I am wondering if anyone can help or advise me on levels and symptoms.
My B12 was 183 last August and then 247 in May as I supplemented for a while, but I was admitted to hospital with a racing heart beat of 123. I have regular disabling palpitations, fatigue, crumbling nails, blurred vision, balance issues when my eyes are closed, migraines, tinnitus, stabbing pains in head that come and go, restless legs, weight loss, lack of appetite and its been getting worse over the last year. My vitamin D is 52. My great grandmother had PA and my mum has said I am very much like her, and get upset because if I do have it or if Im deficient my Dr keeps telling me my bloods are fine and they tested me for PA but I dont know if the Intrinsic factor was tested
I dont know whether to have private tests as my husband has said it may be a good idea as Im getting quite weak now and I cry alot.
Many thanks for any help
Written by
Mrss25
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Each CCG/Health Board in UK will have its own local guidelines on treatment/diagnosis of b12 deficiency. I suggest you try to track down the local guidelines for your area of UK and compare them with BSH, BNF and NICE CKS links. It's good to know what you are up against locally.
Some of these local guidelines have been posted on forum so may be worth searching forum posts for "local guidelines".
Hope you are not in the UK area mentioned in blog post below.
If your GP is convinced it is a dietary issue, you could write out a typical weekly diet, food and drink, and discuss this with GP.
If you eat plenty of B12 rich food eg meat, fish, shellfish, eggs, dairy, foods fortified with B12 then less likely to be a dietary deficiency and more likely to be an absorption problem in the gut.
Guidelines below suggests that anyone with unexplained B12, folate or iron deficiency should be tested for coeliac disease.
Any chance of internal parasites eg fish tapeworm infection?
Have you ever eaten raw or uncooked fish eg sushi, smoked salmon?
Have you ever lived or stayed in an area where internal parasites are common?
One potential sign of fish tapeworm infection is an increase in eosinophils, a type of white blood cell. Eosinophil result can be found on Full Blood Count results.
Search online for "internal parasites B12 deficiency" for more info.
Table 1 in above article is about frequent misconceptions about B12 deficiency.
Referrals
Does your GP have a complete list of all your symptoms especially all your neuro symptoms?
See Symptoms Lists at top of this reply.
Have you been referred to ....
1) a neurologist?
2) a haematologist?
If you look at NICE CKS links it suggests that doctors should seek advice from a haematologist for patients with B12 deficiency with neuro symptoms. Has your GP done this if you have neuro symptoms? If GP won't refer you, perhaps they could write a letter to local haematologist seeking treatment advice.
3) a gastro enterologist ( for gut symptoms)
Gastro specialist should be able to spot signs of gut damage from PA, Coeliac disease, H Pylori infection plus other gut conditions.
I've written some very detailed replies in the threads below which hopefully have B12 info you will find useful eg causes of B12 deficiency, books, articles, more UK B12 documents, B12 websites along with a few hints about managing unhelpful GPs.
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B12 level 460 but lots of symptoms. Ferritin 52
Serum B12 levels compared to active B12 levels 
Serum B12 level 160ng/L with symptoms, Doc says just take a multi-vit for now.
High levels of b12!!!
Checking b12 levels while supplementing?
