anaemia

[bowler]

I had 3 heart stents done a year ago, I am now on a blood thinner, my blood test is

Serum Ferritin 10.86

B12 247 [ within range ]

platelets 114

My GP has put me on Iron tablets, but I'm wondering if I need some B12 even though I am in range,

[Foggyme Administrator]

Hi bowler.

There are some instances where B12 replacement therapy (oral or injections) has to be undertaken with caution, and following heart surgery and / or the insertion of stents is one of those occasions.

With caution means that those who have confirmed B12 deficiency should receive sufficient B12 to address the symptoms of deficiency (because B12 deficiency must be treated), and no more B12 than is necessary to do that. So, a careful 'balancing' act is required.

Here's a couple of links to further information about B12 replacement therapy and the potential risks following heart surgery or stent placements:

ncbi.nlm.nih.gov/pubmed/152...

webmd.com/heart-disease/new...

This is one occasion where I would strongly advise not to self treat with vitamin B12 supplements (oral or injectable) since it may well do more harm than good (especially if a B12 deficiency is not proven - though I say that with hesitation given the difficulties of 'proving' B12 deficiency).

Your current symptoms may be due to the already proven iron deficiency anaemia so you may well find that your symptoms resolve once the iron deficiency anaemia has been sufficiently addressed (usually about three months for full recover though things may well improve gradually during that period).

Most certainly, I don't think you should take any form of vitamin B12 unless or until you have discussed this with a doctor - preferably one who is knowledgable about B12 deficiency, it's treatment, and the circumstances where this has to be undertaken with caution.

You may well find yourself in the position where you have to educate your GP about these issues since even those who are 'B12 deficiency informed' may not be aware of the need to treat with caution in cases like yours.

Good luck and I hope treating the iron deficiency anaemia does the trick for you.

👍

[bowler in reply to Foggyme]

Thank you Foggyme for your excellent advice and links. I don't want to cause more harm than good, I know that blood thinners can cause anaemia and low platelets which I have.

I was at a lower B12 several years ago and did take Solgar sublingual tablets which did raise my B12 way up in the 1000s at that time my B12 was 200, so maybe I'm susceptible to lower end B12

Thank you bowler

[Foggyme Administrator in reply to bowler]

No problem bowler 🙂.

If problems persists, a good way to clarify the existence of B12 deficiency is with an MMA test (homocysteine testing is more to do with folate). Many GP's either haven't heard of the MMA test, or don't have access to it.

It is available at larger teaching hospitals and I think in your case (especially with your previous bout of lower end B12) then it would be worth suggesting (insisting nicely 😉) that your GP arrange for you to have test (because if your MMA is raised and other potential causes for this ruled out (kidney or liver problems), then the cause is B12 deficiency, which would obviously need treating.

Another thing to consider is wether you are taking any medication that impede the absorption of vitamin B12 (for instance, PPI's, antacids, metformin etc.). If you do take mediations that impede the absorption of B12, it may be possible to change to alternatives that do not have that effect.

Good luck 👍

[bowler in reply to Foggyme]

It's a problem to get some Dr's to listen, especially as our small village surgery is run by Locum's and also a problem seeing the same Dr., I don't see my Cardiologist for another 4 months, he prescribed the blood thinner, but did say "any problems see my GP," I don't take any PPIs

Sorry I should have told you that I have just been changed over from one blood thinner to another, the first one made my gums and nose bleed, so that didn't help [ no bleeding now ] so hopefully this new one helps with the low blood results. I also have stage 3 kidney disease, so I must take all this into consideration when self treating ie, B12.

The Dr's always say re my B12 "that I'm within the limits,"

I will mention a MMA test, but probably the Locums haven't even heard of it !!!

bowler

[Marz]

Reading your other posts it seems you have had so much to cope with - do hope you have lots of good days too.

With kidney and adrenal issues in addition to your heart - I am hoping your thyroid has been correctly tested to include a T3 test.

When Ferritin is that low - along with low B12 & VitD it can affect the conversion of the storage thyroid hormone T4 into the Active hormone T3 - needed in every cell of the body. The T3 test is the most important test and yet rarely done in the NHS. Low T3 affects the muscles including the heart.

I am not a medic - just someone with a B12 issue caused by surgery and a thyroid problem - Hashimotos - and Crohns.

[bowler in reply to Marz]

Yes I do have a lot going on re my health, but didn't want to "overload" you all again with it as it can sometimes confuse, I also have a leaky mitral valve, it's a watch and wait with that, I'm under Papworth hospital, so hopefully in good hands

My vitamin D is fine, and thyroid test was ok,

Thank you for your reply

bowler

[Marz in reply to bowler]

I have lived in an ex-pat - mostly retired - community since 2004. I was diagnosed with a thyroid problem in 2005 having gone to the GP with a funny heartbeat ! All is now well. I was aware that so many people had heart issues and bit the bullet and bought the book on Amazon - Thyroid and Heart Failure. All research papers from around the world when Endocrinology and Cardiology came together for the first time for the purposes of research. You can read the Contents on-line and see that liothyronine (T3) is the star of the show !

I do hope you saw the actual results and did not have to rely on someone telling you your results for the Thyroid were OK. TSH is good around 2.5 - FT4 and FT3 are good for most people in the upper part of the range - and then of course the anti-body testing for TPO and Tg rules out Hashimotos ( the most common cause of Low Thyroid globally ) So often just the TSH is tested - a Pituitary hormone ! VitD good around 100+

I really do not wish to add to add your issues - but sometimes optimal thyroid hormones can be the missing link and can support many conditions ... You can click onto my username and have a quick read of my Bio - only takes a couple of minutes ! Wishing you well ....