Looking for advice onB12, folate, ferritin and heamoglobin levels? Are my levels below deficient?

[Rachel000]

I just joined this forum on HU to try and find the levels for the below tests to find out when my gp should treat with B12 injections and if I have a deficiency.

I am feeling pretty frustrated, I know something is going on and not right and just want to figure out what’s going on to feel better.

I have been feeling terrible lately well for quite a few months more so but over the last few years. I am exhausted, eye twitching, pins and needles and the worst the foggy head. I was off work for two weeks went back this week and almost fell asleep at my desk yesterday really considering being off again.

Last week I had my bloods done again waiting on results but below is my blood results from last August and I raised back then PA and they brushed past it and said I was fine. I think last year I should have had treatment.

Would really appreciate your thoughts on the below levels and if I should go in and ask for b12 injections?

Haemoglobin estimation - 114g/l (slightly under)

Haematocrit 0.35 l/l (slightly under)

Mean corpusc haemoglobin 26.5 pg (slightly under)

Red blood cell dist 19.2 (over)

Serum ferritin 14 ug/l

Serum b12 207 ng/l

Serum folate 2.9 ug/l

Note: edited by admin

[clivealive Forum Support]

Hi Rachel000 with the above test results was there not a column to the right of them which showed <From ----- To> ranges?

Off the top of my head I would say that last August you were definitely Folate deficient and maybe B12 Deficient or at least at the bottom of the range. Have you been supplementing with either since then?

You may or may not have Pernicious Anaemia as P.A. is but one of many causes of Vitamin B12/Folate deficiencies. But get your recent test results to hand and come back if your doctor brushes you off again and then come back here where there are lots of knowledgeable people who can advise you.

You are entitled to have a copy of your blood test results - the surgery may wish to charge (a reasonable amount) but it is your right to have them.

I am not a medically trained person and I wish you well.

[buster_uk]

Ferritin is very low too. (iron stores)

[Gambit62 Administrator]

Rachel1000, please note that this forum is sponsored by the PAS but being a member of this forum is very different from being a member of the PAS - I am going to edit your post to reflect this.

The high RDW suggest that you may have a mixture of macrocytic (symptom of B12/folate deficiency) and microcytic (symptom of iron deficiency) anaemias going on.

[fbirder]

A high RDW on its own can't differentiate as it can occur with macrocytic anaemia, microcytic anaemia and a combination of the two. It needs to be interpreted alongside the size of the red cells (the MCV). It's only when you have a normal MCV with a raised RDW that one should think about anaemia - of both types.

From your results, I wouldn't be surprised if the latter were the case.

[Cherylclaire Forum Support]

Ranges differ between laboratories so a bit of a postcode lottery.

According to the lab my medical centre uses :

B12 deficiency would be below range starting at 197 ng/L (take note of units of measurement used here) - this one particularly variable from area to area.

Folate range: 4.6 - 18.7 ug/L

Ferritin range: 13- 150 ug/L

Sorry, don't have details for the rest.

This would make you clearly deficient in folate, and very low range/ possible borderline in range for B12 and ferritin. I think it unlikely that folate range would start at significantly lower reading for you NOT to be described as deficient.

[Rachel000]

Thanks for all your messages I was just sent home from work because I am so drained and exhausted.

It could be work burn out because the level of work has been intense for many months but I feel something else is going on possibly because of my levels above.

My bloods are back and I have asked my gp to give me a print out because I can’t get in for an appointment for another 2 weeks. I kinda hope it’s the same or lower just so they will listen to me and I can get something sorted!

clivealive

Cherylclaire fbirder Gambit62 buster_uk

[Tnhundley]

Those B12 levels are incredibly low. Symptoms can start anywhere under 500. If you are not a vegan or vegetarian, you should look into a lack of absorption with Pernicious Anemia and investigate shots. At the very least you should be on a sublingual.

b12deficiency.info/signs-an...

[fbirder in reply to Tnhundley]

No, they are not 'incredibly' low. They are probably borderline.

207 ng/mL is 153 pmol/L. If Rachel had been tested in Hull and East Yorks NHS trust then her value would put her just above their borderline range (115 to 150 pmol/L). Their range was set so that only 13% of people without a deficiency would be intermediate or low. hey.nhs.uk/wp/wp-content/up...

That's the problem with the serum B12 test. It has too many false positives. Already HEY are labelling 13% of all patients tested as potentially deficient. If they raised their limits even more then almost everybody would be labelled as possibly deficient.

Rachel might be referred for further testing (MMA, hCys and/or holoTC). HEY would, however, treat her for a folate deficiency.