Could this be PA?

[Ordinary39]

My serum B12 was 206 ng/L (180-900)

I have Hashimoto's which I'm only just starting to get under control some 25 years post diagnosis! I still have many symptoms which could be linked to either condition. I am concerned my GP won't test for PA as my B12 is "normal". All thoughts welcome!

[Gambit62 Administrator]

Your B12 is low in range. As serum B12 isn't a gold standard test and will miss 25% of people who are B12 deficient (and catch 5% who aren't) looking for symptoms is important. Macrocytosis (enlarged red blood cells) are a common feature of B12 and folate deficiencies but it isn't a defining characterisitic and isn't present in 25% of people presenting with B12 deficiency.

May be worth writing to your GP and referring them to the BCSH guidelines on diagnosis of cobalamin and folate deficiencies which they can access through the BNF but can also be accessed here

onlinelibrary.wiley.com/doi...

also put together a full list of symptoms

pernicious-anaemia-society....

and then follow up with an appointment, and take a friend along with you to help if you are experiencing anxiety/cognitive challenges.

The symptoms of B12 and folate deficiencies are very similar. Do you know what your iron levels are like - if all 3 are on the low side and/or if B12 is dropping significantly over a period of time then try getting your GP to look for an absorption problem.