Can anyone advise if these results are “normal”, I have been advised they’re within range but I have many symptoms: breathless upon walking and weak legs when walking up stairs, I get restless painful legs also, water retention, bloating, lacking in energy and tired, then during the night I wake frequently.
Serum B12 289 ng/L (211-911)
Serum ferritin 31 ug/L (was 22 in June) 10-291
Serum folate 7.1 ug/L (3-14.40)
Platelets 380 (140-400)
Haemoglobin estimation 138g/L (115-150)
Total white cell count 6.7L (3.50-11)
RBC 4.36 (3.80-5.00/L)
MCV 92.7fL (80-99)
MCH 31.7pg (27.50-32.50)
MCHC 342g/L (310-350)
Do I need to call the doctors back and query this?? It’s been many years of feeling this way and I have stabilised my thyroid which consultants like to focus on. I was told I have chronic fatigue symptoms and nothing can be done?
Any advice would be lovely,
Thank you
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Pinky3
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Thank you for your reply, when I mentioned my ferritin the gp said it was normal for women to have low ferritin?
I didn’t want to take my supplements before my test so I temporarily stopped them. But I take B12 spray and a complex. I also take a gentle form of iron.
Yes the results are all in the normal range but for some of them that doesn't mean that they are at the right point in the range for you eg B12 tends to be pretty stable at a point in the range because of the use of stores but if there is an absorption problem it will start to fall once those stores are used up but this can take a very long time.Have you had a previous B12 measure, for instance, that showed a significantly higher level? A downwards tend over time would indicate and absorption problem - but serum B12 is only accurate to about 20% so a difference within that amount isn't conclusive of anything.
If you weren't supplementing more than RDA at the time then that's a significant drop and suggestive that B12 may be part of your issue. Are you experiencing any numbness or tingling in hands and feet - if so you could try pushing back on that grounds that you have neurological symptoms and ask for a trial of shots but it can be very difficult getting GPs to listen.Link to the BCSH standards here - if you go back a few days there are also links to local standards in various threads
I was told the same as you. Re: CFS. My levels were almost identical to yours. They continued to drop over the next couple of years. I have had good results with b12 injections.
You could try requesting that they treat symptoms and say that you believe you have an absorption problem. I think it depends on the doctor. Mine was not interested at all.
After paying for private showing my levels had dropped to low 200s (and I was supplementing with oral b12 by then not realising I should have waited and had probably skewed the results) I was still told I was in range. I then paid for private b12 injections through a clinic and went back to doctors to report improvements and was still told it was placebo. I ended up having to self inject after the clinic was shut in March.
I will request this and see what they say, otherwise I will try the self inject as it would be great to finally feel better! How annoying for you that the clinic shut, do you find it easy to inject yourself? If I need that route are you able to PM me the details of where you source it from? Im hoping that my persistent hounding will be heard and they’ll help me 🤷♀️
You would need to have your first injection in a clinical setting in case of allergic reaction if you have not Already have one. It is very unlikely but best not to risk anything.
I don’t much like it but you get used to it and the health benefits of feeling half normal fat outweigh my fears. I got mine from apohealth.de some german pharmacists have stopped sending but I ordered from there the other day and it was fine.
From personal experience, I can tell you it's possible to have severe b12 deficiency with a result that is well within range. I had over 40 symptoms including neurological problems with most of my results from 300 - 500 ng/L.
Vital to get adequate treatment for B12 deficiency as being untreated or under treated can lead to permanent neurological damage including problems with spinal cord.
Table 1 in above article is about frequent misconceptions about B12 deficiency.
Useful B12 books
"What You Need to Know About Pernicious Anaemia and B12 Deficiency" by Martyn Hooper
Martyn Hooper is the chair of PAS (Pernicious Anaemia Society). BNF treatment info in book is out of date. See BNF link in this reply for up to date info.
"Could it Be B12?: An Epidemic of Misdiagnoses" by Sally Pacholok and JJ. Stuart (US authors)
Very comprehensive with lots of case studies.
Lots of B12 info in my replies on the the thread below eg symptoms, causes of B12 deficiency, more B12 books, B12 websites, more B12 articles/documents and a few hints about dealing with unhelpful GPs.
Wow that’s a really helpful amount of information there, thank you for taking the time to put all together and send to me. I have a phone call tomorrow to discuss my results and I am going to ask for a trial of injections and see what they say. It’s funny as I have also been told I have fibro which I contested at the time so it’s interesting a lot of people are diagnosed with these conditions first. Many many years ago I was given b12 injections and then it stopped, I didn’t have the understanding at the time that these injections were for life but when I query this now, I receive a quizzical expression. I hope for a good response tomorrow now that I’m armed with this knowledge. Thank you 🙏
If you were tested for coeliac disease, did the GP .....
1) order both the tests listed below?
TTG IgA test which checks for a particular antibody to gluten.
Total IgA test which checks which patients have IgA deficiency.
Patients with IgA deficiency need alternative tests for coeliac disease.
2) ask you to eat plenty of gluten in more than one meal per day for several weeks before blood taken for coeliac tests?
People with coeliac disease can get a negative result in TTG IgA test if they are IgA deficient and also if they weren't eating enough gluten prior to blood tests.
Letters avoid face to face confrontation with GP and allow patient time to express their concerns effectively.
Best to keep letters as brief, to the point and polite as possible. It's harder to ignore a letter in my opinion.
When a letter is sent to GP, worth including a request that GP practice sends written confirmation to letter writer that they have received letter.
I included a request in letters that a copy of letter was filed with medical notes.
My understanding is that in UK, letters to GPs are supposed to be filed with medical notes so are therefore a record that an issue has been raised.
Useful to have a paper trail in case there is a need for a formal complaint over treatment in future.
Letters could contain relevant test results, date of diagnosis, brief family and personal medical history, extracts from UK B12 documents, requests for referrals to relevant specialists eg neurologists, haematologists, gastro enterologists.
Keep copies of any letters sent or received.
Most medical records are deleted after 8 years so don't rely on there being evidence of a past diagnosis of PA (Pernicious Anaemia) or other cause of B12 deficiency in current medical records.
Best piece of advice I ever got was ......
to always get copies of all my blood test results.
I am aware of forum members who have been told everything is normal/no action on blood tests when there are actually abnormal and borderline results.
Process in other parts of UK may vary from process in England.
Some people get copies of/access to their complete medical records. My understanding is that patients can request copies of/access to paper records as well as online records.
Warnings
1) B12 deficiency is not always well understood by GPs and specialists so it pays to be well prepared for any appointments.
2) Some GPs are not able to cope well with assertive patients so be prepared for GP/patient relationship becoming strained and have a back up plan eg another GP surgery to go to.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.