Specialists and MMA tests.

[Cn13]

Hi all,

Just wanted to post again because I'm not sure if my replies get lost and not replied to after a few days. I just need help with trying to sort out whats going on with my health and I don't always find the GP to helpful.

I had a GP appointment this week after private blood tests showing I have a Thyroid problem. GP seems to only go by test results and was not a bit interested in my symptoms and asked do I still think I have a B12 issue. So she is repeating my Thyroid testing before she will do anything about that.

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?

It's just a bit confusing as I have also been referred to Neurology too.

Also Gambit I am hoping you might see this and help me again. I was just thinking when enough months had passed after my loading injections in April that the B12 would reduce and then I could get an Active B12 test or else how can I be sure it is B12 that is the problem with my 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]

. I seem to be having a problem absorbing nutrients as so far I had iron deficiency, vitamin D deficiency.

My folate in my last private test was 6.38 ug/l 2.91-50.00 so not looking great.

I just want to try and find out if I have a B12 deficiency or not. Would trying to convince one of these specialists to do an MMA test be a good idea? It seems there is no point me wasting money with private tests when the GP just repeats them anyway.

Hoping I can get some advice please. Thanks.

[Gambit62 Administrator]

Endo is more suitable for thyroid than B12 but possible you may get one who knows about B12 as well.

Both Active B12 and serum B12 are looking at levels of B12 in blood - don't tell you what is happening at the cell level. Test that can do this are homocysteine and MMA - both nasties from processes that build up if your cells don't have enough B12 to recycle them. They can be raised by other things (including folate deficiency in the case of homocysteine) so need to be evaluated in context.

Serum B12 levels after loading shots don't really mean very much and treatment should not be withdrawn on the basis of high results - though a low result would be a good indicator that you need injections more frequently. Loading shots introduce a new factors that means normal range really doesn't apply - the possibility of functional deficiency amongst other things.

There is an overlap in symptoms of iron deficiency as well as B12 deficiency and thyroid. If you have multiple conditions then the only way to know which ones are really involved is going to be to try each one at a time, which seems to be what your GP is doing. However, important that they don't forget that it is possible to have more than one thing going on at a time - and statistically this becomes more likely if they are auto-immune conditions.

[Cn13 in reply to Gambit62]

Hi Gambit62,

Thanks very much for your reply. Good to know the GP is doing things right it just seems I need to really convince them to do tests, referrals etc which becomes tiring. I am sorting out the iron deficiency by myself now because when it was into normal levels they don't seem to think it a concern anymore.

I just hope I have not messed things up by having those loading injections in April. Obviously too late now. I think the stress of not knowing if I have a b12 deficiency or not is getting to me.

I don't know if I should be taking folate supplements or just leave that for now but it does look quite a low result to me.

Hopefully I will see a good Endocrinologist who will help. I appreciate the advice.

[Gambit62 Administrator in reply to Cn13]

assuming that your diet is really good in folate (dietary is the best source) then you could consider a 200-400mcg dose from supermarket.

Be careful with the iron - even for thyorid you are back in what seems to be the okay range. Ferritin is only one indicator - it doesn't tell the whole story and it is possible to overdose on iron and most other vitamins and minerals.

[Cn13 in reply to Gambit62]

Maybe I should stop the iron and just wait to see the Endocrinologist and see what they say. The GP didn't do a full iron panel so I have no idea what the other results might be.

I try to follow a healthy diet so the Folate might improve.

Thanks so much for your help.