New blood test results

[Cali25]

Hello everyone, these are my latest bloods after finally getting a B12 shot 8 weeks ago? I will be getting the next shot on Monday as it was cancelled last week because there was no nurse to give it to me!

Range in brackets

Total white cell count 7 10*9/L (3.60-10.5)

Red blood count. 4.76. 10 * 12/L ( 3.85 - 5.20 )

Haemoglobin estimation 141 g/l (118 - 158 )

Haematocrit 0.426 (0.350 - 0.455 )

Mean corpuscle vol 89.4 fl (80 - 101 )

Mean corpusc Haemoglobin 29.6 pg ( 27 - 34 )

Mean corpusc. Haemoglobin concentration 331 g/L (315 - 360 )

Red blood cell distribution width 15.2 (11.5 - 14.7 ) !! This has not changed since the last test.

Platelet count 305 10*9/L (160-370)

Mean platelet volume 6.8 fl (5.90-9.90)

Neutrophil count 3.07 10*9/L (1.50-7.70)

Lymphocyte count 2.89 10*9/L (1.10-4.00)

Monocyte count 0.41 10*9/L (0.10-0.90)

Eosinophil count 0.44 10*9/L (0.02-0.50)

Basophil count 0.05 10*9/L (0.00-0.20)

Large unstained cells 0.17 10*9/L (0.0-0.5)

Folate. 8. ug/L ( 3 - 19 )

B12 285 ng/L. ( 170 - 730 )

Serum Ferritin 28 ug/l ( 10 - 290 )

Ferritin has only increased from 7ug/l to 28ug/l in 6 mths even though the dose has been doubled.

Just to recap on the B12 the level was 292ng/l Dec 16, 304 ng/l Jan 17, 254ng/l May 17, these results were before my B12 shot. You could say that it has stopped it dropping lower than it was in May but it is still lower than Jan 17. As my GP consulted with his colleagues and decided I have functional B12 deficiency have a shot every 8 weeks is precautionary against PA lol! Even though he knows I have neuro symptoms which are getting worse eg. burning sensation in hands, arms, feet and legs. Brain fog and lightheadedness, thought I was going to faint in the supermarket the other day, had tingling down my right arm, fortunately my son was with me. GP says I don't have PA and don't need loading doses, I have an appointment with him on Monday before my next shot. Somehow I have to persuade him I need loading doses or I will have to SI, any advice on making my case would be much appreciated.

Thanks in advance, Cali.

[Gambit62 Administrator]

High RDW is a pointer to anaemia that isn't being corrected, if it isn't moving - it suggests that you have a mixture of microcytic and macrocytic anaemia going on.

The B12 serum test is not a gold standard test - it will miss 25% of people who are B12 deficient if taken as a single measure (and also pick up 5% who aren't) so symptoms are very important.

Has the cause of your iron anaemia being established - eg has your GP looked for an absorption problem - PA isn't the only absorption problem that will lead to B12 deficiency eg coeliacs and crohn's as well as h pylori (treatable) and a whole raft of drug interactions.

Your B12 level just after a shot will be off the scale and is reducing to around the 300ng/l level within the space of 2 months which is quite a substantial drop and suggests that you are removing the B12 from your blood very quickly.

not sure where 'functional deficiency' comes in in your case as functional deficiency actually occurs where B12 levels are high meaning above the normal range and yours are not at the levels that I would associate with a correct application of the term 'functional deficiency' - more likely to be that you are one of the 25% for whom the B12 level at which the right amount is getting through to your cells is higher than the bottom of the statistically normal range.

Also, what is your GP basing the statement that you don't have PA on - if it is the result of an IFA test coming back negative then they need to bear in mind that the IFA test is prone to false negatives 40-60% of the time depending on the assay method so a negative is a long way from proving that you don't have PA.

[Cali25 in reply to Gambit62]

Thanks Gambit, as you will know from my previous posts my GP is a numpty. Yes the IFA test came back neg no other info and I've also had endoscopy/ colonoscopy investigations, no Coeliacs or anything else. GP seems to be incapable of treating the symptoms without a consultant telling him wha to do! Along with my family history of PA it's a no brainer.

[Gambit62 Administrator in reply to Cali25]

suggest you refer him to the BCSH guidelines or to the area of the PAS website aimed at educating medical professionals about B12

pernicious-anaemia-society....

but in a nice way - opportunity for them to learn a bit more about the condition and enhance their ability to treat patients.