Help with B12 results please - Pernicious Anaemi...

Pernicious Anaemia Society

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Help with B12 results please


Hi there, i had a total thyroidectomy in January for Graves’ disease. I’m on 100mcg Levothyroxine and feel tired all the time, memory problems, can’t think straight, numbness and tingly hand and arm, especially during the night. Could my B12 level be to blame? My gp said the results were all normal. Is it worth seeing the gp or will he just dismiss me?

Vitamin B12. 204 ng/mL (187-883)

Serum folate 3.4 ng/mL (3.1-20.5)

Serum Ferritin 23 no/ml (20-204)

Thank you so much in anticipation!

5 Replies
clivealiveForum Support

Hi Argie1 all three results are at the very bottom end of the scale and thyroid problems will put you at risk of developing a B12 deficiency.

Symptoms of B12 deficiency tend to develop slowly and may not be recognised immediately. As the condition worsens, common symptoms include:

Weakness and fatigue

Light-headedness and dizziness

Palpitations and rapid heartbeat

Shortness of breath

A sore tongue that has a red, beefy appearance

Nausea or poor appetite

Weight loss


Yellowish tinge to the skin and eyes

If low levels of B12 remain for a long time, the condition also can lead to irreversible damage to nerve cells, which can cause the following symptoms:

Numbness and tingling in the hands and feet

Difficulty walking

Muscle weakness


Memory loss




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".

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 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"

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.

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

I am not a medically trained person but I've had Pernicious Anemia (a form of B12 deficiency) for more than 46 years.

I wish you well.

Argie1 in reply to clivealive

Thank so much for taking the time to respond. I have made an appointment with the gp. I’ve just found out that my grandad had PA and I do have Graves’ disease which is an autoimmune disease too. Once again thank you 😊

When you have a thyroid problem you need your B12 to be in the upper part of the range. B12 needs folate and ferritin in order to be absorbed properly, so all your results are too low.

Argie1 in reply to MariLiz

Thank you MariLiz for taking time to reply. Is there anything I can take over the counter or would you say I need to see the gp. I do have an appointment at the beginning of July but just think he will think I’m a hypochondriac as one gp has already said the results are normal (knowing I’ve recently had a thyroidectomy). Sorry, not feeling very assertive at the moment.

MariLiz in reply to Argie1

The difficulty is once you begin self treating your GP will only see better results from any blood tests and refuse to treat you. You can return and plead your case for treatment, listing your symptoms. Doctors are supposed to look at those and take them into account, not just rely on the blood test results.

If your GP totally refuses to help there are sublingual tablets or sprays, the spray can be bought at a well known health food shop. The tablets are available online.

I used the spray myself as a top up between injections, and found it helped me.

Low B12 can leave you feeling very low, unable to put a good argument forward. I took my husband with me to the GP as back up. Have you someone who could be there as support?

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