Blood test results 6m on

[mesadies]

So blood test six months after loading injections with no top up injections has come back B12 400, serum foliate 3.8, serum ferritin 15. 3 months ago B12 was 800, is it dropping fast or does anyone know if that is normal? Thanks

[clivealive Forum Support]

Hi mesadies how are your symptoms now?

[mesadies in reply to clivealive]

Hi Clive thanks for asking the last few weeks the exhaustion has come back brain fog and pins and needles in my foot and fingers feel clumsy, the gp says no action though from the blood results

[clivealive Forum Support]

Your doctor should be treating your symptoms not just looking at the computer screen, and your Folate looks to be bumping along the bottom of the range but without knowing the range <from - to> it's hard to say whether your are deficient. Were you supplementing with folic acid?

It is important that your Folate level is monitored as this is essential to process the B12.

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

The British Society for Haematology guidelines say on the Diagnosis of B12 and Folate Deficiency "In the presence of discordance between the test result and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment".

google.co.uk/url?sa=t&rct=j...

Make a list of your symptoms and present this to your doctor and ask him to treat you according to your symptoms and (perhaps) even re-start you on loading doses "until there is no further improvement" according to the N.I.C.E guidelines below. Click on the link, then on "Scenario: Management" and scroll down to "Treatment for B12 deficiency"

google.co.uk/url?sa=t&rct=j...

If possible take someone with you who can validate your neurological symptoms as the doctor is less likely to pooh pooh you in front of a witness.

I am not saying that this is an easy thing to do but try to stay calm, write out what you want to say and keep to the script and be confident that you are "in the right" and your facts are correct.

I'm not a medically trained person but I've had P.A. for over 45 years and I wish you well.

​

[mesadies]

Thanks for the info and advice, I have got another blood test in three months which I will compare to these ones and my last ones and if it has all dropped again the doctor will have to consider my symptoms and b12 injections. I often feel breathless too so I will ask if they can check the haemoglobin as well

[Gambit62 Administrator]

Are you based in the UK?

The drop in your levels just shows that you have a B12 absorption level - so you aren't able to build up a store of B12 and then use it to regulate your B12 levels any more (because the release from stores relies on the same mechanism that you use to absorb B12 from your food which is broken). Your levels will just continue to drop as the B12 gets removed by you kidneys mainly, though a small amount of it will be used by your cells as levels drop

Even though your levels now in the normal range the normal range really doesn't apply after you have had loading shots. You should be on regular maintenance doses.

[mesadies]

Hi gambit yes that's my thoughts too but my gp seems to only go by blood results levels. I might try and see a different gp and explain my symptoms