Help with blood results

[gina76]

Dear fellow members... Newby.. I have been reading you for a month /trying to educate myself/ and I am getting more and more confused. Would someone be so kind to help me read my blood test results. My GP told me my results are fine, even though I was complening from beeing very tired all the time. My symphtoms are tireness, breathlessness, panic attacks, balance problems(as like I am not stablle on my feet), palputations. Initially i started taking the sublingual b12 by nature provides/mixture of methyl and adel/, for a about a month, then self injected 10 injections from the german hydroxy. I am very confused to which kind of b12 to use- hydroxy or methyl, how to inject SC or IM, how often to inject, etc.

And the biggest confusion is - how to actually define what exactly do I have and what tests more to request. After I kept repeating to the GP I am very tired - she told me to buy b 12 over the counter, wait 2 months and than go back they will do another blood test and see how I get on and decide from there.

Forgot to say that it is almost 2 months now from self medicating and I feel a lot better, still have balance problems, hence the reason i was wondering about methylcobalamin, read somewhere that is the type of b 12 japanese use and is for treating nerve issues. Sorry to made the post so long. I would appreciate any help, so i can understand more about this conditions. Thanks to all.

Here is my blood work:

1.Test Undertaken : Vitamin B12 (B1000) Sample Type: SER-GEL [ - 26.05.2020 Vitamin B12 145 ng/L 130-900

Intermediate B12 level, consider treatment if other evidence of deficiency, eg

neuropathy or macrocytosis

2. Test Undertaken : Folate (B1001) Sample Type: SER-GEL [ - 26.05.2020 14:30]

~~~~~~~~~~~~~~~~~

Folate 14.4 ug/L >3.0

3. Test Undertaken : Ferritin (B1002) Sample Type: SER-GEL [ - 26.05.2020 14:26]

~~~~~~~~~~~~~~~~~

Ferritin 16 ug/L 15-300

4.Test Undertaken : Full blood count (B0001) Sample Type: BLD-EDTA [ - 26.05.2020 13:03]

~~~~~~~~~~~~~~~~~

4.1 White blood cell (WBC) count 6.4 x10^9/L 4.0-11.0

4.2 Haemoglobin(Hb) 128 g/L 115-165

4.3. Platelet (PLT) count 264 x10^9/L 150-400

4.4 Red blood cell (RBC) count 4.08 x10^12/L 3.80-5.50

4.5 Haematocrit (Hct) 0.38 L/L 0.37-0.47

4.6. Mean cell volume (MCV) 92 fL 80-100

4.7. Mean cell haemoglobin (MCH) 31.4 pg 27.0-33.0

4.8. Red cell distribution width (RDW) 13.0 % 11.0-14.8

4.9. Neutrophil count 3.8 x10^9/L 1.7-7.5

4.10.Lymphocyte count 1.8 x10^9/L 1.0-4.5

4.11. Monocyte count 0.5 x10^9/L 0.2-0.8

4.12. Eosinophil count 0.2 x10^9/L 0.0-0.4

4.13. Basophil count 0.0 x10^9/L 0.0-0.1

4.14. Nucleated red blood cell (NRBC) count 0.0 x10^9/L

Test Undertaken : HbA1c (IFCC traceable) (B3051) Sample Type: BLD-EDTA [CAV: 4BVAMS2 AMS Results - 26.05.2020 14:12]

~~~~~~~~~~~~~~~~~

HbA1c (IFCC traceable) 39 mmol/mol <48

20 - 41: Non-diabetic range. HbA1c for monitoring: follow NICE and local guidelines.

5. Test Undertaken : Thyroid function test (B3911) Sample Type: SER-GEL [CAV: 4BVAMS2 AMS Results - 26.05.2020 13:52]

TSH 0.76 mU/L 0.30-4.40

Free T4 9.8 pmol/L 9.0-19.1

6. Test Undertaken : Electrolyte Profile (B5373) Sample Type: SER-GEL [CAV: 4BVAMS2 AMS Results - 26.05.2020 13:14]

~~~~~~~~~~~~~~~~~

Sodium 139 mmol/L 133-146

Potassium 4.6 mmol/L 3.5-5.3

Creatinine 63 umol/L 46-92

Estimated GFR 89 ml/min/1.73m2

7. Test Undertaken : C-reactive protein (CRP) (B3023) Sample Type: SER-GEL [CAV: 4BVAMS2 AMS Results - 26.05.2020 13:14]

~~~~~~~~~~~~~~~~~

C-reactive protein (CRP) _ 1 mg/L <5

[Nackapan]

Hello the only thing I can really comment on is your ferritin level. When its below 5o you can get symptoms like being breathless and shaky. I did and so did one of my daughters .so I would read up on low ferritin symptoms and if any fit go back to Gp. They should listen and look at your bloods again. They then hopefully will prescribe iron ot at least tell you what to take. I was told mine were normal as in range but felt alot better with some symptoms when it eventually went up.

Do this with the doctor as your bloods will have to be repeated to monitor it . Too much iron is dangerous.

The amount in a multivit is fine though.(about 14mg) I would stick to Hydroxocobalamin b12 and see if that makes any difference. Some dont get on with methyl. As it can give side effects . Glad your symptoms have improved.

Sorry your doctor wasnt more helpful.

When you say IM or SC injection what have you actually been doing ? Usually the first injection at least is done in the surgery incase of a reaction . Have they not given you any at all?

Also if dietary I.e vegan or not eating enough b12 foods tablets will work. If an absorbtion problem injections are needed. As for tests the intrinsic factor antybody test picks up about 50% of people with PA if positive. If its negative tiu could still have PA .

