b12 levels, advice please.

[Googlie]

Hi

Have been directed here from Thyroid UK site to ask for advice.

Recently had blood tests done by Blue Horizon, mainly to look at my thyroid function. My B12 level came back at 178, attaching photo of results. In December 2016 the levels were 247 range 187-883. A couple of weeks ago I started taking 150mcg of Cyanocobalamin per day after seeing general consultant at local hospital. After looking at the comments & recommendations from folks on TUK on the blood results decided to stop taking the B12 incase you might recommend an intrinsic factor test, incase this skews results.

Thanks for your help.

[Grannyweatherwax]

That is incredibly low. You really need to get in and ask them for the test, and to start you on treatment immediately. Even if you don't have PA, you definitely have a B12 deficiency which needs addressing urgently.

I'm sure that someone more knowledgeable will be along soon.

[fbirder]

It's good to see a lab reporting marginal results ax 'insufficient'.

I would ask my GP for a trial of B12 injections according to the BNF guidelines - and see if they help.

[Gambit62 Administrator]

The drop in levels (you need to make sure you quote units as the blue horizon test may be using different units from the above test) may be more significant - from range looks like the previous test may be ng/L rather than pmol/L.

150mcg may be enough to get the daily amount of B12 from passive absorption but it isn't going to be enough to give you the amounts that will enable you to correct damage from being B12 deficient.

You need to stop supplementing for about 7-10 days (may be as little as 24 hours) to get the IFA test done ... but please note that IFA is notoriously prone to false negatives - 40-60% of time depending on the assay method - so a negative result will be a long way from proving that you don't have B12 deficiency.

Thyroid not being under control may be a complicating factor as it makes evaluation on the basis of symptoms difficult because of the overlap between B12 and thyroid.

[Googlie]

Thanks everyone, sorry for the delay in responding, had a weekend full of visitors. I will be seeing GP on Thursday, she is normally quite open to what I have to say but tends to stick to the guidelines. So, she might just suggest carrying on with the tablets, if so I will probably be back to bite your ears for more information 🙄

[fbirder in reply to Googlie]

If she doesn't want to give injections ask her why she thinks your B12 levels are insufficient. Explain how you eat plenty of meat and fish more than enough to achieve the recommended intake.

That means your deficiency is most likely caused by an absorption problem - which would make the tablets fairly useless.

[Googlie in reply to fbirder]

Thanks fbirder, always good to have a comeback, keeps them alert 😉