Would this indicate B12 deficiency?

[RUBYT1976]

In January I had a complete blood count and:-

MCV 108.1fl (80-96)

MCH 34.9 pg (27-32)

This blood count was taken due to being diagnosed with Hashimotos and my Endocrinologist suggested B12 injections, I was presenting symptoms, tingling, sore mouth and tongue, fatigue as he believed this to be the cause as common in Hashimotos but didn't give me a B12 test. I took my first shot and then stupidly thought I would get my B12 tested specifically but obviously the results were skewed due to have a B12 shot two days previously.

Anyway, I now have no way of knowing my my starting B12 levels were and any test would now be skewed. I was prescribed 2 weeks of loading doses then told one monthly or every two months dependent on symptoms. However, I am finding that my symptoms start returning 10 days post shot at the moment.

Can somebody please look at my MCV and MCH and tell me what they think? I am living in the Middle East and they seem to be much more aware of issues caused by low Vitamin B12 levels here for some reason so don't know if that is why he didn't send me for a specific B12 test.

[RUBYT1976]

PS - I suspect that that I have might have PA hence why I am posting in this forum.

[Ritchie1268 in reply to RUBYT1976]

Hi RUBYT1976

Below was mine when tested.

MCV 115.9

Range 83.0 - 100.00

MCH 38.1

Range 27.00 - 32.00

Red blood count 3.65

Range 4.50 - 5.5010

As Clive has said it does show Macrocytic Anemia as mine did.

I don't know what my Folate level was but Dr said I had B12 deficiency, Folate deficiency & Pernicious Anemia.

[clivealive Forum Support]

Hi RUBYT1976 Hich MCH & MCV

Causes of high MCH levels. High MCH scores are commonly a sign of macrocytic anemia. This condition occurs when the blood cells are too big, which can be a result of not having enough vitamin B12 or folic acid in the body.

The MCV is higher than normal when red blood cells are larger than normal. This is called macrocytic anemia. Macrocytic anemia can be caused by: Vitamin B-12 deficiency.

Hence the need for B12 injections.

Having Hshimoto's puts you at an increased risk of developing a B12 deficiency

Was your Folate level tested?

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

I wish you well.

[fbirder]

You have macrocytic anaemia (well, you had macrocytic anaemia). It is almost always caused by low B12 and/or low folate. The fact that B12 injections reduce symptoms strongly suggests that is a cause. But it might be the case that you also had low folate.

I would start taking folic acid tablets (400 mcg a day should be OK) and ask for more frequent injections of B12.

As you say, any B12 testing now would be pointless.

[RUBYT1976 in reply to fbirder]

I had folate tested and my levels were in the middle of the normal range but am still taking it daily to bring levels up a bit. So I think he was right in putting me on B12. I was given loading doses for a fortnight and now know how to self administer which I have no problem doing. i've been advised one injection a month but I am finding that 10 days after the injection the symptoms are coming back. Fortunately where I am living you do not need a prescription for the ampules and they are very cheap, about £3.00 sterling for 5.

From what I understand there would be no danger in increasing the frequency of the injections would there? 10 days seems to be my limit at the moment but I'm prepared to observe symptoms and go longer if symptoms stop returning so quickly.

Also do you think there is any benefit in finding out if this is Pernicious Anaemia or not? Auto immune diseases run in my family (Mother has Rheumatoid Arthritis, Brother - Graves Disease and me, Hashimotos). Also my diet is excellent with lots of foods containing B12 so I can't understand why I would be low apart from an inability to absorb.

I guess the main reason for knowing is that this would not be a temporary thing if test is positive?

[fbirder]

Good news that you can determine the frequency of treatment for yourself. There is no danger from injecting too much B12 (I do it twice a week).

Autoimmune diseases are more common in somebody who already has one, so it's a very good bet that you do have PA. There is no good way to tell if you do or don't, so it's best to assume you do have it. Yes, that means injections for life - but you may be able to lengthen the gap between injections after the first few months - try it and see,

[RUBYT1976 in reply to fbirder]

Thanks for that, much appreciated.