Understanding Test Results?

[Fierybiscuits]

Hi all,

I’m hoping somebody can help me make sense of my recent blood test results. I was told I had abnormally low B12 following a blood test about 2 years ago (it turns out I’d been tested a year earlier and had equally low levels but nobody picked up on it), so I was put on 6 weeks of loading doses. I was then tested for PA, which came back negative and treatment was stopped completely following the loading doses.

I’ve since had a couple more blood tests which showed my B12 levels have increased to within the ‘normal’ range, but now my doctor is saying my iron is low and that I should consider taking some over the counter supplements. Thus I’ve recently signed up to Patient Access and viewed all these results, but now I’m even more confused:

Serum B12 (normal range 200-900pg/mL) –

284pg/mL most recently

243ng/L in 2018

110ng/L in 2017 (before loading doses)

100ng/L in 2016

Serum Folate (normal range 3-12ng/mL) –

4.2ng/mL most recently

3.4ug/L in 2018

4.6ug/L in 2017

8.4ug/L in 2016

Serum Ferritin (normal range 10-120ng/mL) –

25ng/mL most recently

36ug/L in 2017

For a start, I’m still a bit mystified as to the underlying reason for my original low B12, and why that seems to have since recovered. Obviously I did receive the loading doses, but haven’t had any other treatment for nearly 2 years (with no other changes to my lifestyle/medication). I’ve never been vegan/veggie and have been tested for coeliac etc. (which was negative) so I’d always got it in my mind that the cause must be PA (despite my negative result), but if that were the case then surely my levels would have returned to ‘low’ by now. But they haven’t. However, my folate level seems to have halved in the last 3 years. I haven’t taken any supplements or any other private treatment as I didn’t want to skew any blood tests in the meantime, and now it’s been 2 years and I’ve had these results back I’m left wondering if I was just making a fuss about nothing or if it’s something I should still be concerned about?

And as for iron - I’m still technically within normal range for this but my doctor told me I ought to take some over the counter supplements as they’re cheaper than a prescription. It seems I’m now at the low end for all 3 of the above so, before I take a trip to the pharmacist, I just thought I’d see if anyone could offer some advice on possible supplements. There’s so many out there, and all with differing amounts/prices/other vitamins added etc. and I have no idea where to start. Oh, and I’m still tired and ‘foggy’ all the time, which was the reason for all the blood tests in the first place, so I really want to give something a try and see if it helps.

Many thanks in advance.

[Nackapan]

I would book a doctor's appointment as this is awful to be left like this.

As you say so many over the counter iron supplements. Also once on them you should be reviewed and have a blood test.

Before the appointment consider your options. Ferrous fumarate 210mg is £6.66apeox. For 3 Months supply. Solgar gentle iron 30mg spartane ect ect .

I think you need more specific instructions.

I was really ill on a reading of b12 similar to yours106 b12

Usually b12 is addressed first then folate. Ferritin levels although in range are better higher 40-70 I've been told by a doctor to stay symptoms free.

Write down your symptoms. Read up on symptoms for each thing. (Some will overlap)

Go back and agree a treatment plan and review date.

That is only my personal opinion.

So many times I've left the surgery with basically lik you. .

Well do what you want.

Not any more.

Hope you get on okay and get your treatment plan sorted with a doctor.

[fbirder]

Go back to the doctor and say you want proper treatment for a B12 deficiency. That means injections for life if there is no obvious cause for being deficiency. You have no obvious cause. You need injections every two to three months.

Print out this - onlinelibrary.wiley.com/doi... and send a copy to your GP with a note saying that you weant proper treatment as described on page 501

1 Patients suspected of having pernicious anaemia should be tested for IFAB. Patients found to be positive should have lifelong therapy with cobalamin (Grade 1A).

2 Patients negative for IFAB, with no other causes of deficiency, may still have pernicious anaemia and should be treated as anti-IFAB-negative pernicious anaemia. Lifelong therapy should be continued in the presence of an objective clinical response (Grade 2A).

[Emmapemma]

Generally when doctors talk about low iron levels they don't talk about ferritin but hemoglobin (Hb), is that low by any chance?

Hope you get your treatment sorted!