Why would B12 plummet so quickly?

[MelonJ]

Hi all,

I've just received my latest set of blood results and I'm a bit puzzled, I wonder if any of you lovely people can help.

Currently on Ferrous Fumarate 2 x daily (take vith Vit C tablet) and 1 x VitD3 3200 iu (taken with K2)

15/6/18

TSH 5.95 mu/L 0.35-5.0

(was 5.84 in May but was higher in April at 6.38)

Serum CRP 2 mg/L <7

(was

Serum VitD 49 nmol/L 30-300

(was 36)

Serum B12 232 ng/L 130-800

(was 314 April 18 before starting the Ferrous Fumarate)

Serum folate 8.7 ug/L 4-20

Serum Ferritin 42 ug/L 12-250

Serum iron 18.7 umol/L 5.0 - 30.0

Serum transferrin 2.61 g/L 1.9 - 3.8

Transferrin saturation 29% 15-50

Also FBC done, results available if needed and all previous results in my bio.

I started taking the Ferrous Fumarate April 18 and the Vit D3 1 month ago.

Just wondering why my folate and ferritin levels would be rising but B12 falling?

GP hasn't called me to discuss the results yet so I don't know what her take will be.

Also my TSH has risen again but still not being treated.

Is there any advice anyone can give me please before I speak with her?

I haven't gone gluten free but have been on a low carbs diet avoiding lots of the bad stuff (bread, pasta, potatoes etc).

Thanks

Mel x

[Gambit62 Administrator]

B12 is a bit inconclusive - there is quite a large variation in testing the same sample twice (20% either way) so it could just be that margin of error rather than a drop.

Gluten free unlikely to make a difference unless you really do have gluten intolerance ... and stopping makes testing for coeliacs impossible.

folate is quite responsive to diet so can be affected by time of day or when you last ate food with folate in. Levels are low in range but still in range.

Have you had a full blood count?

Has your GP looked for thyroid anti-bodies/gone any further than failing to monitor your TSH by looking at T3 and T4?

[MelonJ in reply to Gambit62]

Hi Gambit62,

Yes I’ve had a FBC, which results do you need?

Thyroid antibodies were found, in April TPA 55iu/ml <49

previously on medichecks

TGA 194 iu/ml 0-115

TPA 66.2 iu/ml 0-34

My T3 and T4 were done in May by GP

FT4 14.1 pmol/L 12-22

TT4 96.9 pmol 59-154

FT3 4.34 pmol 3.1-6.8

My GP doesn’t want to treat anything it seems.

I managed to get vitD prescription and she told me to buy ferrous Fumarate as cheaper over counter.

Thanks for your help

Mel x

[Gambit62 Administrator in reply to MelonJ]

Red blood cell measures - particularly MCH, MCV, MCHC and RDW

I think you need to find another GP - current one seems to be a waste of space.

[MelonJ in reply to Gambit62]

I’m with you on that 😔 I do have these numbers so will dig them out and post.

Thanks x

[MelonJ in reply to Gambit62]

June 18 followed by previous Feb 18 in brackets, before any vitamins etc started

Haemoglobin 139 g/l 120-150 (130)

Total white cell count 6.5 10*9/L 4.0-11.0 (6.2)

Platelet count 234 10*9/L 150-410 (257)

RBC 4.49 10-*12/L 3.8-4.8 (4.29)

Haematocrit 0.413 L/L 0.36-0.46 (0.385)

MCV 92.1 fL 83-101 (89.7)

MCH 31.1pg 27-32 (30.2)

MCHC 337 g/L 315-345 (337)

Red cell dist width 13.7 11.6-14.0 (13.8)

MPV 9.6 fL 7.5-11.2 (9.1)

Neutophil count 3.8 10*9/L 2.0-7.0 (3.5)

Lymphocyte count 1.9 10*9/L 1.0-3.0 (1.7)

Monocyte count 0.4 10*9/L 0.2-1.0 (0.4)

Basophil count 0.1 10*9/L 0.0-0.1

Eosinophil count 0.3 10*9/L 0-0.5 (0.4 10*9/L 0-0.4) - range change

I hope these can help

Mel x

[fbirder in reply to MelonJ]

OK, you don’t have macrocytic anaemia, one of the signs of a B12 or folate deficiency. Coupled with two normal (and well above the lower range) B12 blood tests, if I were a GP I’d say that you don’t have a deficiency.

[MelonJ in reply to fbirder]

Thanks fbirder