Re tested B12 and Iron levels Results - Pernicious Anaemi...

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Re tested B12 and Iron levels Results

Humdiddydum profile image
16 Replies

Hi

I posted here recently with some old b12 results I've recently been re-tested and my levels have dropped and i'm a bit worried could someone take a look and let me know what you think. Do I have anything to be worried about? Having lots of symptoms and have been ill for months.

I've been eating well but my bowels aren't really absorbing food that well at the moment so I'm looking for a way to push my levels up a bit and if my Iron could have anything to do with it?

All advice welcome

Thank you!

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Humdiddydum
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16 Replies
Gambit62 profile image
Gambit62Administrator

have you discussed these results with your GP?

On the face of it, both iron and ferritin levels look okay - implying that iron isn't an issue.

The drop in active B12 is quite significant - so could indicate a problem absorbing B12. Have you had a full blood count at all?

Humdiddydum profile image
Humdiddydum in reply toGambit62

Hi I've had a FBC in hospital recently and they said nothing strange all normal levels the most recent results I have access to are on my original post link below. I've not been supplementing yet but i've been eating so many greens and healthy foods. I know im in the "normal" ranges but they still seem a little low and the fact the B levels have dropped when i've been eating well.

Thanks for your help

J

healthunlocked.com/pasoc/po...

Gambit62 profile image
Gambit62Administrator in reply toHumdiddydum

B12 is only found in animal products - meat/fish/egg/dairy

greens are good for folate and iron but no sign of those being a problem in your results.

I would be more concerned about the drop than whether you are in the normal range - your serum B12 is quite low in the range so quite possible that you could be deficient as the test isn't a gold standard test and will miss 25% of people who are B12 deficient (and catch 5% who aren't) if taken as a single measure.

fbirder profile image
fbirder

Were you talking any vitamin supplements in the months before testing?

Humdiddydum profile image
Humdiddydum in reply tofbirder

No none at all just eating super healthy lots of greens and juices etc

Humdiddydum profile image
Humdiddydum in reply tofbirder

Im worried if I start taking supplement pills they wont get absorbed because my bowels seem to be not digesting my food properly.

Marybrown06 profile image
Marybrown06

Hey, there is no B12 in greens! So if you had a vegan (or almost vegan) diet it is normal it dropped.

There is some B12 in dairies and eggs.

You must supplement with B12 if you have a vegan diet (2 x 1000 mcg per week orally).

Gambit62 profile image
Gambit62Administrator in reply toMarybrown06

Marybrown, if you are a vegan you only need to be taking in the RDA - which is actually 2.5-5mcg per day unless you have an absorption problem. The doses you have described would only be applicable to someone who has an absorption problem and could cause problems in someone who doesn't have an absorption problem

Humdiddydum profile image
Humdiddydum in reply toMarybrown06

Hi Mary

Sorry I half explained I was fresh out of hospital yesterday. I am eating dairy and meat products I am just eating more greens and juices than when I last tested so my diet is overall my healthy. I eat at least one of beef, chicken, eggs and milk daily so there shouldn't be an issue with getting the B12 in my system.

Marybrown06 profile image
Marybrown06

Hi Gambit,

The recommended dose for vegans is the following:

- 1 mcg three times a day

- 10 mcg once a day

- 2 000 mcg once a week (or 2 x 1000 mcg)

- 5000 mcg every two weeks

This is the French vegan society recommendation (vivelab12.fr/combien-de-vit... - sorry it is in french.

However it is easier and cheaper to find 1000 mcg, in this case someone without any absorption problem should take 2 x 1000 mcg per week

ITYFIALMCTT profile image
ITYFIALMCTT in reply toMarybrown06

Similar advice and supplement recommendations given on Vegan Society UK: vegansociety.com/resources/...

ETA: "[For the] full benefit of a vegan diet, vegans should do one of the following:

Eat fortified foods two or three times a day to get at least three micrograms (mcg or µg) of B12 a day

OR Take one B12 supplement daily providing at least 10 micrograms

OR Take a weekly B12 supplement providing at least 2000 micrograms."

Gambit62 profile image
Gambit62Administrator in reply toITYFIALMCTT

thanks Marybrown06 and ITYFIALMCTT . The statements being made are rather worrying and, having looked at the link to the vegan society page and the sources they give, seems to be based on misunderstanding one of the articles that they use as source.

nap.edu/read/6015/chapter/11

It isn't that you need to take more if you take it less frequently - it is that you will retain less if you are taking a higher dose (because the rate at which you lose excess B12 in the blood is greater if the levels in your blood are greater. This is also based on looking at administration by intramuscular administration rather than by dietary means.

Treatment for a dietary deficiency in the UK (and I would imagine in most other countries) is 50mcg cyanocoballamin orally once a day - this is deliberately higher than RDA - which allows for the fact that 50% of dietary intake normally passes through the gut (so no need to double that up) because it is also rebuilding reserve levels in the liver.

I return to my original statement above that high dose oral is unnecessary for vegans and can be potentially problematic because of the impact of temporarily raising blood serum levels (prior to it then being removed from your system by your kidneys, over time, and passing out in urine).

Gambit62 profile image
Gambit62Administrator in reply toGambit62

Marybrown06 , ITYFIALMCTT

further research has thrown up a couple of articles

ncbi.nlm.nih.gov/pmc/articl...

which includes this paragraph

Absorption of Cbl from supplements depends on the dose and frequency of the intake [170]. The absorption capacity depends on the saturable active transport and on the efficiency of the aspecific route. The consumption of oral doses of 1 μg, 10 μg, 50 μg, 500 μg, 1000 μg, are absorbed with an efficiency of 56%, 16%, 3%, 2%, 1.3%, respectively [151]. ...

However the study mentioned as 170 is specifically about injected administration and in the study 151 includes the following in relation to Vegetarians which seems to go against the 1000μg quoted above

Vegetarians.

Preventive supplementation is justified in strict vegetarians,31 including immigrants from the Asian subcontinent, whether or not they have liberalized their diets.30 If small oral doses (eg, 2-6 μg) are ineffective, absorption should be evaluated. ...

ncbi.nlm.nih.gov/pmc/articl...

Gambit62 profile image
Gambit62Administrator in reply toMarybrown06

Marybrown - just looked at the French vegan society pages - and whilst I accept the information they provide in relation to slightly higher than RDA may be needed if you are taking doses in one go because there may be a limit on how much the ileum can process in one go - the recommendations do seem to have confused active and passive absorption and assume that all absorption will be passive if you are using a high dose tablet. This is something that I would really like to see proved by studies as it doesn't quite gel for me and they don't actually seem to provide any references to studies.

I remain highly sceptical on the advisability of using 1000mcg tablets where an absorption problem doesn't exist and would recommend that people stick with lower doses more frequently in that instance.

fbirder profile image
fbirder in reply toGambit62

Gambit62

I couldn't agree more. Taking a small dose daily is likely to be much more effective than taking a huge dose weekly. Doing the latter would be like starving for six days, then eating 20 meals for a total of 36,000 calories on the Sunday.

It's the same reason why people are researching the possibilities of extended-release injections of B12.

Marybrown06 profile image
Marybrown06

Maybe it is different in UK, but in France you can buy 500 mcg or 1000 mcg but it is difficult to find smaller doses, except in multivitamins

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