Pernicious Anaemia Society
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B12 & Folate advice

vitimin b12 240 pmol/L 0.27----4.20

Folate 3.67 ug/L 2.91---50.00

I have been to the Docs today with a bucket full of symptoms relating to B12 & Folate disorders and took several information leaflets from nhs choices and PASociety and hit a brick wall all i got was in range bla bla bla, i have read that my b12 should be at least on the better side of 500 and Folate about 26 to 30 as you can see i am far from them with the above i think this may have occured because of malabsorbtion but Doctor not interested and will not treat so can anybody give me some information on how to get these levels up with self shots and supplements.

5 Replies

i have read that my b12 should be at least on the better side of 500

Yes, and we all know where that advice comes from.

Proper studies in normal people have shown that about 80% have B12 levels lower than 500. Should all of those people be given B12 injections? Obviously not.

What symptoms do you have that make you believe you need B12 injections? Have you ruled out the many other possibilities?


Where does the "better side of 500" come from and why does it matter?

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Whilst I am aware of studies that have shown that healthy range for people with thyroid problems is slightly higher than that for those that don't I'm not aware of any significant studies showing that people with thyroid conditions need to keep their levels over 500 (ng/L or pmol/L????). Except may be information being quoted out of context.

Evaluating B12 deficiency is more complex than just a single measure and needs a context - symptoms are one part - full blood count is another (though macrocytosis isn't always present in folate and B12 deficiency. How long you have had the symptoms will also be a factor. But evaluating symptoms is going to be difficult anyway because of the overlap with other conditions.

not sure what the figures you are quoting above are as the figures that I'm assuming should be ranges look extremely odd and obviously aren't ranges.

I see from your post on TUK that your GP suggested a memory clinic - that might not be a bad idea as that should involve a proper evaluation of your B12 and folate status as well as a number of other possible conditions. Taking supplements now - particularly B12 and particularly high dose is likely to be counter-productive as it may raise your blood levels without resolving the problem - there is a lot more to B12 deficiency than serum levels anyway - getting it into your blood is one step - then there's getting it from blood to cell and even using it in cell.

Being on a PPI can certainly exacerbate absorption problems, and generally it isn't recommended to use them for more than a couple of months but that depends on why you have been given them in the first place.


I was given lasoprazole because i had severe bloating and severe stomach lining inflammation which has been caused by aspirin eroding my stomach lining, also have severe bowel discomfort not sure whats causing poor digestion could be bacteria mis match, yeast infection yeast overgrowth,constipation gut leak, gall stones, the diet i eat i should be overun with nutrients but hardly getting any vitimins, also when i went to the Doctors as i said went loaded with information from their own website, but as i expected still took no notice of the list of symptoms that all corrisponded with what was put on nhs choices for b12 defficiances, i have only gone to the Doctors because i feel ill every day and took the symptoms and when he refused to listen to what i had said totally refused to do anything, yet when i asked him quoting his so called in ranges why am i feeling so ill i could not get an answer, so please tell me how i am supposed to get better.


so the PPI is being given to try and give your stomach lining time to heal. Not sure how long that would take and may be that aspirin wasn't the only thing going on.

I know it is frustrating and GPs can be arrogant SOBs sometimes but think that there are still options. You could write to your GP with a copy to the practice manager, summarising information and asking specifically why symptoms are being ignored. You could also ask for a referal to a gastro - particularly if you haven't had any investigations earlier - difficult to know how your GP would react to that without knowing how long the problems have been going on. Sounds like you really need to tackle this from the gastric issue levels - and in particular use information about avoiding long term use of PPIs because of the health issues associated with them.


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