Is my B12 level ok

[Joanneconnor]

It's 375ng/l (181-910) doc has prescribed me folic acid as its below range, is it ok

[clivealive Forum Support]

Hi Joanneconnor your B12 level is probably classed as "Normal"

However 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

Do you have any symptoms?

Folic acid works closely with vitamin B12 in making red blood cells and helps iron function properly in the body.

I am not a medically trained person but I've had P.A. (a form of B12 deficiency) for more than 45 years.

I wish you well

.

[Joanneconnor]

I have reduced sense of taste and tingling of hands mainly

[Polaris in reply to Joanneconnor]

I've just read your post on TUK Joanne re. recent diagnosis of primary biliary cirrhosis 🙁

The serum B12 test is flawed for a number of reasons. Many experts would consider your B12 result low and shouldn't be considered in isolation of history and symptoms, especially as it looks like primary biliary cirrhosis is autoimmune and, with thyroid disease, puts you at higher risk of PA/B12 deficiency.

You've also noted that many problems (thyroid, etc.) started after pregnancy. Pregnancy makes extra demands on the body, especially B12, which can lead to deficiency in the mother, causing many symptoms, such fatigue, post natal depression, etc. and tingling in fingers and toes. These, with reduced taste, are neurological and should be treated with injections without delay according to the BNF and UKNEQAS guidelines below, as there is a short window of opportunity before they become irreversible.

"The BNF advises that patients presenting with neurological symptoms should receive 1000 ug i.m. on alternate days until, there is no further improvement".

bmj.com/content/349/bmj.g5226

The above latest UK research document is supported by many research papers and has a useful summary if GP won't read full document. It also tells GP that, once b12 treatment is started, the test results don't mean anything and blood levels are not reflective of how effective the treatment is - it is the clinical condition of the patient that matters....

ukneqas-haematinics.org.uk/...

b12deficiency.info/b12-writ.... (List of symptoms and an excellent film)

Good luck with getting treatment Joanne (might be a good idea to take someone close with you to next appointment to ensure this is taken seriously.

[Gambit62 Administrator]

the symptoms of folic acid deficiency are similar to those of B12 deficiency. On the face of it your B12 levels are quite good making it unlikely that B12 is part of the problem, but serum B12 is a difficult test to evaluate - and it will miss 25% of people who are B12 deficient if used as a single measure.

there is a test that can help clarify - MMA - but this test isn't generally available through GPs - it will be raised if B12 is low but can also be raised by other factors so needs to be done in a context that checks for those things - it isn't affected by low folate.

if you have problems absorbing folate then you may well have problems absorbing B12 so it would be a good idea for your GP to keep an eye on your B12 levels as the two generally go together.

[Joanneconnor]

This is my b12 results from March it’s 286 which I thought was quite low, he said I don’t have anemia

[Joanneconnor]

How do I know if it is low then, do I just self treat with injections anyway?