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Pernicious Anaemia Society
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Help with test results please

I have a number of the symptoms for PAS but as I have a number of other medical conditions, including hypothyroidism, I am now getting very confused. I have just paid for some private blood tests and those on the Thyroid UK suggested I post here. The results are:

Vit B12 252pg/ml Range 197-771

Serum Folate 3.2 Range > 2.9

Ferritin 108 ug/L Range 13-150

Vit D 28.0 nmol Range 15-30 Deficiency

Would you recommend that I raise the possibility of PAS with the doctor or are the results okay?

4 Replies

Hi Dbe447 your Vitamin B12 would probably be flagged as "Normal" although at the lower end of the range and your Folate is also "bumping along the bottom".

Symptoms of B12 deficiency tend to develop slowly and may not be recognised immediately. As the condition worsens, common symptoms include:

Weakness and fatigue

Light-headedness and dizziness

Palpitations and rapid heartbeat

Shortness of breath

A sore tongue that has a red, beefy appearance

Nausea or poor appetite

Weight loss


Yellowish tinge to the skin and eyes

If low levels of B12 remain for a long time, the condition also can lead to irreversible damage to nerve cells, which can cause the following symptoms:

Numbness and tingling in the hands and feet

Difficulty walking

Muscle weakness


Memory loss




If you have any of the above symptoms please list them and talk to your doctor about them.

Having thyroid problems may put you at risk of developing a B12 deficiency.

I'm not a medically trained person but have had P.A. (a form of B12 deficiency) for more than 45 years.

I wish you well


Thank you. The problem I have is that I have already been diagnosed with depression, ADHD, Arthritis, Asthma, Vetigo, Hypothyroidism, amongst others, all of which have overlapping symptoms. It just seems to me that either I am that unlucky or there is a underlying cause that is being missed. I will raise as part of thyroid treatment and see what my GP says.

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I've assumed you're in UK.

I'd suggest reading up about B12 deficiency before discussing it with doctor. My experience has been that B12 deficiency is not always well understood by doctors.

B12 Deficiency Symptoms




Risk factors for PA and B12 Deficiency




B12 books

"What You Need to Know About Pernicious Anaemia and Vitamin B12 Deficiency" by Martyn Hooper

Martyn Hooper is the chair of PAS (Pernicious Anaemia Society). Book is up to date with UK B12 guidelines.

"Living with Pernicious Anaemia and Vitamin B12 Deficiency" by Martyn Hooper

Has several case studies.

"Could it Be B12; An Epidemic of Misdiagnoses" by Sally Pacholok and JJ. Stuart (USA authors)

Very comprehensive book about B12 deficiency with lots of case studies.

B12 blogs

There may be stories that are relevant to you on Martyn Hooper's blog about PA and B12 issues.


There is also an interesting blog about B12 issues on "B12 Deficiency Info" website.


UK B12 documents

1) BSH Cobalamin and Folate Guidelines


Flowchart from BSH Cobalamin and Folate Guidelines


Flowchart outlines when PA and Antibody Negative PA can be diagnosed in UK. Also makes it clear that people who are symptomatic for B12 deficiency should have an Intrinsic Factor Antibody (IFA) test and start initial B12 treatment whether B12 is low or within range.

IFA test can help to diagnose PA but test is not always reliable and it is still possible to have PA even if IFA result is negative/normal range.

2) BMJ B12 article


Emphasises the need to treat people who are symptomatic for B12 deficiency even if B12 level is within range.

3) BNF British National Formulary Chapter 9 Section 1.2



Gives details of recommended UK B12 treatment.

All UK GPs will have access to BNF.

UK B12 treatment info can also be found in BSH Cobalamin and Folate Guidelines, about a quarter through guidelines.

PAS (Pernicious Anaemia Society)

If you think PA is a possibility, may be worth joining PAS. They can offer support and information. Lots of info about PA on PAS website.


PAS tel no +44 (0)1656 769 717 answerphone

"Serum Folate 3.2 Range > 2.9"

Your folate result is only just within range. What has your GP said about this?

Have you had a full blood count (FBC) test recently?

Blood tests






More B12 info in pinned posts on this forum.

I am not medically trained just someone who has struggled to get a diagnosis.

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Thank you for all of the links. Looks like I have some reading to do. :0)

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