Hello, after 1 month of b12 treatment (nasal spray) i waited 2 weeks and made a new b12 deficiency test. The test shows I am no longer anemic. (I was taking folic acid and B6 when i made the test.)
Is it possible that the test shows false non-deficiency because of the folic acid and B6 i was taking the day before the test?
Yes...I don't get it.
What Eaoz says is correct. And what I'm about to say might be as factually wrong as a Donald Trump tweet.
If you did have a B12 deficiency, along with macrocytic (large cell) anaemia, then, when the body gets enough B12, it starts making new red cells at a much faster than normal rate.
Now this is the bit where I might be very wrong. But, if I remember correctly, these new cells are smaller than normal. That would explain another unusual result - your RDW (red cell distribution width) is very high. That means that, while most of your cells are too smal, some are quite a bit bigger.
If I'm right (and it happens sometimes) then you had a B12 deficiency that caused macrocytic anaemia. The extra B12 (and your blood levels are nice and high, showing that it's getting absorbed) kicked off a burst of red cell formation - of smaller than normal cells.
You now have a mix of large and small cells. In the near future these will get replaced by normal-sized, normal-functioning red cells.
Now this is all guesswork. I might be totally wrong and I'd love to hear comments from those who know more about the biology and physiology involved.
The test doesn't show any obvious signs of macrocytic anaemia but one month is a bit quick for that to have corrected if you had macrocytic anaemia before - new red blood cells form as old red blood cells 'die' and red blood cells live for about 120 days.
So, did you have signs of macrocytic anaemia in an earlier test?
Your Haemoglobin looks like it is bumping along at the bottom of the range.
Another explanation for the high RDW could be that both microcytosis (which would result from iron deficiency) and macrocytosis (folate and B12 deficiency) are present.
Did using the nasal spray make any difference to your symptoms?
Slightly better.
and did previous blood tests show you had macrocytic anaemia or is this the first test?
It showed low hemoglobin, mcv, mch.
so sounds like you didn't have clears signs of microcytosis but you certainly didn't have macrocytosis.
microcytosis (smaller red blood cells) is typical of an iron deficiency
macrocytosis (larger rounder red blood cells) is typical of folate and B12 deficiencies).
the RDW indicates that you have a mix of macro and micro-cytosis going on- suggesting that you are deficient in iron and folate/B12.
Suggest that you follow up on this with your doctor - as it implies you probably have an absorption problem and getting to the bottom of that would be good as it could have other consequences.
Candidates would include: PA, coeliacs, h pyorli infection
Yes, but why my iron and b12 levels are normal? Also my folic acid is 25 out of 26. B12 in the other test was less than 50.
deficiencies can lead to anaemia - this is a symptom.
Any anaemia involving red blood cells takes time to correct - at least a few months.
Normal ranges are statistical averages of where most people are okay. That doesn't mean that they are the levels that are right for you.
In the case of B12 - 25% of people who have results in the normal range are not okay and 5% who are outside the range are okay.
Ttonev...your B12 levels have gone up because of the B12 nasal spray you have been using 😉.
It's also possible to have a 'normal' ferritin level but still have an iron related anaemia (there are lots of different types of anaemia).
Ferritin is only one marker for iron related anaemia, of which there are many sorts.
A full iron panel might clarify further as this measures other iron in the body (i.e. serum iron, transferrin, iron binding capacity, iron saturation etc).
This is a good site for more informatio about iron disorders:
Not that I'm suggesting you have an iron disorder...just a good source of information 😉
Thanks Hidden .
Just wondering...could some of the microcytic cells be 'left-overs' from the iron deficiency anaemia that haven't quite been destroyed yet?
And could there be a similar impact still present in the RDW.
(i.e. the blood 'picture' is slowly changing - emerging - rather than undergoing a sharp sudden shift?)
Happy to be told if I'm being stupid 🙄😉.
thank you Eaoz.
you are correct that the body does tend to respond to low levels of red blood cells or low oxygen getting through to cells by releasing a hormone that stimulates the production of more red blood cells. However, it does nevertheless seem to take several weeks for these to really get into the system so not convinced that macrocytosis would have disappeared so quickly - and from ttonev's response above it would appear that his blood work was showing microcytosis not macrocytosis to start off with.
However, I'm not a medic or a biochemist.
What are the chances for me to have PA?
Also why I don't feel the mental improvement yet... 
the tests you have had don't really say anything about PA which is just one possible absorption problem that will cause of a B12 deficiency.
I wouldn't like to say whether or not they are conclusive that you don't have a B12 absorption problem or a problem metabolising B12 because I don't think they are conclusive on that score either - your levels have risen quite substantially but there is presumably quite a lot of B12 in the nasal spray that you are using and you do seem to be managing to absorb quite a bit of that. Following symptoms and whether they improved or not is more likely to be an indicator of whether you have a problem with B12 - if the nasal spray made a difference then that would be a strong indicator - if not then it would imply that B12 isn't a problem for you.
Your test results are suggestive of iron problems.
This forum is about supporting people - it isn't a substitute for professional medical advice.
Tests that could help clarify if B12 is an issue would be MMA and homocysteine.
The other strategy would be to look into what lead to the iron deficiency.
Well I think there is a small difference but i am not sure....maybe it is depression (without b12 causing it.) And i need antidepressants... It sucks because I don't want them and am afraid of them...
iron deficiency can also cause depression.
I don't like ADs either and they never really did much for me but they can help some people. You really do need to talk through all of this with a doctor. All we can do is help you with what questions and issues you might want to focus on with your doctor.
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