How long to wait for Active B12 test.

[Cn13]

Hi Everyone,

I have been posting here since March when I found out I have Iron deficiency anaemia and Vitamin D deficiency these results are improving with supplements now.

I also think I have Vitamin B deficiency as I have a lot of the symptoms including neurological ones.

I have recently done a Medicheck blood test and found out I am hypothyroid too.

My recent result for B12 was 371 pmol 140.0 - 724.0. My query is would this result be low enough to correspond to a low Active B12 test. I had loading injections of B12 in April and am waiting for my B12 to drop enough to show a deficiency.

Does anyone have any advice or should I just wait longer. Thanks in advance.

[Gambit62 Administrator]

active B12 test is unlikely to be helpful after loading doses.

treating B12 deficiency on the basis of serum B12 levels is no longer a recommended practice in the UK. The serum B12 test is not a good guide to whether a patient is deficient before loading doses because the normal range is built over huge variations. It is even worse as a single guide after loading doses and treatment really needs to be based on symptoms and when these return.

Symptoms are, unfortunately, going to be really difficult to evaluate if you also have a thyroid condition because of the overlap in symptoms.

What is happening about getting your thyroid under control?

[Polaris]

Just wondering if this research posted by 'Diogenes' (scientist and advisor to HU TUK) recently would help convince your GP that you may not be absorbing B12 and other nutrients. It explains the progression of Hashimoto's autoimmune thyroid disease to gastric atrophy to eventual Pernicious Anaemia:

journal.frontiersin.org/art...

"Clinical signs of this disease appear after several years of its onset, when the progressive reduction to disappearance of the parietal cells leads to atrophy of the gastric mucosa, impairing the absorption of iron, vitamin B12 (cobalamin), folate, and other nutrients (22)."

"In the initial phase of the atrophic gastritis, the damage of parietal cells can lead to iron deficient microcytic anaemia as the only clinical sign (38). When the gastric atrophy becomes severe and/or the IFA is no longer produced, even the absorption of cobalamin becomes compromised. "

...........

Re. treatment for thyroid, usually autoimmune Hashimoto's, I found 'Understanding Thyroid Disorders', by Dr A. Toft, - published in association with the BMA, very helpful in Judging the correct dose of thyroxine.

[Cn13]

Hi,

Thank you all for your helpful replies. I was just considering the Active B12 test to try and convince the Gp's to treat the B12 deficiency I think I have. But yes I agree Gambit there is such an overlap with symptoms of Thyroid that it is going to be difficult. I am only going for the GP appointment on Wednesday after getting the private results last week and am hoping I will be put on some Thyroid treatment maybe I should wait and see if that helps with symptoms that's if I even get treated.

Thanks Polaris I will have a read of the journal and book. It was a bit of a shock when I got the results of my Thyroid but it seems I suffer from a few autoimmune diseases.

I am hoping this GP will treat me.

[Cn13]

Hi all,

Just wanted to update after GP appointment and ask further advice. GP seems to only go by test results and was not a bit interested in my symptoms so she is repeating my Thyroid testing before she will do anything.

I have been referred to an Endocrinologist to talk about what I think may be a problem with B12. Is this a usual speciality to be referred to?

Also Gambit I was hoping when enough months had passed after my loading injections that the B12 would reduce and then I could get an Active B12 test or else how can I be sure it is B12 as there is the problem with the symptoms now overlapping with the Thyroid symptoms.

My neurology appointment has not come through yet and actually the tingling in my feet has improved which could be due to the increase in my ferritin level which is now 46.6 ug/l [13.0 - 150.00]

Hoping I can get advice please.