I've assumed you're in UK. I'm not medically trained.
Your B12 is below range 175 (180 - 700ng/L), ferritin within range but not very far up range.
Were you given an IFA Intrinsic Factor Antibody test? IFA test can help to diagnose Pernicious Anaemia but IFA test is not always reliable and it is still possible to have PA even if IFA result is negative or normal range.
Flowchart outlines when PA and Antibody Negative PA can be diagnosed in UK. Makes it clear that a person who is symptomatic for B12 deficiency shoudl have an IFA test and start initial b12 treatment.
I noticed that there are exclamation marks against transferrin and transferrin saturation. These marks mean that the lab that carried out the test thinks the GP should take notice of them. What has GO said about these results?
Hi sleepy bunny- thanks for your reply. Wow that’s a lot of info- I will try and get through it over xmas.
Sorry I forgot to mention my other symptoms and conditions which I’d previously posted about;
I am autoimmune Hypothyroid (hashimotos ?)
I have PCOS
And I am undergoing frozen ivf cycle in a few months.
I’m treated with 125mcg thyroxine and my tsh is usually around 2mark.
But I have had a host of new and worsening symptoms over past year; including fatigue, dizziness, pulsatile(?)/tinnitus, vertigo and motion sickness to varying degrees... that’s what led me to think it was b12 deficiency. As my April results showed normal iron levels.
I have had severe vit D deficiency in past and my results again show low as I haven’t taken a high daily dose recently (ran out).
I didn’t ask for IFa test for PA as GP couldn’t get me off the phone fast enough. So thought if b12 is low I might do the test privately among t3 thyroid tests too.
There is a very active Thyroid UK forum on HU. Probably worth putting any thyroid results on that forum.
Marz who posts on this forum knows about thyroid problems so may be worth searching for her posts.
"I didn’t ask for IFa test for PA as GP couldn’t get me off the phone fast enough"
Sadly some people on this forum find that in UK (and sometimes other countries ) B12 deficiency is not as well understood as it could be. I think it pays to do some homework on B12 deficiency.
My understanding is that in UK, a person who is symptomatic for B12 deficiency and/or low in B12 should not have to ask for an IFA test but that it should be done as a matter of course.
I cut out a lot of grains and cereals and dairy (subconsciously!)and have possibly left out my main sources of these vitamins.
I should have known when I started craving liver lol.
I certainly do think I have absorption issues/leaky gut or a host of other problems leading to all round nutrient deficiencies. I’m not entirely sure whether it’s all autoimmune - PA/coeliac etc but since I have hashimotos I could Wel have another.
If I can test for these privately I think il do that first to get to the bottom of it.
Time is sort of against me due to ivf cycle starting in next few months. I can’t hang around for the NHS
if you have cut grains out then there is no point checking for coeliacs. the test for PA gives false negatives 40-60% of time(depending on test method) so a negative is a long way from proving you don't have PA. worth ruling out h pylori/ sibo instead but not sure about private testing for those
I have wondered for some time if I had coeliac too but I’m thinking against it now- although if that’s the guidelines it might justify me asking the GP!
Sorry my Q regarding supplements vs injections is whether I could get right amount of b12 via supplements or only through injections?
I guess it depends on absorption!
I think I’m flagging with all the differential diagnoses... trying not to be a hypochondriac but also concentrating my efforts to my biggest issues.
I think I’m just going to have to throw everything at it with supplements and private testing. Go surgery is only taking emergency appointments for the whole holiday period- I doubt I’ll get anywhere (!)
Thanks again for all your help- sorry to be a nuisance with all the Qs ☺️ I promise this will be the last (!)
Ok you’ve convinced me- I think I had given up on GP and was happy to think I could self treat. It seems part of the reason I haven’t started supplementing yet- was going to do private blood tests first. Will get cracking with it- new resolution!
saya was that the first time you had B12 levels checked? showing a fall would be good evidence that you have an absorption problem
It doesn't sound as if you are vegetarian or vegan which means that the deficiency would be an absorption problem. Highdose oral is going to be very slow in correcting the deficiency (if it would work at all) - which is why you need injections to get the levels in your blood up quickly - high level oral can be effective at maintaining levels where you then need them to be - but again it doesn't work for everyone.
Yes this is the first time I’ve had it checked although my MCHC (or whatever it is) which was tested in April pointed to a b12 deficiency that wasn’t picked up by GP.
I found it myself and made me research it. I’ve had symptoms of b12 deficiency for almost a year I think.
The nurse said I didn’t need any treatment for the b12... and on the picture above it just says repeat in 3months.
No I’m not vegetarian, and eat enough meat and eggs (less dairy) so yes it’s probabbly an absorption issue too... I was thinking of high dose oral supplements and if in 3months it didn’t improve that would help my case with GP?
But maybe that’s too long to take a risk- and I need injections for now.. ah it’s kind of overwhelming.
How long does it take for b12 levels to stabilise? If I did a private blood test in a month would that be long enough to show a change?
high MCV and high MCH are indicative of B12 deficiency. MCHC is a ratio between the two so would be not necessarily definitive of B12 and could be affected by an iron anaemia.
If you have neurological symptoms - eg tingling in hands and feet - I'd be inclined to back to your GP and ask for injections.
Serum B12 isn't a gold standard test and will miss 25% of people who are actually deficient if taken as a single measure. I don't have a specific US reference for this but there are lots of papers on diagnosis and treatment of B12 deficiency on pubMeds in the US that cover the limitations of the test.
Thanks gambit- you actually replied to my original post of my results in April to see if it could be PA/b12. I can’t remember exact figures but it was suggested multiple times that it could be b12/ferritin.
Yes I have a lot of symptoms and neurological ones too.
Ugh it looks like I’m going to have to chase up my Gp after all 😔
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