[gina76 in reply to Nackapan]

Hi, Nackapan,

Thank s so much for reply. I did the injections myself. Watched so videos on -line. Doctors told me they can't do injections, because of Covid. Told me to try pills over the counter. Asked advice on what kind - the answer was - anything will work. Give it a try for 2 months and come back. I am not a vegetarian, do not eat much meat, but eat plenty of diary. I will try with iron tablets, as you suggested. I really appreciate your advice. Now you mention - i used to be shaky, but I was actually thinking this is alongside and part of the panic attacks.

Thanks again for help

[gina76 in reply to gina76]

Forgot to say that the B12 i took for a month was the liquid b 12- 2400 mcg, 10 drops under tongue

[Nackapan in reply to gina76]

Do talk to your doctor about your iron as I said a multivit should be okay but you will need doctors advice on what more to take if needed and a follow up blood test usually 3 months later. I am surprised they have not acted upon tour results.When you have that blood test ask for vit d . Ferritin/iron again. Folate. Added to anything else your doctor wants to keep an eye on .

A telephone consult is possible with tour list of questions

[gina76 in reply to Nackapan]

I was surprised too, especially as I kept repeating that I feel knackered all the time. My first ,,visit,, was also over the telephone and I was told that my results are fine. From what I read from all members here and understood myself is that 145 is very low B12. I mention Japan before, because i was reading about their reference numbers, which even back in 1980 we set as 500. Under 500 they consider it as initial b12 deficiency. Also started to read ,,Could it be 12? ,, book, which also mentions how low lab ref numbers are. But it seems that doctors go by that and do not want to know about how you feel.

Thanks again for help. WIll try to confince for more tests

[Nackapan in reply to gina76]

It should go by your symptoms not just numbers.

The Japanese numbers seem to be a fallacy.

Persevere . T C

[gina76 in reply to Nackapan]

Thank you, makes more sense. Will see what the doctor says about iron. I was actually told by a friend of mine, that goes to the same surgery - that there is only one doctor there that is switched on b12. Will ask for him next time. Many thanks for your time and advice

[fbirder in reply to gina76]

Nope, sorry. That 'Japan use 500 as a lower limit' is an oft-repeated total fantasy.

If they did use 500 as the lower limit then they would have to treat 99.5% of their population as the average is just 340 pmol/L.

This is what the Japanese government say - ncbi.nlm.nih.gov/pmc/articl...

"If serum vitamin B12 levels are <200 pg/mL, vitamin B12 deficiency is very likely. If serum vitamin B12 levels are >300 pg/mL, vitamin B12 deficiency is unlikely."

Unfortunately Pachalok's book repeats this nonsense, but in a confusing manner. In one sentence she says that everybody below 550 pg/mL (99% of the population) should be treated. On the next page she says that people below 450 pg/mL should be treated if they're symptomatic.

Just because you read it on the Interwebs doesn't make it true. This site - clancymedicalgroup.com/vita... complains about how the levels are set too low in the USA. But people are treated if they have levels below 500 (or 550) pg/mL - in Europe!

When they set levels they have a problem. Described in this post - healthunlocked.com/pasoc/po....

If you want a good book, get Martyn Hooper's. I gave a copy to my doctor, safe in the knowledge that almost all of the science is good.

[gina76 in reply to fbirder]

Dear fbirder, thank you so much for your reply and guidence where to read from. I will definately read that book. I read so many contradictive things about B12- levels, best kind to use, etc. But when you are new and it all became very confusing. Many thanks will definately read it.

[FlipperTD]

Scientist's, not medic's response. Always seek guidance from your doctor!

Your blood results only show a low-ish serum B12 and a low ferritin. Neither of these have shown up in your FBC; your Haemoglobin is normal, your MCV is normal, and your RDW is normal so it's not indicating much in the way of change.

Be guided by your doctor's advice on Iron treatment, as it's toxic in excess, and 'too much of a good thing' isn't a good idea at all, because it's stored, whereas excess B12 is eliminated. Good luck; I hope you're feeling better soon, but these things take time.

[gina76 in reply to FlipperTD]

Dear Flipper, thanks for your advice. I actually feel a bit more relaxed after all of you have told me that my results are not bad. I think all these worries of mine are triggered by having anxiety and panic attacks for quite some time. I even thought that my thyroid was not functioning properly, because started to gain weight. Now it seems like i am loosing a bit, after I started B 12. But overall I feel much much better. I appreciate your reply. All the best to you too.

[Midnight_Voice]

The received wisdom is that blood tests for B12 levels can be misleading if you have been having injections, but in your case I will make an exception, since 145 is low by any standards, and if you need injections to get to there, then you need to maintain these at least, and maybe even increase their frequency.

Have you any evidence of macrocytosis? (Maybe one of those other numbers covers this? I wouldn’t know, as IANMT.)

And what about neuropathy? Do your fingers tingle, for instance? And the balance problems could be this also, possibly.

[gina76]

Hi, Midnight

I do not think I explained myself very well. Excuse my english/ it is not my mother tongue/

I actually self-injected, after I had the blood tests done and after they told me they can not give me injections, because of covid and I have to buy supplements myself over the counter.

I am not medically trained either, to be honest I do not know if any of my blood counts show macrocytosis. Going by what other members here have said, my blood results are fine apart from B 12 and iron.

I think that my balance problems are actually neuropathy sympthoms, related to the b 12 deficiency. No tingles in my fingers or pin and needles. But I think the balance actually shows that your nervous system is affected somehow. Thank god - apart from the balance - the rest of the symptoms are a lot better. And even the balance I think is slightly improving, as I am a key worker and work quite a long hours. It seems like I am getting it bad now, only when really tired. The injections seems to be worked. I am injecting now subcutaneously- which is much easier and helped me get over my methal blockage with needles.

Thank you for your reply

All the best