Levels and reference

[Mx143]

Doctor didn't think anything wrong

Serum B12 185ng/l range >203ng/l

Serum folate 15.6.ug/l range >4.0 ugl

Any ideas on this welcome

[Nackapan]

Have you symptoms? B12 clearly low

[Mx143 in reply to Nackapan]

Yes but doctor wasn't convinced she didn't understand why I was feeling tired. Going for blood test tomorrow but did tell her I was taking b12 oral but she said it shouldn't affect the outcome mmm

[Nackapan in reply to Mx143]

Oh dear. I assume she did full bloods ect. Let us know how you get on. Your symptoms should be treated.

[Gambit62 Administrator]

The results above show that you are B12 deficient as they are below the range so really unclear why your GP is confused if you are showing signs of B12 deficiency.

If their confusion is because your blood work doesn't show any signs of macrocytic anaemia (larger rounder red blood cells) then you need to point out that macrocytosis/macrocytic anaemia is a symptom of B12 deficiency and isn't present in something like 25% of people who first present with B12 deficiency.

You may also have an iron deficiency which causes microcytic anaemia (smaller red blood cells) and the two can mask each other - this would probably show up as the RDW (red blood cell distribution width) being over range.

PA is an historic misnomer - it was first observed as a type of anaemia where the patients then went on to develop neurological and other symptoms and eventually died - this was a few hundred years before the discovery of B12. PA is actually an auto-immune disorder in the gut where your body attacks and destroys the mechanism that allows you to absorb the majority of your B12 from your food, and also re-absorb B12 from stores in your liver. If this mechanism is broken you go on to develop a B12 deficiency. B12 is used in your cells to facilitate a number of processes including those that create new red blood cells, those that maintain the sheathing around your nerve cells, those that reset neurotransmitters and the ones that recycle homocysteine and MMA into useful building blocks.

Unless you are a vegan your GP should be starting you on B12 shots. If you are a vegan then the deficiency may be dietary and could be treated with 50mcg tablets for a couple of months to replace your liver stores.

[Mx143 in reply to Gambit62]

Thanks for reply, she wants another blood test and seemed puzzled why I was tired all the time tried to say was it in my mind.. Bizzare. So I have another appointment with a different doctor next week.

[Gambit62 Administrator in reply to Mx143]

hope the second GP is a bit more clued up.

[Mx143 in reply to Gambit62]

Not a vegan