long post (sorry) this is the missing... - Pernicious Anaemi...

Pernicious Anaemia Society
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long post (sorry) this is the missing blood results from the other day,thank you for looking,


hello sorry for the delay in typing this out. its not one of my strong points. if someone could please advise me on these results i'd be grateful as I have to speak with the doctor on the 8th of August. this is the report

Liver function tests:(x77WP)

serum bilirubin level (XaERu 10umol/L [<21]

serum albumin level (XE2eA)42g/L [35-50]

serum adjusted calcium concentration (Xabpk) 2.38 mmol/L [2.2-2.6]

serum alkaline phosphatase leval (XE2px) 105iu/L[30-130]

serum globulin leval (XE2eB)28g/L[20-35]

eGFR using creatinine (CKD-EPI) per 1.73 square metres(XacUK)88 mL/min

slight decrease in eGFR

for african - caribbean subjects multiply the reported eGFR by 1.159(im not african -caribbian)

eGFR calculation by CKD-EPI equation from 6/11/17

eGFR is not an accurate measure of the true GFR in : acute kidney injury,acute illness, pregnancy.

serum alanine aminotransferase level (XaLJx) 14 iu/L [<40]

serum total protine leval (XE2e9)70g/L [60-80]

Urea and electrolytes (X77Wi)

serum sosium leval (XE2q0)140 mmol/L [133-146]

serum creatinine leval (XE2q5)63umol/L[49-90]

serum calcium level (XE2q3) 2.42 mmol/L [2.2-2.6]

serum potassium leval (XE2pz)4.2 mmol/L [3.5-53]

serum urea leval (XM0lt)4.2mmol/L [2.5-7.8]

urea and electrolytes; CALCIUM: Liver function tests: eGFR using creatinine (CKD-EPI) per 1.73 square meters.

report normal no further action .

clinical information moniroring

serum vitimain B12 leval (XE2PF)241 ng/L [150-1000]

serum folate leval (42U5.)7.3ng/ml [2-18.8]

serum vitimain B12 leval folate level report , Normal No Furthur


clinical information monitoring

serum total 25-hydroxy vitamin D leval (Xabo0)54nmol/L [>50]

vitimin Dadequate 50-75 nmol/L optimal >75nmol/L

serum levals vary with exposure to sunlight, peaking in summer.

Vitimin D assay change to Roche Generation ll assay from 6/6/2018

serum TSH level (XaELV) 0.5 miu/L [0.3-4.5] Euthyroid picture ( including satisfactory thyroid replacment )

serum TSH Leval ; serum toral 25-hydroxy vitamin D leval report,Normal, no further action needed.

Nucleated red blood cell count (4266.) 0 10^9/L

Monocyte count -observation (42N..)0.7 10^9/L [0.2-0.8]

Eosinophil count- observation (42K..)0.2 10 ^9/L [0-04]

Full blood count (424..)

Platelet count -observation (42p..)223 10^9/L [140-400]

Mean cell volume (42A..)88.3 fL [82-100]

Haemoglobin concentration (Xa96v) 13.6 g/dL [11.5-16.5]

Total white blood count (XaldY)10.1 10^9/L [4-11]

Neutrophil count (42j..)3.8 10^9/L [2-7.5]

lymphocyte count (42M..5.3 10^9/L [1.5-4]

Mean cell haemoglobin concentration (429..)33 g/dL [32-36]

Red blood cell distribution widith (XE2mO) 12.7%[12-15]

Mean cell haemoglobin leval (XE2pb) 29.1 pg [27-32]

Haemarocrit (X76tb) 0.412 [0.37-0.47]

Red blood cell count (426..) 10^12/L [3.8-5.8]

Full blood count report, Borderline, No furthe action: mildly raised lymphocytes rpt at next planned bloods.

9 Replies


Did you have a ferritin or other type of iron test?

B12 241 ng/L [150-1000]

It is possible to have severe B12 deficiency with an in range B12 result. In UK, the emphasis in official guidelines is on treating people who are symptomatic for b12 deficiency even if B12 is within normal range.

Are you symptomatic for B12 deficiency?

