Low B12 and Red Blood Cell Count-is it PA?

[Jbear6060]

Hello...I have been having symptoms like numbness in my hands and feet, muscle twitching, headaches, dizziness, weak muscles, confusion. I was tested for b12 and it came back at 219. I also had my red blood cell count tested and that was low. But my hemoglobin level was normal. My doctor want later me to get and MRI to look for MS but I’m wondering if it can be PA?

[Gambit62 Administrator]

could you give the range and units for the serum B12 test - there are two different units that get used to measure serum B12 and they give different results?

It is low in enough in range to make B12 deficiency a possibility.

Would also be useful to know exact results of the full blood count. GP is probably thinking that there would be macrocytosis (larger, rounder red blood cells) present if you were B12 deficient/had PA, but it's just another symptom of B12 rather than a causal factor in all the symptoms of the condition and isn't present in 25% of people when they first present with B12 deficiency ... and if you have problems with iron as well that can also mask it and make the bloods difficult to sort out.

Further tests that could be done in relation to B12 are MMA and homocysteine. You may need to attend a hospital to get these tests done.

If you need to point your GP at the evidence for the above then it is in the BCSH guidelines on treatment and diagnosis of cobalamin and folate deficiencies which they can access through the BNF but can also be found here

onlinelibrary.wiley.com/doi...