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Pernicious Anaemia Society
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Do I have Pernicious Anaemia?

I have mild cognitive impairment, brain fog and dizziness. My memory loss is worrying and so I am trying to find out how I should supplement. I had a gp blood test which showed the following

Serum vit B12 266 ng/L (170 - 730)

" Ferritin 50 ug/L (10 - 290)

" Folate 8.7 ug/L (3 - 19)

" TSH level 3.47 miu/L (0.3 - 5.0)

Haemoglobin estimation 140 g/L

(118 - 158)

Any help Wld b appreciated

10 Replies

Hi mfrie I cannot comment on your TSH level but if you have thyroid problems this may elevate the risk of your developing a Vitamin B12 deficiency.

I assume that your doctor has not suggested any treatment for your "Serum vit B12 266 ng/L (170 - 730) as it would be classed as within "NORMAL" (I hate that word) range.

Symptoms of B12 deficiency tend to develop slowly and may not be recognised immediately. As the condition worsens, common symptoms include:

Weakness and fatigue

Light-headedness and dizziness

Palpitations and rapid heartbeat

Shortness of breath

A sore tongue that has a red, beefy appearance

Nausea or poor appetite

Weight loss


Yellowish tinge to the skin and eyes

If low levels of B12 remain for a long time, the condition also can lead to irreversible damage to nerve cells, which can cause the following symptoms:

Numbness and tingling in the hands and feet

Difficulty walking

Muscle weakness


Memory loss




The British Society for Haematology guidelines say on the Diagnosis of B12 and Folate Deficiency "In the presence of discordance between the test result and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment".


Make a list of your neurological symptoms and present this to your doctor and ask him to treat you according to your symptoms and (perhaps) even start you on loading doses "until there is no further improvement" according to the N.I.C.E guidelines below. Click on the link, then on "Scenario: Management" and scroll down to "Treatment for B12 deficiency"


If possible take someone with you who can validate your neurological symptoms as the doctor is less likely to pooh pooh you in front of a witness.

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 well.


Thanks Clive. When I got these results the gp all but ran me out the door when I referred to B12. He said everything is normal. When I said the B12 was on the lower side of normal, he repeated Normal. I referred to my symptoms and he said Normal. How can u appeal to someone like that? He wldnt engage at all. By the way, I do not have thyroid problems. I only listed the TSH results cause I have them. Wld it do me any good to supplement B12 myself without the evidence of P.A.


Of course you can buy B12 tablets/sprays at pharmacies and health food shops and (as long as you don't have an absorption problem with your digestive system) see if they "do anything" for your symptoms. It is quite safe and you cannot overdose on B12 as any excess is excreted via your urine.

What is your diet like? Do you eat plenty of meat, fish, seafood, eggs, poultry and dairy produce? It's from these foods that we source B12 naturally. Even some non dairy yoghurts and a number of breakfast cereals are now flagging that they contain B12 and then of course there's Marmite :) Yummy!

Are you on any medications that indicate that they may affect B12 absorption.

I wish you well and I'm off to bed now.


Thank you Clive. Sleep well.



I was diagnosed as b12 deficient over four years ago. Along with many other symptoms, for some time I had memory loss and severe speech problems - I couldn’t finish sentences being unable to remember words - and I was an English teacher!

My b12 was very low when I eventually went to the doctor but it might not have been low enough for the several years where the above symptoms were occurring. It was only the further symptoms which made me seek medical help.

Because my b12 was so low I was put on the injection routine for life with injections every 12 weeks.

After four years my articulation is pretty much on a par with the old me and my memory is almost back to where it was hence self supplementation is a good idea. Even though I have injections I take a multivitamin and a 1000mg b12 tablet daily.

A major problem that I have found with my doctor and the practice nurses, is that they assume b12 = PA and that there is not a condition(s) that is simply related to b12 deficiency. But there is and the range of symptoms I have experienced are rare on the PA site but on the b12 deficiency site they are listed.

Getting competent medical support is very difficult and, if you read some of the horror stories on this site, a referral to a so called specialist will take you to places you do not want to go!


With your neurological symptoms you should be on injections every 8 weeks, but try getting that through to your GP or a specialist for that matter.


Hi. Can I suggest that your Tsh level is a little on the high side as well. In some countries you would be diagnosed with thyroid disease when your Tsh level reached 3. In the Uk it’s 10. If possible, ask your Gp for full thyroid tests including Tsh, T4 & T3 & in the meantime have a look at Thyroid uk. They have a wonderful array of information. Please don’t think I’m suggesting you have any form of thyroid disease as I am not medically trained but it’s worth getting information and some knowledge. Good luck


Oh yes, thank u.


B12 can be "overdosed". My spouse tested extremely high in B12 and I believe a simple search on B12 will give you symptoms of overdosing. I think Supplementing in B12 would not hurt you but try to find the most bioavailable form. There are crappy forms that aren't helpful especially for people with mthfr. I agree that you could have an absorption issue so it will be important to get tested again after Supplementing for some length of time. Also, I thought I'd add that I have hashimoto's disease and also suffer from brain fog and memory loss. I saw that someone in the endometriosis page also suffers from it. This makes me wonder what the real culprit is. What makes you think you don't have a thyroid issue? Where I'm at most doctors have no idea how to test for thyroid problems and only test one or two things. Many rely just on TSH alone which should be considered malpractice. Update if you find a solution!


Cheers Samantha. Will do. Thanks very much.


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