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Pernicious Anaemia Society
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New - help making sense of blood results

Hi there, I am new to the group and looking for some help making some sense of these results. My GP stated nearly a year ago that my bloods were normal. Due to current health issues i requested a copy of all bloods and found some results questionable. What do you guys think?

Folate 6.5 (3-20)

Vitamin B12 288 (200-700)

At that time I was having a lot of the symptoms of PA, my gp didn’t feel it was and I was diagnosed as depressed. I wasn’t convinced so I have since started a methyl B12 and a activated B-complex. Levels now -

Vit B12 - 806

Folate - 7.3

Pernicious anemia can be secondary to a condition I am being investigated for and I wonder if I had PA or Vit B12 Deficiency all along but I have now managed to correct it with oral vitamins? I look forward to hearing ur thoughts. Many thanks for ur time.


6 Replies

PA is an auto-immune condition. As far as I am aware it can't be secondary to any other conditions. I think you mean that you are actually talking about being investigated for a condition that can also cause B12 deficiency, such as ceoliacs or crohn's.

serum B12 is a problematic test as it will miss 25% of people who are B12 deficient but also pick up 5% who aren't if taken as a single measure. It needs to be taken in a context which includes symptoms.

Presumably the supplements you are taking are 1000mcg+ - and they seem to have raised your serum levels but its not clear if this has resolved your symptoms - even with PA or an absorption problem its possible that your levels could be raised by taking an oral supplement of that strength so not possible to really draw any conclusions.

Did you have a full blood count and was there anything odd in that? eg raised MCV or MCH, low MCV/MCH associated with iron deficiency

what is your diet like in terms of B12 and folate?

unfortnately the symptoms of B12 overlap with so many other conditions that it can be difficult to unravel what is going on even on the basis of symptoms.

1 like

Thank you so much for taking the time to reply. My symptoms (main ones) are - extreme fatigue, I usually crash hard in the evening. I can sleep 18 hours and awaken still feeling tired. Brain fog - I’m sorry my message didn’t make sense. I struggle to think straight at times. Worsening constipation (I’ve had issues with my bowels for years), Wobbly legs - feel like Jelly, chest pressure and very aware of my heart beat harder and at times palpitations, weight loss and low mood (with feeling so physically drained). I’m currently being investigated for two other autoimmune conditions - hashimotos and adrenal insufficiency. Bloods show poor T3 conversion, awaiting antibody results (my mum has hashimotos). Had a synacthen test which was bordeline and recieving further investigation into that.

Supplements I am taking is 5000 micogram lozenges. Other blood results I have which u mentioned are -

Before supplements -

HB - 136 (120-160)

RBC 4.4 (4.0-5.0)

MCV 91 (82-99)

MCH 31 (27-32)

Once on supplements -

HB 149

MVC 93

MCH 32

Ferritin 98.61 (13.00-150.00)

We have a good varied diet as a family. I have two young children and 6 out of 7 days we have homemade food such as chicken cassserole, cottage pie, bolognaise etc all containing at least 4 different vegetables.

I’m not sure what is going??


I would suggest that you stop the supplements for a little while and see if that makes any difference - if you need to start them again (the amount you are taking is 2000xRDA for someone who doesn't have absorption problems so may well be more than you need given that your serum levels have risen so much) look at a lower dose. If you don't have an absorption problem then RDA is around 1.2-2.4mcg a day.

The constipation sounds more like a thyroid problem to me than B12 - yes B12 deficiency can result in bouts of constipation but these are generally alternating with periods of diarrhoea.

I'd suggest sorting out the T3 conversion and then coming back to B12 if the T3 doesn't resolve the problem.


Ok, I’m currently trying to sort out my adrenals, then I will need to tackle my thyroid and look at the Vit B12 Deficiency. A bit of a juggling act at the moment. Thank u so much for ur time. I really appreciate it.


Sorry I meant to ask, how long would it take for the vitamins to come out of my system?

I was under the impression with vitamin B12 ur body will only take what it needs and the rest would be passed in ur urine?? Many thanks again


a) difficult to say how long B12 will take to clear as it varies so much from person to person

b) if the rate that you put something in to a system is greater than the rate that it is being removed (nobody's kidneys will instantaneously remove all the excess) then levels will build up, which is what has been happening in your case.

For most people an excess of B12 isn't a problem but for some it can lead to a functional deficiency - probably another auto-immune response - because a reaction stops the B12 going from your blood to your cell leaving you with lots of B12 in your blood but none for your cells to use.

There is some research that implies that this reaction also slows down removal by the kidneys.

There isn't any toxicity from high levels of B12 - just the possibility of this reaction - and not clear how prevalent it is - some studies show it could affect as much as 30% of people.


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