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Pernicious Anaemia Society
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Advice please

Did put on thyroid uk.

Serum folate2.2ug/L 3.9-26.8ug/L

B12 247ng/L 197-771ng/L

Ferritin 175ug/L 30-400ug/L

Tsh 0.89miu/l 0.27-4.2miu/l

Haemoglobin 152g/L 130-180g/L

Toatal white cell 10 10*9/L 4-11109/L

Platelet count 274 10*9/L 4-11109/L

Haematocrit 0.5 0.4-54

RBC 5.15 10*12/L 4.5--6.510*12/L

MCV 29.5pg 27-32pg

MCHC 323g/L 320-360g/L

Neutrophil count 4.9 10*9/L 1.8-710*9/L

Lymphocyte count 4.1 10*9L 1-4.810*9/L

Monocytes count 0.8 10*9/L 0.1-110*9/L

Eosinophil count 0.2 10*9/L 0-.110*9/L

Basophil count 0.1 10*9/L 0-.110*9/L

Many thanks for your comments.


7 Replies

can't really add much to what has already been said on TUK -

Have you looked at the pinned posts.

serum B12 is a problematic test because it doesn't actually measure what is happening at the cell level. People vary a lot as to how what is happening in cells relates to the level of B12 in blood with the result that serum B12 if taken as a single measure will miss 25% of people who are B12 deficient but will also pick up 5% who are so looking at symptoms is very important.

One common symptom of B12 deficiency (and folate deficiency) is macrocytosis - in which red blood cells are larger and rounder than normal. Your blood results aren't showing any sign of this - however, this isn't a defining characteristic and isn't present in 25% of people who are deficient.

These facts come from the BCSH (british committee for standards in haematology) guidelines for the diagnosis and treatment of cobalamin and folate deficiencies. Assuming you are UK based your GP can access them through the BNF but they can also be accessed here if you are in the UK


Evaluating symptoms is going to be very difficult if you have two conditions that have similar symptoms - like thyroid and B12. If you have neurological symptoms then that means B12 needs to be considered promptly because there is a risk that damage may become permanent. Otherwise it would be a lot easier to make sure that you have thyroid under control and see if that resolves the problems before going on to look at B12.

Hope that you can work with your GP - and find away of drawing their attention to the limitations of serum B12 as an indicator of your B12 status on its own


To Gambit62 thanks for ur advice.

I bin on folic acid tablets for 12 weeks now and it's still low which I don't understand.

My thyroid is under control and better than it's ever been after an increase from 125 to 150 6 weeks ago.

I am still getting tremors 24/7 also doctor told me I av fibro somthink.tired I sleep a lot,no energy etc.Just not sure wat to do now.I don't think it's my thyroid causing problems but I doe know.



Forgot to mention weakness in left arm pins&needles and numbness in hand&fingers.


is your doctor aware of the information above in relation to B12?

Have you been tested for PA or another condition that affects absorption of vitamins and minerals like h pylori infection, coeliacs, low stomach acidity?

Would your GP be open to investigating possible absorption problems ... or a trial of B12? if you shared the information above?


They aware of my problems my last b12 test was in range I think it was 246 low end I think it was 771 top end braket.


could you raise with them the fact that the result may not necessarily mean that your levels are okay for you as per the details given above - many GPs and doctors aren't aware of the limitations of the serum B12 test.


I av to c doctor 21st I will have a chat with him/her.

Many thanks for ur advice.


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