...I remember...the additional tests, the courier, the wasting NHS resources...the miraculous curing of PA. Ha.

A few thoughts about the of potential possibilities you could think about in terms of remaining symptoms:

1) you have not supplemented with folate for two weeks prior to the blood tests - This means that your folate level would have have been even higher than the test result, which was over the top of the reference range when tested. Check out the folate link I gave above, which lists the symptoms of over-supplementation (200ug daily is too. Uck when you already have too much). Not saying this is the answer but it possible that some of your symtpoms may be due to over supplementation with folic acid. Suggest you stop the folic acid (find a multi complex that does not contain folic acid - you obviously don't need it and not everybody with B12 deficiency needs to supplement with folic acid).

2) you are being under-treated with B12. If you had neurological symtpoms at the time of diagnosis you should have received six loading doses and then every other day injections until no further improvement - then injections every eight weeks (though some people need more than this to remain symptom free - but thats another story). If you had neurological symptoms when diagnosed and did not receive this regime there has been a 'missed step' in your treatment. You may need to ask for this regime - or consider whether you are one of those people who need more frequent B12 injections to get and keep well (or as symptom free as possible).

3) your body is not processing B12 properly at a cell level. Consider asking your GP to do an MMA (methylmalonic acid) blood test. If the MMA is raised, this shows that B12 is not being processed at a cell level.

Good luck with your GP, lets us know how it goes 👍

[topazrat]

I've just got back from the Doc. I've been told to stop my multivitamin supplement as she thinks that may be the reason why the folate is high, and that is probably making me feel unwell - just as you suggested Foggyme . She suggested just taking an iron supplement for the low end Ferritin. She's retesting in 6 months to see if stopping the supplement brings down the folate. If not, she'll do further testing.

[Foggyme Administrator in reply to topazrat]

Excellent news topazrat...and a GP who sounds knowledgable. Hurrah.

The good news is that folate levels will even-off quite quickly once the supplements are stopped so hopefully you'll start to feel better very soon.

Be really interested to hear how it goes topazrat so let us know how you get on 😀.

Take care 👍

[Cherylclaire Forum Support]

Well done, Foggyme - and what a relief, topazrat , not to have to gear up for a fight ! Good that the GP was on it, good that Foggyme was too, and hopefully you will feel better soon. Love a happy ending.

[topazrat]

Yep I was very happy with what she said, especially when I pointed out the high B12 and said that I'd had a jab a couple of weeks previously. She just waved her hand dismissively and said 'Ah, I don't worry about that - you're on jabs'.

I was a bit worried beforehand, as it was the Doc that I staged a sit in with when she refused to do further tests because my original B12 was 250, despite obvious symptoms!

[Cherylclaire Forum Support]

A sit-in !! Good for you, topazrat - and good for your GP that she didn't take it too personally ! Maybe did a spot of homework....