B12 Deficiency Symptoms



b12d.org/admin/healthcheck/... (may need to be B12d.org member to use this) .

Link below about writing to GPs about B12 deficiency if symptomatic with an in range B12 result.

b12deficiency.info/b12-writ... link has lots of useful info eg UK NEQAS B12 statement.

UK B12 documents

BSH Cobalamin and Folate Guidelines


Flowchart from BSH Cobalamin and Folate Guidelines


BMJ B12 article






B12 books I found useful

"What You Need to Know About Pernicious Anaemia and B12 Deficiency" by Martyn Hooper

Martyn Hooper is the chair of PAS (Pernicious Anaemia Society). Book is up to date with UK b12 guidelines.

"Living with Pernicious Anaemia and Vitamin B12 Deficiency" by Martyn Hooper

Has several case studies.

"Could it Be B12?: An Epidemic of Misdiagnoses" by Sally Pacholok and JJ. Stuart (USA authors)

Very comprehensive with lots of case studies.

PAS (Pernicious Anaemia Society)

Based in Wales, UK.


PAS tel no +44 (0)1656 769717 answerphone

PAS support groups in UK


B12 Deficiency Info website


Full Blood Count


I have written other more detailed replies recently on forum. May be useful info if you search for them. More B12 info in pinned posts on forum.

I am not medically trained.

in reply to Sleepybunny

You need an Active B12 test, i had one done at st thomas's hospital london and my NHS serum blood test was 334 about 4-6 weeks before on the private test i had done it was 304 and i was still found deficient and the people at the lab were so helpful with my GP. Its a leading world renowned hospital they cannot argue the result. I cannot recommend them and this test enough, they now do it by post as well.


in reply to 1Cazza

Thank you 1cazza I will see if GP will authorize that test if not ill pay for one .

Yes and no yes sleepybunny I have symptoms but no only tests done where those I copied off the report .symptoms are Burning /tingling roof of mouth and tongue

A sort of aching tingling lower legs (I'm not diabetic)

Elbow joints both sides are aching a lot

Mouth can be sore a bit sort of tender in places( dentist recently hasn't noticed anything) but I have extremely sensitive teeth. I have a fat geographic tongue.

General aches and pains with sharp pains stabbing into my body any part anytime these pains start as a sharp stab then radiate into my body before reducing and disappearing.

A numbness and cramping coming from my forearms into my hands the cramping goes into feet as well but these don't happen to hands and feet at same time.

A feeling of being off balance comes and goes occasionally.

Occasional short lived slight tinnitus

Increased arterial fibulation ?(spelling) it's a increase in palpitations like a bird wildly fluttering its wings. doctors are aware of this but it's increasingly now .I have hashimotos and I'm receiving treatment I also have osteoarthritis no treatment. I'm sure I have other symptoms but can't think of them at the moment that's another problem memory forgetting things confusion and I've noticed I can over heat and my brow sweats (recent heat wave?) Also so tired go to bed tired wake up tired nod off during the day . I can be irritable and resentful this is not like me .I get very constipated too. Thank you for helping just checked your link I have lots of the b12 symptoms .including feeling ill it comes like a wave I feel ok then from no where I feel so ill I would like to lye down if I could it doesn't last long but happens daily and sometimes frequently through the day .

Hi again,

Just to add that if you are supplementing b12 in any way it may affect results of Active B12 (Holotranscobalamin) test. Supplementing B12 without a diagnosis of B12 deficiency may make it difficult to get a diagnosis.


Has GP considered ordering MMA, Homocysteine tests?

Blood tests


Thank you sleepybunny I'm not supplementing at all but eat lots of bananas which I've just learned contain b12 had to stop eating as

Any as January's blood test came back with a top of range potassium level

in reply to pet-lamb

Oh and no doctors aren't taking me seriously no further tests ordered I'm talking to one on the phone on the 8th will I ask for these tests ?

in reply to pet-lamb

Bananas do not contain vitamin B12 ! Only meat , fish, dairy products and eggs contain B12

in reply to wedgewood

Oops I read it somewhere wondered why that sounded odd .Thank you for clearing that up

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