Blood results - help with interpretation pls?

[dorigen66]

My daughter has been very symptomatic for low B12 for 6 years now. We have recently had the following results from medichecks. Her ferritin levels are sky high but that MAY be because she has to follow FODMAPS diet for her IBS while we wait to have colonoscopy etc and other tests done for coeliac/ crohns, etc. She eats red meat, carrots and black olives most nights as there are very few other things she can safely eat.

I am aware that the symptoms of too much ferritin in the blood can mimic the symptoms of B12 deficiency, but I still believe she has a B12 problem, due to the active B12 levels being at 53..... Can anybody help me to unpick this?

[Gambit62 Administrator]

active B12 at 53 is actually well into the normal range - on average 20% of B12 in blood wiil be active - which is where the results above sit. This is way the lower end of the range is much lower than for serum B12

Her folate is definitely low - because B12 and folate are used together the symptoms overlap considerably.

MCV is high - which would be an indicator for macrocytosis - but this could be due to the folate deficiency.

Do you have a history of previous B12 serum levels - a downward trend on these would be indicative of an on-going absorption problem?

Otherwise the results above aren't screaming out B12 deficiency - and the Gastric Parietal Cell antibodies would also point away from PA - though IFA is generally considered to be a better test for PA - though IFA being negative would be a long way from ruling PA out.

I'm not saying that B12 deficiency isn't a possibility - just that the above isn't actually pointing to that.

if the colonoscopy and tests for coeliacs/crohn's come back positive then both of these are conditions that can lead to B12 absorption problems

Test that might be useful to clarify if B12 deficiency is involved would be MMA - a waste product that builds up if cells don't have enough B12 to recycle it.

[dorigen66 in reply to Gambit62]

Thank you! Was hoping that the test would include MMA but will look into that once the coeliac/crohns tests have been done.

[fbirder]

Like Gambit62 says, your active B12 suggests that isn't the cause of the problem.

Low folate could well be, especially with the extremely restrictive diet you describe.

[greenbexy]

Have you looked into B6 deficiency? I know we 'spoke' about the seizures your daughter has. The low folate will overlap with low vit B12 symptoms.

I have 'looked at' the articles on vit B6 deficiency and seizures but no concrete evidence of a link. Just thought I would mention another possibility for you to look into maybe.

[dorigen66 in reply to greenbexy]

Thank you - no I hadn't thought of B6 deficiency but I will look it up now.

[Sleepybunny]

Hi,

Was your daughter supplementing with B12 before the tests? Supplementation prior to tests could affect the results of B12 and Active B12 results.

I am not medically trained.

[dorigen66]

Hi - she wasn't supplementing with anything - she doesn't trust tablets or sprays, even of vits and minerals....