Need some help understand my test res... - Pernicious Anaemi...

Pernicious Anaemia Society
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Need some help understand my test results

First try at this.

So this is my current lab work. Total bilirubin went down to 14. In November it was 18

ALT is 31 but was 30 in November and my TSH WAS 1.01 in November.

Vitamin b12 was 334 in November not tested again yet

I believe anemia test was within range figures

Any ideas suggestions. Sorry I’m so new to all this and very scared. I suffer from anxiety as I was a soldier and served in Afghanistan.

Thank you kindly.

17 Replies

All those results are totally normal.


Hi Runnerlove

I wouldn't necessarily concur with the previous comment.

In fact I would post those thyroid results in the Thyroid UK forum:

FT4 and FT3 needs to be towards the top of its range. Yours is not. It's possible you have a sub clinical hypothyroidism going on. Doctors tend to look only at TSH and if that is anywhere in range they are happy. Meanwhile you are not. Example of a scenario where TSH could be "normal" is central hypothyroidism . Where the body (the pituitary gland to be precise) cannot produce enough tsh (thyroid stimulating hormone) for it to ever be elevated, despite inadequate levels of ft3 and ft4.

Also, depending on what time of day your test was done and what you had eaten or drunk....this too will have impacted the accuracy of the test results.

B12 doesn't sound great if that's a total serum number. Not below range, but far from optimal.

Also check folate, vit d and iron. Do you have numbers (and ranges for those?)

All in all I'd say you need more tests.

But defo post those results in the Thyroid UK forum. Think that's an area you probably need to explore.

Don't be scared. I can't imagine what Afghanistan would have been like....but there is nothing here to be scared of. Just, potentially a few things you could get to better levels that will have you feeling better. Anxiety can be a direct result of some deficiencies so it's important for you to look after your levels.

Do you have any other blood results?


Thank you so so much. I feel like I’m searching for a needle in haystack. I guess I should have taken a class in biochemistry of the body lol.

Your information is excellent I very much appreciate your time in writing to me. 🙏🙏🙏

I do have ferritin levels initially at 156 in November and now it’s 206. No vitamin d though. I’m going to ask for it tomorrow.

I agree with you completely I think because I’m within ranged the dr also thinks there is nothing wrong but I think you are correct I’m just sub at clinical levels. My dr only checked TSH and it wasn’t till I read somewhere you need to check Free T4,3 that I went to a walk in clinic and requested it. Because my liver is barely surviving I decided I would first start with a liver complex to help cleanse and support the liver. Once my levels have renewed I was thinking of doing the b12 and bcomplex supplements. But I had no idea about levo so I’m going to have to ask about it.

Thank you again. I will get more labs done and follow your advice. I will also post the updated labs to that other site you mentioned.

Have a great week!! THANK YOU!!!


Gosh you're welcome!

Ask surgery for a print out of all recent blood tests WITH units and ranges. (Don't let them fob you off its your legal right and they cannot charge you a fee). Am looking at that ferritin number and thinking it's edging too high (could be related to your liver problems) but without units and ranges can't say for sure. Plus I know more about low ferritin than high as am deficient . But over range is not good either.

Over in the thyroid forum there are a couple of admins who are especially good with vitamin & mineral levels.

Definitely get some advice over there on your thyroid stuff plus other bloods and obviously here too.

Take care of yourself :)

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The ferritin range is 15-247. In November it was 156 and April it was 206 and now I realize dr had not checked it.

I cannot believe we have to tell dr what tests to run. My goodness who are the ones that spent years in bed school. ?? Lol

Thanks again. I’ll definitely follow up on the other site. I’ve started liver clense and support complex to get my liver back to healthy levels again. I’ll do all lab work again to see how things are going and then start getting my body all the vitamins it needs.

Do you know if a test that checks all vitamins?


Look up Well Woman (or Well Man) Ultravit kit on medichecks. They also do a thyroid one. For thyroid it might be a good idea to get the kit that includes a test for thyroid antibodies.

And yes...having educated myself it now astounds me when I look back at the lack of knowledge and care I've been subject to at the hands of numerous "professionals" over the years. It's quite literally gobsmacking isn't it? The best part is their reaction when they realise you know your onions and call them out on their BS. Fortunately I have now found a very patient, open and progressive GP who talks to me as an equal rather than a subordinate to be rushed out the door as quickly as possible (which is how I find a lot of doctors and consultants talk to you). It's refreshing not to be treated like a moron , lol! Should be a given though!

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In the UK, people who are symptomatic for B12 deficiency are supposed to be treated even if B12 is within range. I've assumed you're in UK. I had multiple typical symptoms of B12 deficiency with B12 results between 300 - 500ng/L, within normal range in UK.

Link about " What to do next" if B12 deficiency is suspected.

