Results help please

[Andypandy30]

These are my brothers results . He has in the last year experiences a decrease in his health . Weakness in legs . Joint pain . Depression . Fatigue. He is also dealing with a hernia which will be operated on shortly .he has stopped the omemprazole he was stuck on for 20 years due to helicobactor pyloris . As we are worried due to the family history of pa and because he will be getting an op in the near future and due to his symptoms . We encouraged him to get his bloods tested . I have pa and vit d deficiency and hashimotos . Please can you lovely experienced people help decipher his blood tests as he had an appointment on wed and I want him to be able to say the right thing . The doctor has only highlighted one blood test donr as it was not in range . Others are low though but these have not been highlighted by doctor . Full blood count :haemaglobin 145 g/l (130-180) ‘Pcv’ 0.433 (0.36-0.5). Red blood cell count 5.18 (3.8-5.5). Mean corpuscular volume Mcv83.6 (83-101). Mean corpuscular haemaglobin 28 (27-32) mean corpuscular Hb conc 335 (310-350). platelet count 228 (150-400). white blood count 4.8 (4-11) Differential white cell count : lymphocyte count. 1.6 (1-3). monocyte count 0.42 (0.2-1). neutrophil count 2.46(2-7). eosinophil count 0.28 (0.02-0.5). basophil count 0.04 (0-0.1) erythrocyte sedimentation rate 2mm/hr (2-15). vit b12 +folate serum vit b12 320 ng/l (197-771). serum folate 6.6 ug/l (3.9-26.8). Bone Profile. : serum calcium. 2.27 (2.15-2.55). serum adjusted calcium conc . 2.28mmol (2.2-2.6). serum inorganic phosphate 0.79mmol (0.8-1.5) serum alkaline phosphatase 94u/l (30-130). serum albulmin 46g/l (35-50). Electolyte Profile :serum sodium 143 mmol 133-146). serum potassium 4.2 mmol (3.5-5.3). serum chloride 103 mmol (95-108) serum urea level 6.7 mmol (2.5-7.8). serum creatine 85 mmol (59-104). vit D 46 mmol. (30-50)mmol/l viy D insufficiency

[clivealive Forum Support]

Hi Andypandy30

Re your brother's Vitamin D "insufficiency"

It has been estimated that between 50-70% of people living in the northern Europe (where daylight length reduces your chances of receiving adequate sunlight in the winter) are deficient in this vitamin by March each year. Symptoms of vitamin D deficiency include chronic pain, weak bones, frequent infections (recent research has detected an association between vitamin D deficiency and severe pneumonia), depression and fatigue.

Supplementation may be beneficial.

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

I wish you and your brother well.

[Andypandy30 in reply to clivealive]

Thank you Clive yes I have vit d deficiency also x

[Gambit62 Administrator]

Unfortunately it is very difficult to know what is really going on with B12 from a single reading, particularly when the reading is well into the normal range. If your bother has had B12 measured in the past and the result this time is significantly lower (20%+) that would indicate a problem with B12 absorption.

Omeprazole is a potential cause of B12 deficiency. So is H pylori infection.

Other points for to contemplate - 25% of people with B12 deficiency don't present with any signs of of macrocytosis so absence doesn't rule out B12 deficiency. 25% of people who are B12 deficient present with serum B12 levels in normal range - though most of these will be towards the bottom of the range.

Further tests to clarify would be Homocysteine and MMA levels.

On the whole though it would probably be better to look at treating the vitamin D deficiency first and then see if the symptoms continue.

[Andypandy30 in reply to Gambit62]

I have pa myself gambit and vit d deficiency. I agree he should be treated for the vit d as the symptoms overlap and see how he is then . However his b12 result is the same as a year ago . No less no more . As the folate is low I wondered does that affect how he is absorbing b12 . Folate was a similar result a year ago . Low folate also gives the same overlapping symptoms as low vit d and low b12 . He has asked for intrinsic factor but they have not dibs this test again and now he is going to have to get that done again before his op . So aside from the family history he has also been wide open to deficiency due to the omeorazole and the helicobactor pyloris

[Gambit62 Administrator in reply to Andypandy30]

folate doesn't affect absorption of B12 - problems with B12 absorption can also affect folate absorption and not having enough folate will mean that some processes in cells don't run and this includes some of the processes that also require B12.

Folate is much more responsive to dietary intake and the test is more sensitive meaning that there is less likely that you will be deficient in the normal range.

If his levels haven't changed in the last year its unlikely that he has a B12 absorption problem - as an absorption problem would result in reducing levels of B12.