my b12 is 266.9 ... is it considered normal ?? ... by the way my MCV is normal ...

[anas_pipo]

as far as i can go back ... i've always had a low concentration and very bad memory and very very skinny, low energy, cold hands and feet ... since i was a kid ... but my parents being uneducated they just thought that i was born that way and that wasn't a medical condition that can and need to be treated ... it wasn't that severe back then ... but it's just got worst by time ... i knew i wasn't normal ... but i didn't know what exactly i had or what to do ... all doctors said i was fine ... so since then i just chose to adapt ... but since a few years ago ... i've reach my limits ... i can no longer adapt anymore ... it's hard for me to live as an andividual ... my life became really hard

[Ken-ard20]

Have you had thyroid tested.I had over active years ago had operation now under active my body always hot now under active.

I emphasise with parent bit similar to mine.

[Gambit62 Administrator]

anas_pipo, do you have the units and reference ranges for the B12 test - there are two units of measurement so ranges are a bit different for the two.

It is possible to be deficient at the level you report, and 20% of people presenting with a B12 deficiency do not have macrocytosis but the symptoms you describe also overlap with a number of other conditions - including thyroid conditions, iron deficiency and folate deficiency.

If you had an early B12 test that showed significantly higher levels of B12 then that could support an absorption problem.

[anas_pipo in reply to Gambit62]

it's 266.9 pg / ml ... the range in my test is 180-914 ... so it is considered normal .... i do actually eat enough healthy food ... even though my appetite is weak ... but i do not see any reason for a deficiency except if that was because of lack of absorption ... i still think i'm deficient in b12 ...

i have talked to my GP and she said that everything is fine ... i only have Depression ... but it doesn't explain my very bad brain fog that made me struggle even with daily conversation or the coldness i feel in my arms and legs and tiredness and other symptoms that astarted since my childhood ...

at this point i don't know what to do ... should i take mma test? if mma wasn't high ... does it mean 100% i'm not deficient?

[Gambit62 Administrator in reply to anas_pipo]

you can find a list of symptoms here

pernicious-anaemia-society....

It is possible to be deficient at the level you report - serum B12 isn't the best test in the world - can be helpful in diagnosing an absorption problem but won't pick up other metabolic problems and doesn't tell you how B12 is being processed at the cell level

it is extremely difficult to diagnose a B12 absorption problem from a single measure - if you have had previous tests and they are all showing a downward trend - or even two showing a significant drop - more than 20% - that would be suggestive of an absorption problem.

There is a lot more to B12 than just absorbing it from your diet (complex though that process is). it also needs to be transported in your blood to cells where it is needed, transferred to the cells and then used in those cells - and things can go wrong at those points as well.

If you have had something since childhood the that could indicate of a problem after B12 has been absorbed. These problems are genetic and tend to be rare but there are a large number of genes involved in the metabolism of B12 and variants on all of them that can affect how efficiently B12 processes run and could mean that you need much higher levels of serum B12 than you actually have at the moment.

However, the symptoms of B12 deficiency overlap considerably with other conditions - many of which are also quite difficult to diagnose, and some of which would be easy to rule out.

Have you had a full blood panel done? - including thyroid, blood-count, full vitamin spectrum, liver and kidney function. This would pick up obvious avenues to explore. At the moment B12 isn't an obvious avenue.

If the tests don't show an obvious avenue then your GP might be persuaded to dig a little deeper into tests that might clarify things where results look potentially unusual - which for B12 would be MMA and homocysteine (if folate levels are okay). But testing does cost money.