Iam a member of the Thyroid UK site and would appreciate advice on the following results. My mother had PA and I am concerned that I may be heading in that direction. Doctor not willing to do further investigation.
Dec17
B12. 273 (197-771)
Folate serum. 12.7 (>2.9)
Ferritin 212 (13-150)
Results 4 months later - should ai be concerned that levels are dropping?
Apr 18
B12. 252.7 (180-900)
Folate serum. 4.6 (2.5-19.5)
Ferritin. 158.9 (33-400 post menopausal)
could you double check the B12 ranges you have quoted and give the units used in the tests - there are two different units that are used.
To be honest even if it is the same units the difference in the two results is within the margin of error that you would expect on the test - ie if you did the same test on the same sample several times you would get readings within a range that would cover both the results you have.
The same comment about units of measure applies to the folate levels (where the multiplier between the two ranges is much larger). Folate is much more responsive to dietary changes.
Ferritin is only one indicator of iron status, others being elements of a full blood count.
The overlap between thyroid symptoms and B12 symptoms also makes using B12 symptoms as an indicator difficult, unless you are absolutely sure that your thyroid levels are under control.
A consistent downward trend for B12 over a period of time - eg a few more readings at 4 monthly intervals, adjusted for consistent units - would be an easier position to argue to absorption problems.
Hi Gambit
The units are ng/L for B12 and ug/L for folate. Appreciate your explanation of margin of error. I have very good TSH levels hence my investigation of continued tiredness and other symptoms which I understand could also be linked to PA. I do have FBC results so will continue to monitor the downward trend.
Sorry sent before finished. The units given were for the most recent tests.
Dec 17 B12 units pg/ml (different lab as private tests). Other units the same.
they are actually the same units - just different ways of expressing the same unit (medics do like to confuse themselves 
). The alternative units are pmol/L. It may be different test methods that mean the upper ranges are so different ... or it may be the quirks of the labs concerned.
According to latest BMJ research document, there is no completely reliable test and symptoms are paramount. As your B12 is low/borderline and dropping this, together with family history of PA' with its known link to thyroid disease, makes me wonder if the other symptoms,as well as the fatigue you mention, are all neurological. If so, It is important they are treated without delay. Here is a helpful link to the very varied symptoms of B12def. and templates for writing to GP In case you haven't already seen it:
b12deficiency.info/signs-an...
B12 deficiency is v. subtle and creeps up slowly over time so, the earlier it is treated with injections, the faster you will recover and avoid the risk of permanent neurological damage - see Dutch results in the pinned posts on the R/h side of forum.
I understand your concern Mrs 964, as family history sounds very like my own family's and there is evidence that having Thyroid disease, eventually leads to PA/B12deficiency:
ncbi.nlm.nih.gov/pmc/articl...
My personal experience is that the symptoms of Hashimoto's are not the same as 12def. especially when on medication and TSH low or suppressed. The fatigue of B12 deficiency was like nothing I'd ever experienced even with severe undiagnosed Hashimoto's.
This is the link to the latest BMJ research document - summary only - GP should be able to access the full document (behind a paywall):
It also contains information regarding frequency of injections for neurological symptoms :'every other day until no further improvement (British National Formulary).
Very best wishes
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