Low B12, MMA test

[lucylocks]

Hi

In July I had my some blood tests with Medichecks my results show my Active B12

low at 41pmol/L range 25.1 165

Viapath advise checking MMA if level under 70, and I believe Medichecks do the same now.

My doctor said they don't test for MMA but did do some other tests.

Last week results came back.

Serum B12 has come back at 129 pmol/L range 115 - 1000 ( I have never had it this low before)

Instrinsic factor antibody level 0.98 u/mL range 0.00 - 1.19

Folate has risen from level Medichecks level in July, from 2.7 ug/L to 5.8 ug/L

Ferritin 36 ug/L no range given, I have never had this so low, has dropped from 90 ug/L at Medichecks in July

Spoke to doctor who said no treatment needed, and again said they do not do a test for MMA. I said I have symptom of B12 deficiency and she asked was I vegetarian, which I am not.

She said I can take B12 supplements if I want to.

I will add I stopped all vitamins a few months ago because I was breaking out in hives and wanted to check if any of the supplements were causing them, at least I have found they do not cause them, but in the meantime everything as plummeted.

Should I start taking B12 or insist on further tests.

Thank you

[Gambit62 Administrator]

Suggest you write to GP with copy to practice manager.Reference the BCSH (British Council for Standards in Haematology) standards on diagnosis of diagnosis and treatment of cobalamin and folate disorders

onlinelibrary.wiley.com/doi...

Specifically mention the following:

- Serum B12 test is only accurate to 20% - your result is well within the range that could make a repeat on the same sample below the normal range

- People can be B12 deficient well into the normal range - and the standards emphasis the importance of evaluating symptoms, not just going by test scores, particularly where the symptoms include neurological symptoms

- Intrinsic Factor is not very sensitive and gives false negatives 40-60% of the time, which means that a negative is a long way from ruling out PA as a cause of B12 deficiency

- You are not a vegetarian, which would point to an absorption problem that is unlikely to respond to normal supplements.

- Request a trial of injections

If you have previous results showing that your B12 levels (either serum or active) have been falling over time that is a good indicator that you have an absorption problem.

MMA would be available at a hospital but not as a test ordered by GP so you could ask for referral to a haematologist.

[lucylocks in reply to Gambit62]

Many thanks Gambit for the excellent information and the link, I will do an online consultation tomorrow and include the information and the link you provided.

Thank you again.