Loading doses and Blood Test - Pernicious Anaemi...

Pernicious Anaemia Society
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Loading doses and Blood Test


First of all, a huge thank you to the wise people who have given so much information to me about PA. Thanks to you and a humble enough doctor who admitted she didn't know the NICE guidelines I am now on every other day loading doses and about to have the recommended re-blood test x10 days into my treatment. Can someone tell me what should be tested at this stage? I know my B12 should be sky high, but what else will they be looking for? My B12 was deficient 128 (180-999) and my MCV was high 97.5 (78-97) and my lymphocyte 0.8 (1.10-4) and monocyte count 0.1 (0.2-1.1) were low. Other than these anomalies my other results were well into normal.

Thank you.

12 Replies

Folate? Maybe potassium as that can get depleted as new red cells form.

Thank you. Both were normal in my original test and I am hoping that as they were markers included in our surgery's FBC that they will still be included. I will check.

clivealiveForum Support

Initially, replacing B12 will lead to a huge increase in the production of blood cells and platelets (which occurs in the bone marrow) and can lead to rapid depletion of folate and iron stores

Sorry, I should have added, what is the difference between my folate results and my iron results? Or are they the same?

clivealiveForum Support
in reply to Hambledonia

The test for iron (haemoglobin) is different from Folate (Vitamin B9)

Was your haemoglobin level "well into normal" as you said originally?

Vitamin B12 and/or folic acid deficiency may associated with macrocytic anemia (high MCV numbers). You know that you were B12 deficient

I don't think that testing Folate is automatically included in an F.B.C hence the need to ask your doctor about it. It is possible that you may have to supplement with folic acid.

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

I wish you well


Hi Clive, thank you so much. The difference is very clear now. Looking at my results, my folate was 11 and guidelines say >3 ug/L. And my serum ferritin was 89 (13-150 ug/L. My MCV was high. I will ask for my folate to be tested today as I am having a blood test today.

Maybe I should take folate as a precaution anyway? Although I do eat a diet very rich in green leafy veg/ salad.

Thank you for your great help as always.

clivealiveForum Support
in reply to Hambledonia

I didn't know that you knew your Folate level was 11 - which is fine - and as long as you don't have an absorption problem with vitamins and minerals via your digestion your diet should be sufficient to maintain it. However it would be good to check it out with your doctor and get it included in the test.

Please remember I'm not medically trained

I didn't know either until you prompted me to look again and to see the difference between folate and ferritin, so again, many thanks!

I will ask for my folate to be checked again today to see if it is being depleted. Hopefully that bit of me might be working!

Clivealive sorry to hijack the threàd...is that why my hair has started shedding?

clivealiveForum Support
in reply to pollianna

No problem pollianna

"Since B12 helps produce red blood cells, having enough of this vitamin is essential to the hair growth process. ... Vitamin B12 is essential for overall health, not just hair growth, so a deficiency could cause multiple problems including anemia. With a minor deficiency of B12, there may be no symptoms."


Hi Pollianna, my hair started falling out which is what prompted me to to go to the doctor initially. I have subsequently discovered that I was diagnosed B12 deficient 10 years ago but not prescribed anything. Thanks to this forum and the PA society I am trying to get it all sorted now.

Wow, 10 yrs.Thank Goodness you joined.

My red blood cells were huge over 2 tests and for 6 months. GP said "all normal". Thank God I got them and read them. I have no diagnosis but I know enough to know if my blood cells are too big I need B12.

Its helped me, my body likes it.

Hope it kicks in soon and you feel the benefit

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