I had a blood test on Monday (because of my weird nails which look like Terry's nails) and the surgery phoned me today and told me my haemoglobin is low and the GP wants to do a repeat test and check the B12 and folate levels. I was half asleep so didn't actually tell them that I'm on B12 injections and I've been supplementing folic acid 400mcg for more than a year. I self inject B12 usually every 6 days.
Is it likely that I could still be deficient in folate despite supplementation? They checked for other things: liver/kidney function, ANA and I'm not sure what else, but all apparently normal (I don't have a copy of the test results). Obviously a full blood count. I assume the MCV is high as they are checking B12 and folate. It's odd because I didn't even have actual anaemia when first diagnosed with B12 deficiency.
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Curlygal
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It takes a while to sort this mess out, Akashrajput - just like it took a while to get this ill in the first place. Sneaks up on you. Good that you have youth on your side, though. I have high hopes for your recovery. But you really need to have your bloods monitored - not obviously B12 as no known harmful effects beyond spots initially, but folate, ferritin and vitamin D. Maybe thyroid too wouldn't hurt. Didn't you say your doctor was a family member ?That is good news- especially since covid is presenting real problems with GP access. I should imagine this is virtually impossible in India at the moment.
Yes, folate can still be low or low-range when supplementing - my folate was a bit up and down for two years before stabilising at a good level. Sometimes I would need double the daily supplement to get out of a trough period - GP would monitor this, ferritin (which was alos blippy) and vitamin D (on prescription because of osteoporosis of spine). It didn't seem to matter how improved diet was. These are the most likely additional problems with a B12 deficiency, and mine continue to be checked fairly regularly. The GP always gives me copies of results.
I'm always confused between folic , ferritin and folate And in my case I think something is wrong with me will have to do a complete body checkup to know what's the real problem behind all this deficiencies
Thank you Cherylclaire . I'm not sure if it's possible to get printouts from my GP at the moment (but I will ask). Normally it's fine but they're basically shut because it's impossible to social distance in their tiny premises. I go to the local community hospital to get bloods taken.
And your experience is very informative, thank you 🙂
My local practice has still got a receptionist so although not easy to see a GP, you can ask on the phone for a copy of results and pick it up from reception. Hopefully some similar arrangement at your one ?
Yes the receptionists are still at my surgery, although I think the doctors may be working at home most of the time. I really look forward to actually seeing a GP in person once this is all over! If it ever ends!
Think they just have to say "yes" to the receptionist.I expect that there is always at least one GP present in the surgery and that they are taking it in turns.
A lot of the local GPs are giving covid vaccinations.
I'd like to know why my nails are like that. If you look it up it mentions liver, kidneys, thyroid, diabetes. The GP seemed to think it was linked to anaemia but I haven't seen that in anything I've researched (although apparently I do have anaemia?!)
Have you shown your nails to your doctor, Akashrajput ?
I haven't showed them to my doctor and I don't think my doctor will emphasize it that much but yess I came across people who have anemia and have Terry nails even I'm anemic and I've Terry nails so don't worry
I'm not too worried but really want to know the reason why (I'm autistic so the way my brain works I find it hard to let things go, I have to know WHY!)
Anna B Witkowska, Thomas J Jasterzbski,1 and Robert A Schwartz1
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Abstract
Terry's nails are a type of apparent leukonychia, characterized by ground glass opacification of nearly the entire nail, obliteration of the lunula, and a narrow band of normal, pink nail bed at the distal border. The aim of this study is to guide clinical practice by reviewing all of the data concerning Terry's nail that have become available since the original description by Terry in 1954, with particular reference to all clinical features, associated medical conditions, pathogenesis, and necessary workup. PubMed was searched using the keywords “leukonychia” and “Terry nails.” Although the abnormality can occur with normal aging, Terry's nails can also be an indication of an underlying medical condition, most notably, cirrhosis, chronic renal failure, and congestive heart failure. A change in nail bed vascularity, secondary to overgrowth of connective tissue, is thought to be responsible, with nail bed biopsy revealing telangiectasias in the distal band. The differential diagnosis for Terry's nails includes half-and-half nails (Lindsay's nails), Muehrcke's nails, and true leukonychia totalis/partialis. Having the ability to delineate these nail findings can be a valuable tool in clinical practice as each entity is associated with a different set of systemic conditions. Terry's nails highlight the intimate connection between nail changes and systemic disease as well as the importance of thorough nail inspection with every physical examination.
Keywords: Chronic renal failure, cirrhosis, congestive heart failure, leukonychia, nails
Terry's nails. A classic presentation of Terry's nails demonstrating ground glass opacification of nearly the entire nail with A – No visible lunula and B – A narrow band of normal, pink nail bed at the distal border
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