Advice please

[Allie6]

What do I do about results please thankyou

Folate 2.4 (4.6 - 18.7)

Vitamin B12 201 (190 - 900)

Ferritin 27 (30 - 400)

MCV 77.5 (80 - 100)

MCHC 379 (310 - 350)

Haemoglobin 121 (115 - 150)

Iron 9.3 (6 - 26)

Transferrin saturation 16 (10 - 30)

[GGourmet]

Iron, Folic Acid and B12 supplementation. I think others will go in to more detail. With all 3 it could be malabsorption at the ileum, if not dietary. Are you consuming good quantities of Vit C?

[Gambit62 Administrator]

Allie6 - are these results from a private test or from a test done by your G?.

Ideally you should be talking them through with your GP.

They show multiple mineral and vitamin deficiencies implying an absorption problem (unless your diet is amazingly bad - if you eat a varied diet including animal products as well as plenty of green vegetables then it's definitely absorption not diet)

Your full blood count shows microcytosis - small red blood cells - which is classic symptom of iron deficiency.

B12 may also be deficient - and its quite likely it is given the other deficiencies - if you have a series of tests that show the level dropping over time that would be really good evidence of a developing deficiency.

refer your GP to the BCSH guidelines on diagnosis and treatment of cobalamin and folate deficiencies which they can access through the BNF but can also be accessed here

onlinelibrary.wiley.com/doi...

in particular:

- serum B12 isn't a gold standard test - used as a single measure it will miss 25% who are B12 deficient and pick up 5% who aren't.

- Symptoms are an important part of evaluation

- Whilst macrocytosis (larger rounder red blood cells) is a common symptom - it isn't present in 25% of people first presenting with B12 deficiency.

- if symptoms don't tally with test score then follow symptoms, particularly if the symptoms include neurological symptoms (pins and needles, balance, tinnitus etc)

- B12 treatment should start 24-48 hours before folate treatment

Please be aware that there is considerable overlap in the symptoms of iron deficiency, B12 and folate deficiency and also with the symptoms of other conditions such as thyroid and diabetes.

As you have multiple deficiencies your GP should also be looking for the underlying cause - which would include:

PA, Coeliacs, Crohn's, h pylori infection (treatable), drug interactions (eg PPIs, Metformin), low stomach acidity (which can also be a consequence of PA)

Note: test for PA - IFA - is prone to false negatives - 40-60% of time depending on the assay method - so a negative result is a long way from proving that you don't have PA.

[Allie6 in reply to Gambit62]

GP did blood tests thanks

[Gambit62 Administrator in reply to Allie6]

suggest you follow up with the GP then.

You might try putting the above in writing as concerns rather than demands, and arrange an appointment to discuss ... and take someone else with you as a second pair of ears as well as support.

[clivealive Forum Support]

Hi Allie6

Do you have any of the following symptoms?

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

Diarrhoea

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

Irritability

Memory loss

Dementia

Depression

Psychosis

You are clearly deficient in folate. There is a complex interaction between folic acid, vitamin B12 and iron. A deficiency of one may be "masked" by excess of another so the three must always be in balance.

Symptoms of a folate deficiency can include:

symptoms related to anaemia

reduced sense of taste

diarrhoea

numbness and tingling in the feet and hands

muscle weakness

depression

Folic acid works closely with vitamin B12 in making red blood cells and helps iron function properly in the body and your B12 levels are "bumping along the bottom of the range.

As Gambit62 says, follow up with your GP, list amy symptoms you are having and (if possible) take someone with to to the appointment.

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

I wish you well