Can anyone help interpret my Daughter... - Pernicious Anaemi...

Pernicious Anaemia Society
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Can anyone help interpret my Daughters blood test results please?


Hi all I've previously posted about my own B12 deficiency but I need some help with my Daughters results. Apologies in advance for the long explanation!

She began feeling unwell beginning of this year with almost identical symptoms to mine apart from one which was Vertigo she keeps having really bad episodes where she has to get down on the floor because the room is spinning, as well as numbness tingling, anxiety dizziness, brain fog, loss of balance, fatigue, stiffness in her neck, blurred vision, difficulty swallowing, palpitations, sore tongue, heavy painful periods, etc, so I suspected it to be B12 deficiency. She had blood tests done on 03/04/18 which are shown in the photo, as you can see she was very iron deficient and her B12 was also quite low, what I don't understand is her MCV was at the low end & her MCH very low which I believe indicates iron deficiency but her Red blood cell distribution width suggests enlarged blood cells which I thought was indicative of B12 deficiency? Can anyone identify with this or explain what might be happening here?

She has since been taking 2000mcg Hydroxo B12 sublingual per day for the last 4 months now and also a multivitamin which includes folic acid and iron and more recently some extra iron although only 5mg tablets.

Her recent blood test shows her B12 has gone up to 552 but still not great, her folate is much higher at 19.6 but her iron hasn't changed and is still very very low at 7 and she is still feeling very unwell, also her RBC distribution width has come down a tad to 14 but is still at the very top end of the range. I have a copy of these but can't see how to upload more than one photo at the moment.

Although I have learned much about all this stuff I'm not able to figure out what's going on, her GP has now given her 200mg tablets of ferrous sulphate to take and of course the usual antidepressants amitriptyline! They keep trying to say she's suffering from some form a migraine (rolls eyeballs!!) probably due to low B12 & Iron!!

When she first started taking the B12 & multi vits she did seem to improve for a while but is now back to feeling as bad as she did before.

If anyone has any idea what might be happening here I would be so grateful for your response

Best wishes

Alesia x

4 Replies

Not seen the results but,

Low MCV and high RDW are signs on iron deficiency.

Normal MCV and high RDW are an indicator of both iron and B12/folate deficiencies together.

High MCV and low RDW are an indicator of low B12/folate.

A B12 level of 550 pmol/L is well above average. Higher than about 85% of the population. It is nowhere near low.

Ferrous sulfate if possibly the most useless for of iron supplementation (apart from rusty nails). Ask for a more easily absorbed form - iron fumarate or bisglycinate.

in reply to fbirder

Thanks fbirder very helpful! Her MCV is normal within range but lower end & RDW high, her B12 was 233 before she started taking 2000mcg B12 per day and is now up to 552 so I'm guessing she was deficient alongside an ongoing iron deficiency. I refer to 552 being not great as Dr Chandy & Prof David Smith say anything below 500 is deficient as far as they are concerned and I know myself when my B12 drops to around 600 I start getting symptoms again.

in reply to Alesia

here Is part of an email exchange I had with Prof Smith...

I said,

Dear Dr Smith,

I suffer from Pernicious Anaemia and I have seen your name mentioned many times across the internet. Often it is associated with this quote:

"B12 deficiency is more common after the age of 60 and, once levels fall below 500 pg/ml (picograms per millilitre — the normal range being 500 to 1,000), the brain starts to deteriorate at twice the usual rate, making memory loss six times more likely. "

His reply:

Thank you for alerting me to the quote. I never said or wrote that - can you kindly give me the source?

I am travelling in Germany just now and will reply more fully in a few days.

Best regards,


in reply to fbirder

Oh dear! I wonder who wrote that then? It's still floating about on the internet as I think it was Polaris who mentioned it to me

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