B12 Test Results

[Theopop]

Hi guys, I was wondering if you could look at these results for me and advise.

I originally had a full blood count and B12 checked at the beginning of the year.

Original test done in March:

*Serum vitamin B12 level 205 ng/L [211.0 - 911.0]

*Serum folate level - Red blood cell folate level 12.1 ug/L [> 4.0]

.

Thyroid function test - Serum TSH level 1.9 mU/L [0.35 - 5.5]

Serum ferritin level 64 ug/L [10.0 - 291.0]

Serum iron level 29.1 umol/L [9.0 - 30.0]

Serum transferrin level 2.65 g/L [2.5 - 3.8]

Percentage iron saturation 44 % [15.0 - 45.0]

Immunoglobulin E level 16.5 ku/L [< 114.0]

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Due to the low B12 level I had injections once a month for 3 months and then just one 3 months later and then a test. These are the results of the test in August:

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*Serum vitamin B12 level 272 ng/L [211.0 - 911.0]

*Serum folate level - Red blood cell folate level 12.5 ug/L [> 4.0]

.

After the injections my B12 has risen from 205 to 272 in 6 months.

It says the results are now normal and no further action is to be taken.

However, from what I read online that result is still quite low. Can anybody advise what I do now? Should I try supplements to raise it? Should I be tested again in future?

Thanks

[Gambit62 Administrator]

Your levels have not risen from 205 to 272 it has fallen from off the measurable scale after the last loading dose to 272 when you had the blood test.

Serum B12 can be a useful test for diagnosing an absorption problem but it is not a test that can be used to manage B12 treatment - if your symptoms had come back that was because your B12 levels had fallen below where you needed them to be (and on average people need higher levels after receiving loading shots - though there is a huge amount of variation and for some people post loading levels need to be off the scale - but others are still okay in the normal range.

It would help to know which country you are based in as treatment protocols vary.

Is your GP trying to manage your B12 levels using serum B12?

[Theopop in reply to Gambit62]

Ahh, I think I understand. It's dropped back to that in the 3 months since the last dose? Thanks for the response. I'm in England.

I'm not sure what they are trying to do. We have an online system here for results. I checked online and it just said the new result and 'no further action required'.

Does that seem like quite a normal level then or should I be worried.

[Gambit62 Administrator in reply to Theopop]

the question is are you symptomatic - if yes then you need injections more frequently (though getting it may be a problem).

Normal - no action required - is probably a general comment from the lab and is guidance only - and the lab probably wasn't aware this was a retest - which changes the significance of the results dramatically.

You will need regular injections for life and that is what is in the national guidelines - if your GP is still trying to use serum B12 to manage the frequency of shots you need to go back and point them at the national guidelines which they can find on NICE or through the BNF (BCSH guidelines for diagnosis and treatment of cobalamin and folate disorders).

BCSH guidelines can also be accessed here

onlinelibrary.wiley.com/doi...

These make it clear treatment is for life and not to be based on serum B12 levels