New member question:anaemia Blood res... - Pernicious Anaemi...

Pernicious Anaemia Society
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New member question:anaemia Blood result advice pls!!


Hi All,

new poster here from the UK. I'm very glad places like this exist so people that are not really clued up on anaemia can get some advice.

I have suspected I have anaemia for over 15 years now; having continuously had many of the symptoms. ( which i won't bore you with)

Anyway, it has recently occurred to me that often the NHS blood reference ranges are not always correct and people have been denied diagnoses and treatment because of this. I was hoping a member on here with good knowledge and experience of this could help me in interpreting my recent blood results.

Serum Iron level: 24.9 umol/L

Serum TIBC: 69.4 umol/L

Serum ferritin: 126 ug/L

Serum vitamin B12: 394 ng/l

Serum folate: 10.6 ug/L

I have been trying to understand these results, and my GP insists as they are all in the reference range there is no need for follow-ups. I hope someone is able to offer a further insight for me, and perhaps even suggest further tests to rule out other things.

Anyway, thanks very much to anyone that can have a look,

Much appreciated,


4 Replies
clivealiveForum Support

Hi monkeyboy0211 it would probably help the more knowledgeable than I on here to answer you if you did list your symptoms and (if possible) showed the ranges <From -- To> of your above test results.

Hi Clive,

thanks for your reply,

my symptoms are as follows:

Always feeling tired and very low energy

Heartbeat always in the 90's bpm even while resting

physical exertion takes its toll on me too!

brain fog and often its impossible to concentrate

Pale skin (slightly yellow also)


Mood swings

Difficulty sleeping, never feeling refreshed

Leg cramps

weird crawling/burning sensations in my limbs; sometimes sharp pains in my fingers

Serum Iron level: 24.9 umol/L ref fange: 11.00-36.00 umol/L

Serum TIBC: 69.4 umol/L ref range: 53.00-85.00 umol/L

Serum ferritin: 126 ug/L ref range: 30.00-340.00 ug/L

Serum vitamin B12: 394 ng/l ref range: 160.00-925 ng/L

Serum folate: 10.6 ug/L ref range: 2.90-50.00 ug/L

According to the reference ranges I am totally normal, but I have read a lot about certain reference ranges being inaccurate as a basis to diagnose things like anaemia. And with my present symptoms i thought i would be good to get some valued opinions on this forum.

Thanks again,


clivealiveForum Support
in reply to monkeyboy0211

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".

In other words your doctor should be treating your symptoms not just looking at the computer screen.

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




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.

Of course there may be other causes for your symptoms. Have you had checks on your Thyroid or Vitamin D levels?

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

I wish you well.

thanks Clive,

i totally agree with what you've said; i need to see my Gp and get treatment.

As always, the NHS refuse to do more than the very basic thyroid panel which, again, shows up as in the ' normal range'. I will have to be a bit more forceful in getting tests/treatment!

Thanks again,


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