B12 Deficiency

[lucylovesgin]

Hi all

Just posted this on the Thyroid forum and it was suggested this might be the better place to post.

I've just read on someone else's post that a dropping B12 can suggest PA.

My B12 levels were low but in range in Dec 16 but a recent test has shown that they've dropped to below range. My GP wants to see me about the test results - presumably because of this.

I started supplementing B12 and VitD a week ago and have just read that you shouldn't as it could affect further testing.

So my question's are;

Is there anyway to definitely rule out PA (other than testing) and

Should I stop supplementing until I see him in a fortnight? Or is it too late and whatever tests he may run will be skewed?

Last haemoglobin test was 12 and Ferritin was 25.6 which is creeping up so very, very slowly but was "the lowest" doc had ever seen! Im not even sure if this is relevant? Also VitD deficient.

Test results for B12

Dec 16 260 [191-663]

Jun 17 152 [191-663]

Thanks

Lucy

[Gambit62 Administrator]

what level of B12 were you supplementing with - probably a high dose of 1000mcg or more - stopping for a couple of weeks is unlikely to make much difference to any further testing in respect to serum B12 and may affect other tests to clarify - MMA and homocysteine though unlikely that these tests would be offered by GP as your result is quite significantly below normal range.

Do you know if you had any signs of macrocytosis (larger rounder red blood cells) - suspect not if you have an iron anaemia as that would act in the opposite direction. Your GP may think that B12 deficiency is all about anaemia - it isn't so if they say that there isn't a problem you need to push back. 25% of people who are B12 deficient don't present with macrocytosis.

The test for PA is IFA but this is prone to false negatives 40-60% of time so a negative result won't rule out PA as a cause of the B12 deficiency.

Other causes would included coeliacs, h pylori, drug interactions (of which there are many).

IFA test means not supplementing for a week to 10 days before the test or it can give a false positive - so an argument for not supplementing any more.

If your GP is on the ball they should start you on loading doses - if you have neurological symptoms - eg tingling in hands and feed - then you should be on lading shots 3xweekly until symptoms improve (not just 2 weeks) and then maintenance every 8 weeks (rather than 12 weeks) so make sure that your GP is aware of neurological symptoms - and be prepared to draw their attention to the different regime.

PA tends to lead to lower levels of stomach acidity (often mistaken for high stomach acidity as symptoms are more or less the same) which will affect ability to absorb other minerals and vitamins so could explain iron absorption problems. You also need to keep an eye on folate levels - have these also been tested as they may also be low.

[lucylovesgin in reply to Gambit62]

Hi Gambit,

Thanks for replying. I've been taking the Better You B12 Boost which says it's 1200 of 4 sprays. I've only been taking it for 5 days so far. I guess I will stop until I speak to doctor.

I've had a few FBC's but not sure which result would tell me about Macroxytocin - is that the red blood cell distribution width? If so it was 20% in December, 13.5% in March and 15.8% in April. Range 11-15

My Folate has dropped too.

Results if useful

Folate

Dec 16 - 11.3 (3.9-26.8)

Jun 16 - 4.5 (3.9-26.8)

Ive only started learning about AITD which has very similar symptons/causes/knock-on effects! I wonder if ill ever get to the bottom of which came first!

Thanks for the information, I will discuss with my doc and see what he suggests.

[Gambit62 Administrator in reply to lucylovesgin]

MCH raised, MCV raised and RDW raised are all pointers to folate and B12 deficiency,

If folate falling without a change in diet does suggest an absorption problem