Hi Everyone,
I’d really appreciate help with my friend’s daughter’s blood results please. Her main symptoms are being more tired than usual, some breathlessness, and missing periods, or just having a tiny bit of spotting. These symptoms have been going on for about 3 years, she’s 29.
Her GP did some blood tests, which showed low ferritin, but just within the NHS range. This was near the beginning of lockdown etc so he was very rushed. I advised her to ask him to test B12 and folate. His reply was that wasn’t necessary, said her folate has been low before, just eat more green leafy veg! For the B12 he said her MCV was fine (ie not high) so there was no need to test that either. I know from the thyroid forum that MCV isn’t a perfect indicator for B12 deficiency because anaemia can cause low MCV, so the two together can make the MCV look fine.
So I then advised her to take some supplements (B Complex, iron + vitamin C, and D as that was also at an insufficient level) for a few months. She has an iron panel which also showed a low transferrin saturation at only 18%.
She has now had a lot of Medichecks tests done, results just back. She stopped all supplements a week before the test, so no biotin interference. These are the relevant results from 26/6/20:
Active B12 = 31.5 pmol/L (>37.5)
Folate = 1.72 mcg/l (>3.89)
Ferritin = 47.7 mcg/l (13-150)
NHS ferritin in February 2020 was only 27 (10-200)
Vitamin D = 71nmol/l (20-175)
NSH vitamin D in Febuary 2020 was only 53 (50-200)
So ferritin has improved with the iron supplementation but still not optimal. Vitamin D has improved as well, but still not optimal. I was really shocked to see how low her B12 and folate are after 3 months of supplementation. I’ve advised asking for a coeliac test to rule that out, although she doesn’t have any symptoms of it.
Her RBC has fallen slightly from March to June, it’s 4.16 (3.8-5). Am I right in thinking this could well be due to the low folate and B12? Her serum iron has also fallen slightly since March (now 13.13 umol/l, range 5.8-34.5).
There are lots of other results I can provide if relevant.
I have said she needs to ask her GP for testing for pernicious anaemia. What tests do they actually need to do, just so we know they’re doing the right ones? Are there many GP’s who know what an Active B12 test is, I know mine had never heard of it?
Could B12 and folate this low be likely reasons for missing periods/spotting only?
She's a wonderful primary school teacher, she has been working throughout lockdown, so obviously it's vital that she is in the best health possible.
Thanks a lot for any advice.