Results help

[Andypandy30]

My sis in laws results . Trying to get to the bottom of her symptoms . She is aware of the low iron and folate but doctor hasn’t treated her for either . She has symptoms of low b12 for a long time but it’s comibg back in range at 358((197-771) and her folate was 4.6(3.9-26.8) where does she go from here please

[Nackapan]

She can speak to the pharmacist to get the right iron dose tof address her low ferriton levels. I've just done that. And in most multivitamin the maintenence dose of 400 ug folic acid is in them. Or bought cheaply on its own. Doctors don't prescribe vits anymore . I ran the first lot by g.p as was there. He said vit D and c and folic acid fine. I was told 200mg was iron maintenence dose. Just hope tolerated as other post taking ferrous sulfate got diarrhoea. There are gentle forms that have been mentioned. Aso for B12 has the B12 supplements been tried yet? Doctors need to be asked direct questions as we know. My ferriton cane back as normal at 39 which is kin range. That is one thing I do know that ideally ferritin leveks should be between about 60 -80. Which mine were only a month ago?? One sign I had was my hair falling out. Or back to gp to say she needs treatment and advise. I wish her well

[Andypandy30 in reply to Nackapan]

Thank u x

[Foggyme Administrator in reply to Nackapan]

Nackapan. Might be a bit of confusion here so, Just for clarification...200mg iron is the dose given to those who have a known iron deficiency...and then only until that deficiency is corrected.

A maintenance dose implies something that is taken all the time...and taking this much iron on a regular basis when no deficiency is present could well be very dangerous.

Andypandy30 here's a reply I've just this moment written about iron...information may be useful to you too.

healthunlocked.com/pasoc/po...

Can't understand why your sister-in-law's GP isn't treating her for iron deficiency anaemia...which is indicated in the blood results above (sorry, no time to discuss individual elements of the results - look at those marked 'LO'.

Suggest she goes back to GP and asks for treatment - usually four months and then a re-test to check levels again (full iron panel as well as ferritin). GP should want to keep an eye on her and then re-asses.

Sorry if this sounds rushed...I'm in a bit of a rush 😉🤨😀.

👍

[Nackapan in reply to Foggyme]

No confusion apart from the way i wrote it perhaps. The 200mg ferrous sulfate is ' prevention'/ maintenence dose minimum if you have a defiency . Pharmacist said so. I thought it as a stop gap as a safe start until proper higher dosage advised by doctor for how long ect. Yes too much iron is dangerous . It takes so long to get seen. It is cheaper than the prescription charge .I know what you mean about the term maintenence but that was the term the pharmacist used . Should be prevention . Anyhow leaflet in box of tablets very clear. Doctor should've addressed it all ....so bad. Sorry if I wasn't clear enough Andypandy30.

[Foggyme Administrator in reply to Nackapan]

Nackapan. Confusion. Yes. I think so. And still.

To be precise and for clarity (because iron can be extremely dangerous) 200mg is a treatment dose...that is, a treatment dose for iron deficiency anaemia.

A prevention or maintenance dose is much much lower (I take 20mg Gentle Iron daily - that is a prevention / maintenance dose - and usually only necessary for those who have a previous proven issue with maintaining iron status (i.e. healthy people do not usually need a maintenance dose of iron).

Sorry if this sounds pedantic but talking of a maintenance dose of 200mg is not correct. And it may be mistaken by some here as being a dose that they can and should take all the time. Which clearly, it isn't 😉😀. As you know 😀.

Sorry you’re having trouble getting to see your GP - hope they manage to squeeze you in soon.

[Andypandy30 in reply to Foggyme]

So when u have time do u think her b12 and folate are ok ? And is there a chance she has an absorption problem ? What test should he do next while she gets her iron levels up

[Andypandy30 in reply to Nackapan]

I understood thks nackapan

[Andypandy30 in reply to Foggyme]

Thks foggy me . He seemed more interested in keeping her off iron for a week to do a test to work out why she was low . An fob test ? I thought this was very wrong to leave her like that with such low iron

[Foggyme Administrator in reply to Andypandy30]

Hi Andypandy.

FOB stands for Faecal Occult Blood. So, her GP will be looking for hidden (occult) blood in her stools - that is blood that doesn't appear red and so can't see it. Sounds as if he's doing the right thing - looking for a potential cause of her anaemia (and occult bleeding from the GI tract is one potential cause). Samples are usually taken over several successive days (three, I think - but could be wrong).

Taking iron can cause a false positive so that will be why he is holding back on the iron tablets until the test has been done. Incidentally, supplementing with vitamin C (or drinking large amounts of fresh orange) can also cause false positives. As can eating red meat three days prior to the test. (Hope he advised her about this 🤔).

Here's more information about the Faecal Occult Blood test:

labtestsonline.org.uk/tests...

Hope all goes well for her...and you to 'cause I expect you're worried too.

👍

[Andypandy30 in reply to Foggyme]

Thank u for that Foggyme

[Plucky1976 in reply to Andypandy30]

Saturation looks awfully low. What would cause that?