What sort of symptoms do you have? Any neurological symptoms?

B12 Deficiency Symptoms


Risk Factors for PA and B12 Deficiency


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.

Letters to GPs about B12 deficiency

Point 5 is about being symptomatic for B12 deficiency with an in range B12 result.

UK B12 websites

PAS (Pernicious Anaemia Society)

Based in Wales, UK. Offers support and info about PA.


PAS tel no +44 (0)1656 769717 answerphone

PAS support groups in UK


B12 Deficiency Info website

USA B12 website

UK B12 Blogs

May be stories on these that are relevant to you.

Martyn Hooper's blog about PA

B12 Deficiency Info blog

Blood tests

Have you had recent tests for folate, ferritin or other iron tests, full blood count?

B12 and Mental Health

I am not medically trained.

I hope you find the info and answers you need. There are lots of helpful, kind people on here if you have other questions.

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Waow. Impressive amounts of info you have. Thank you so so much for taking time to respond and share with me.

Im in Canadá actually. And my doctor failed to connect my symptoms to my lab results and offcourse I blindly trusted him.

I had a barrage of neurological symptoms, motor problems, fatigue, enlarged glands, bed ridden for months and unable to go out socialize, or to school. Haven’t driven in a year. I’m super sensitive to most things that’s why I don’t drink or take meds unless I truly have to. I workout almost everyday and been an athlete all my life. So to not be able to move has been mentally and physically the toughest thing I’ve ever had to go through.

Im going to read through the links and print out info and walk into his office demanding b12 shots. You’d think if he had practiced over 30 years he would know about the symptoms. Grrrr. It’s hard because we do not hav enough dr in Canada so we are at the mercy of whoever we get. But gaining knowledge from others like you and this site is extremely valuable. So thank you very much for sharing with me and others alike.


Hi again,

PAS are based in Wales, UK but have members around world (link in my post above).May be worth joining and talking to them if you think PA (Pernicious Anaemia) is a possibility.

Might be worth putting Canada in title on next post as this would catch attention of other Canadian forum members.

B12 deficiency can lead to permanent neuro damage if not treated adequately, including spinal problems (sub acute combined degeneration of the spinal cord).

Good luck with getting help you need.

I gave my GPs a copy of Martyn Hooper's book ""What You Need to Know About Pernicious Anaemia and B12 Deficiency".

There is a section on PAS website for health professionals. Although you are not in UK, may be some info of interest to your doctors.



I would suggest you also have Thyroid anti-bodies tested - TPO and Tg. If negative then this could rule out Hashimotos. If positive then it may account for raised Ferritin as your thyroid may be inflamed ...Hashimotos is the most common auto-immune condition globally.


Thank you for this tid of info!! I will most certainly get this checked tomorrow when I go in to dr.

I have noticed that my bilirubin has gone down from 18 where the max range was 17. Now it’s at 14. And my liver enzyme at 31 with a max range of 36.

I did notice ferritin go from 156 in November and at 206 in april. I did have swollen lymph nodes in neck and besides breast. But I thought ferritin was an indication of iron?? Not thyroid. Maybe I read this wrong. but I now realized that I have not had this tested again. My goodness. So many holes in my labs there is no order to my dr tests you’d think they run all tests all the times so you can compare. I guess this is not a common logic.


Yes Ferritin is stored iron - a type of protein - but can be raised when there is inflammation from any cause. I have read that Ferritin is raised with an inflamed thyroid as in Hashimotos. Happened to my husband ... once treated it reduced. Halfway in the range is often quoted as being a good place to be 😊

Hope you soon find answers ...

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Ok. Thanks for your info. I know I had inflamed lymph nodes in my breast area. And my neck too. I had a bit of whiplash from a fall I had before all the symptoms begun. I wonder if this is what caused everything. That and me doing very heavy 3 hour gym workout heavy weights for the past 4-5 months.

Does the Hashimoto test discern a positive due to true immune issue vs injury inflamed?

Thanks again


If TPO and Tg anti-bodies are over range then that will confirm Hashimotos - yes an auto-immune issue 😴

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Thanks marz. Just had the test yesterday awaiting answers. But I did notice my b12 levels have gone up. Originally 332 in November and now 423 in July. This is only due to diet as I had not been taking any medication because I had not linked b12 dedicó quite yet.

Im hoping this means that if my body still producing b12 that it rules out PA.

Since I’ve now been tested I started b12 sublingual methyl and waiting for shots starting next week with my naturopath because my dr is not helping.

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Hi marz my TPO came back and and I scored 8. Were range is <35. So I assume negative on Hashimoto


Homocysteine 6. We’re range is <15

I know I’m super sensitive to all things as my body is so tuned. I react to things most wouldn’t which drives me nuts. But I guess that’s a good thing. Like an early warning system. Hehe


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