B12 test results

[Tldg45]

Hoping for some guidance with regards to my latest blood results as suggested by a member of hypothyroid group.

B12 288 (211-911)

Vit D 53 >51

Serum folate 6.6 >3.4

Serum ferritin 81 (20-291)

Any advice greatly received 🙂

[Gambit62 Administrator]

your B12 is in the grey range - basically it may or it may not be okay.

serum B12 is a problematic test if it is used as a single measure of vitamin b12 deficiency as variations between individuals are quite wide and the normal range will miss 25% of people who are deficient but also pick up 5% who aren't - evaluation of symptoms is difficult if you have a thyroid condition because of the overlap in symptoms so may be best to get ensure that your thyroid is really under control and then come back to B12.

you can find a checklist of symptoms here

pernicious-anaemia-society....

symptoms of B12 deficiency tend to come on very slowly over time.

in relation to vit D would suggests consulting with your GP or at the very least a pharmacist - there are some risks - particularly in relation to calcium levels - from over-supplementation.

Test that can help to clarify B12 when it is in the grey range are homocysteine and MMA, both of which will be raised if cells don't have enough B12 to recycle them. However they can also be raised by other factors.

One common symptoms of B12 deficiency that doesn't overlap with thyroid is macrocytosis - red blood cells being larger and rounder than normal - however this isn't a defining characteristic of B12 deficiency and isn't present in about 25% of people presenting with B12 deficiency.

Tests that can clarify the cause of B12 deficiency are IFA (for PA - but it's prone to false negatives so a negative result is a long way from proving that you don't have PA, tests for coeliacs, test for crohn's, test for h pylori infection. There are also a number of drug reactions.

B12 absorption problems can also be picked up from a downward trend in serum levels over time. B12 isn't generally very responsive to amount in diet because the body stores good amounts in the liver, releasing them to be reabsorbed into blood via the ileum. If you have an absorption level this mechanism doesn't work well so levels in serum start to fall leading to deficiency at the cell level.