Pernicious Anaemia Society
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Could these results,symptoms indicate anaemia ?

Hi everyone ,

I have tested positive on anti TPO antibodies indicating Hashimotos previously ,High Ra factor. I am deficient in folate, vitamin D.

Just got back results

Anti TPO antibodies normal


TPO ANTIBODIES: < 33 iu/mL [0.0 - 60.0]

Elevated Haemoglobin, White blood cells,Esr, red blood cells,lymphocytes, Plasma alkaline phosphatase levels, Eosonophils.

Serum vitamin B12 level 451 pg/mL [180.0 - 914.0]

I am not on any current medication, just vitamin D , folic acid.

I know my B12 is normal but could that level be causing my extreme fatigue/symtoms?

any info would be greatly appreciated

7 Replies

My first thought, although I am not an expert, is that you should consult a hematologist regarding what you've written:

"Elevated Haemoglobin, White blood cells,Esr, red blood cells,lymphocytes, Plasma alkaline phosphatase levels, Eosonophils". To my knowledge, these results are not indicative of anemia but maybe another blood issue.

Seeing an endocrinologist regarding your Hashimoto's thyroiditis may be a good next step. It's my understanding that anti-TPO antibodies can fluctuate or even appear normal with Hashimoto's. A full thyroid blood work-up including free T4 and TSH might show that you have gone from asymptomatic with Hashimoto's (which is called euthyroid Hashimoto's) to symptomatic. If that's the case an endocrinologist would be able to sort this out for you. In the meantime do an online search for "supplements that interfere with thyroid tests"to see if anything you may be taking should be avoided for a bit before having those tests. (I think vitamin D may interfere,and I am not sure about folic acid's effect).

Autoimmune diseases tend to come in groups/clusters with very many identical symptoms. Extreme fatigue is a hallmark of many of those,but you may have something else going on. Others on here may have more suggestions. Wish you the best.

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A magnesium deficiency can cause fatigue and is a cofactor for vitamin d

None of this is to say you might not have a b 12 issue, just wanted you to also know this, as my doctor did not inform me to get magnesium when she gave me 5000 iu of d daily and it definitely caused me problems.

I hope you feel better soon.

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How long have you been taking the folate?

folate deficiency causes macrocytic anaemia in which the red blood cells are larger and rounder than normal which makes them less efficient at transferring oxygen. This will take a few months to clear - new red blood cells will only be made when old ones 'die' and the average life of a red blood cell is about 4 months.

If your tiredness and fatigue came on quite quickly then it is most likely down to the folate deficiency.

Your levels of B12 make it unlikely that you are B12 deficient but the test that could be used to investigate further is MMA - will be raised if you cells don't have enough B12 to recycle it properly ... but it can also be elevated for other reasons.

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Thank you for your reply Gambit62,

I have only been taking folic acid this last week under instructions from GP.

The fatigue and tiredness has been going on for ages (last few years).


do you supplement B12 at all?


no I do not supplement B12, just vit d and folic acid


Gambit62 , I have seen on a few posts about red cell distribution width.

What does this result indicate if any?

This is my result : Red blood cell distribution width 13.5 % [11.6 - 14.0] are mine ok?

Thanks for any advice.


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