Advice on grandsons results please

[Auntyp62]

My 18 year old grandson has just received his blood test results from gp. He is to start b12 injections next week after a blood draw for further tests which I assume will identify PA or just deficiency. I have looked at results and feel he also needs to improve his folate and ferritin. I would appreciate help on if I am right and also advice on what strength folate and ferritin would be appropriate. I believe you should not take the folate when starting injections but how long after starting is it appropriate to take it.

Results

B12.....122...range. 145-914

Folate..4.45....range..3-20

Ferritin....30.4.......range 24 to 337

[fbirder]

As soon as he starts the injections get him to take 400 mcg a day of supermarket folic acid. Ask the doctor about iron supplements, as too much can be as bad as too little.

The test for PA (antibodies to Intrinsic Factor) is good proof if positive. But it means nothing if negative as 50% of those with PA are negative.

[Auntyp62 in reply to fbirder]

Thank you

[Nackapan]

Ferritin is looked at with other full iron results. Doctor will prescribe if necessary

Vitamin c helps you absorb more iron from food meanwhile.

[Auntyp62 in reply to Nackapan]

Thank you

[FlipperTD]

Scientist, not medic.

general rule of thumb:

NEVER take folate when B12 deficient, until B12 replacement has commenced.

NEVER, EVER take iron without medical supervision and appropriate testing. Serum ferritin is a useful guide, but a 'medical opinion' supported by other tests is far more helpful.

Iron deficiency is a symptom of something else.

Good luck.

[Auntyp62 in reply to FlipperTD]

Thank you for your reply. I believe there is a reason for these defiencys as he was borne without a rectum and most of his bowel was missing in fact he had a bag for first few years. At the age of 12 he was given a piristeen system to flush himself every day and discharged by all medics to get on with it. He often bleeds from his man made rectum and apart from being told that is normal has had no medical support from the nhs. His gp only ordered blood tests on his mother’s insistence as he is losing weight and a nurse phoned him his results telling him to book for b12. His parents have always felt they are on their own and have only had support from forums like healthunlocked. Sorry but I felt I needed to give a reason

[FlipperTD in reply to Auntyp62]

Thanks for that. I sometimes don't realise how fortunate I am. His problems are complex, and certainly well outside my experience.

If we have any blood loss at all, then iron deficiency is waiting. One millilitre of red cells lost equals one milligram of iron lost. In most other circumstances, iron is conserved and recycled. Only intact blood cell loss results in iron loss. Iron, in itself is toxic in excess, and needs treating with caution. Too much is probably worse than too little.

I hope you can get the right sort of help he needs.