Are my levels OK

I've just had a full blood test as my hair is thinning and I'm constantly tired. My GP says that everything's normal and that's it. My B12 was 269, Ferritin 61 folate 8.7. I have underactive thyroid on 100g of thyroxine and taking PPI (30mg for a year) My mother has regular B12 injections for pernicious anaemia and like her I am coeliac. Are my levels low am I able to supplement myself? Thanks

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  • Hi Msposh does your doctor know that your mother has P.A? It can be "inherited"

  • Being Coeliac can affect your ability to absorb B12. Using a PPI will also affect your ability to absorb B12. It generally isn't recommended to use a PPI for more than a few months at a time anyway.

    Do you have any previous historical levels for B12 that show a significant drop? - which would demonstrate that you have an absorption problem (in the absence of a significant change in diet).

    Also, do you have the range and units for the above tests?

    Is your thyroid definitely under control? your symptoms are part of the overlap between thyroid and B12 so just evaluating on the bases of those symptoms is a bit problematic.

    Suggest you talk to GP about coming off the PPI. The symptoms of low stomach acidity are pretty much the same as those of high stomach acidity so the PPIs could be lowering your stomach acidity even further and making problems with absorbing B12 and other nutrients from your diet worse.

    Also suggest that you point out to your GP the limitations of Serum B12 used as a single measure for evaluating B12 deficiency: it will miss 25% who are deficient and pick up 5% who are. Also, macrocytosis, whilst a common symptom of B12 deficiency isn't present in about 25% of those who are B12 deficient when they first present.

    Source for these is the BCSH standards for treatment of cobalamin and B12 deficiencies

    onlinelibrary.wiley.com/doi...

    BCSH - British Committee for Standards in Haematology

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