Pernicious Anaemia Society
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Small blood cells?

In February 2017 went to doctors as I had been having diarrhoea every day for 6 weeks, thought other symptoms tiredness, pins and needles etc. were due to that. Nothing helped and blood tests / colonoscopy etc. all come back normal. Many blood tests followed and only thing mentioned was my Folate level was extremely high. Found on google this could be masking a B12 deficiency so doctor agreed to try 6 loading doses (October 2017) followed by injection every 12 weeks. After the loading doses I felt much better for around 6 weeks but told minimum I could have another was 8 weeks. This helped for around 6 weeks again. I went back to see doctor on Friday who agreed to an injection that day however he was reading though my notes and said my B12 was low in 2015! I was never told this, I didn’t even know they were testing for it, I believe I only went to in 2015 as I had menopause symptoms. He also mentioned he was confused as my blood cells are small, he was expecting them to be larger. I have been told to continue seeing the nurse for 12 weekly but to see him if I want one in between appointment in the meantime until I have been seen at hospital. Has anyone here got a B12 deficiency but cells are small? Apparently all my other levels are normal but I am requesting copies of blood tests to see for myself

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Thank you, that is interesting as my GP said otherwise. Then again, he also told me too much B12 is toxic so......

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Ask your doctor to show you some evidence for that assumption . —-there is none . B12 is not toxic . You need as much as it takes to get rid of your symptoms .You can print out evidence provided on the P.A. site , that B 12 is not toxic . Yes some B vitamins can be toxic , but NOT B12 .

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Eaoz - looking at the article it actually says only 60-70% with PA will have macrocytic anaemias - which agrees with the figure in the BCSH guidelines of 25% don't present with macrocytic anaemias.

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The cells can be small if you have iron deficiency anaemia. My blood confused a doc once because I had both small and big cells at the same time - trust me to be different ;)

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Yup, that was the case - I had both. Obviously the Doc hadn't seen it before.

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The 8 weeks probably comes from the current licensing arrangements in the UK which are for frequency of 8 weeks. These are driven by manufactures rather than by an independent authority looking in to the safety. When hydroxocobalamin was introduced in the 1960s it was monthly (as it still is in many other European countries - including Germany).

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Thank you all. I am going to print out some information and take it to my next appointment. There seems to be a real lack of knowledge at my GP surgery where B12 is concerned which is worrying. Fingers crossed for a quick hospital appointment, GP told me the waiting list for my local hospital was around 2 months currently so not too bad

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dippyduck I wonder if it would be worthwhile to begin a diary to record your symptoms? (You can even back date notes on what has been happening to your body). It was very important in helping my GP understand what was going on with my PA.

Good luck.

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Hi dippyduck. I alwayd have large red blood cells with my PA as well as anemia. I would ask for more testing. IF would be good. Also, did your doc say whst your b12 level was before? I agree keeping a journal would be good as well. I did daily loading shots now weekly injections along with daily folic acid. I also take ferrous(iron) pills. Best of luck with further testing and hope you get relief

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