Hi, this is my first time here so apologies if I’m in the wrong place. I recently had blood tests which show I have Hashimoto’s, but also seem to indicate problems with possible anaemia.
Ferritin 43 (13-200)
B12 235 (197-771)
Folate 10.3 (3.89-26.8)
Eosinophil0.6 (0.0-0.4)
Lymphocyte 1.3 (1.0-4.0)
Neutrophil3.2 (1.9-7.5)
RBC 4.62 (3.9-5.6)
Hb 133 (115-164)
CRP 3 (0-10)
Any advice or observations would be appreciated. Thank you.
Hi,
I can see that your eosinophil result appears to be above range.
Raised eosinophils have a variety of causes including internal parasites and allergies. Did your GP say anything about this result?
Eosinophil 0.6 (0.0-0.4)
I'm not medically trained but I can't see any results that show obvious anaemia.
Are there other test results you haven't posted...eg MCV, MCH , MCHC , Haematocrit etc from a Full Blood Count?
Your B12 is within range.
Some forum members including myself are/were highly symptomatic for B12 deficiency with serum B12 results well within range.
UK guidelines indicate that people who are symptomatic for B12 deficiency should be treated even if serum B12 is within range.
Link about "What to do next" if B12 deficiency suspected
b12deficiency.info/what-to-...
Symptoms of B12 Deficiency
pernicious-anaemia-society....
pernicious-anaemia-society....
b12deficiency.info/signs-an...
b12d.org/admin/healthcheck/...
cks.nice.org.uk/topics/anae...
Symptoms of Peripheral Neuropathy (damage to peripheral nerves)
nhs.uk/conditions/periphera...
Peripheral neuropathy can be associated with B12 deficiency and sometimes with folate deficiency.
Neurological Consequences of B12 Deficiency
PAS news item
pernicious-anaemia-society....
PAS article about SACD, sub acute combined degeneration of the spinal cord
pernicious-anaemia-society....
Having an auto immune condition can increase the chances of developing further auto immune conditions.
Has your GP screened you for other auto immune conditions?
PA and Coeliac disease are both auto immune conditions that can lead to B12 deficiency.
NICE guidelines on Coeliac Disease below indicate anyone with unexplained B12, folate or iron deficiency should be tested for coeliac.
nice.org.uk/guidance/ng20/c...
Risk Factors for PA and B12 Deficiency
pernicious-anaemia-society....
b12deficiency.info/what-are...
b12deficiency.info/who-is-a...
PAS (Pernicious Anaemia Society)
Based in Wales, UK.
pernicious-anaemia-society....
There is a helpline number that PAS members can ring.
PA tests
Intrinsic Factor Antibody (IFA) test
labtestsonline.org/tests/in...
Parietal Cell Antibody (PCA) test
labtestsonline.org/tests/pa...
PCA is not recommended as a diagnostic test for PA in UK.
It is still possible to have PA with a negative result in IFA or PCA test.
About 50% of people with PA test negative on IFA test.
About 10% of people with PA test negative on PCA test.
UK B12 documents
BSH Cobalamin and Folate Guidelines
b-s-h.org.uk/guidelines/gui...
Summary of above document
pernicious-anaemia-society....
Diagnostic flowchart from BSH Cobalamin and Folate Guidelines which mentions Antibody Negative PA.
stichtingb12tekort.nl/engli...
BMJ B12 article
Emphasises need to treat patients who are symptomatic even if their B12 level is within range.
BNF Hydroxycobalamin
bnf.nice.org.uk/drug/hydrox...
NICE CKS B12 deficiency and Folate deficiency
cks.nice.org.uk/anaemia-b12...
cks.nice.org.uk/topics/anae...
Each CCG/Health Board in UK will have its own local guidelines on treatment/diagnosis of B12 deficiency. Worth getting hold of local guidelines for your CCG/Health Board and comparing them with BSH, BNF and NICE CKS links.
Two 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 hydroxycobalamin link in this reply.
"Could it Be B12?: An Epidemic of Misdiagnoses" by Sally Pacholok and JJ. Stuart (US authors)
Very comprehensive with lots of case studies.
Unhappy with Treatment (UK info)?
Letters to GPs about B12 deficiency
b12deficiency.info/b12-writ...
B12 article from Mayo Clinic in US
ncbi.nlm.nih.gov/pmc/articl...
Table 1 in above article is about frequent misconceptions about B12 deficiency that health professionals may have.
Links below are to forum threads where I left some more detailed replies with lots of B12 info which you may find useful eg UK B12 documents, causes of b12 deficiency, B12 books, B12 websites, B12 articles and a few hints on dealing with unhelpful GPs.
There may be some details in the links that could be upsetting.
healthunlocked.com/pasoc/po...
healthunlocked.com/pasoc/po...
healthunlocked.com/pasoc/po...
I am not medically trained just someone who suffered with unrecognised B12 deficiency for years.
My GP was utterly useless so I’ve changed surgery in the last couple of days. She said nothing about any of my test results, including one that came back marked ‘abnormal’ and recommending further tests. It was an admin from Thyroid UK who suggested the possibility of anaemia. My MCV was 85.9 (78-96)
Haematocrit 0.397 (0.36-0.47)
MCH 28.7 (28.0-34.0)
MCHC 334 (320-360)
I already have RA and spastic paraplegia, and have just been diagnosed with Hashimoto’s, thanks to private tests and consultation. Hashimoto’s and RA are both autoimmune diseases.
Thank you so much for all the information and the links to further information. Brain fog permitting I’ll work my way through all of them.
do you mean they suggested you had anaemia or you had pernicious anaemia/B12 deficiency?The results above are all in range - with the exception mentioned by Sleepybunny.
Pernicious anaemia is a bit of a misnomer as it is actually an auto-immune disorder of the gut that leads to problems absorbing B12, and one consequence of B12 deficiency (and folate deficiency) is a specific type of anaemia in which your red blood cells are larger and rounder than normal. Your results don't indicate that you have macrocytosis or another type of anaemia. However, about 20% of B12 deficient patients don't actually present with this anaemia when first evaluated.
Your B12 levels are difficult to interpret - they are in range but low in range and people can be deficient at this level - particularly when you take into account that the accuracy of the serum B12 test is only 20% and your result is within this noise level of the bottom of the range.
This issue and how to evaluate a potential B12 deficiency - including the importance of symptoms are mentioned in the BCSH standards on diagnosis and treatment of cobalamin and folate disorders which can be found here
onlinelibrary.wiley.com/doi...
Sorry, they mentioned the possibility of pernicious anaemia. I do have peripheral neuropathy associated with the spastic paraplegia, and am vegetarian. Obviously, I’d rather not have another condition to deal with, but, as you say, the B12 is low in range, as are my ferritin and folate. If I’m even at risk of PA I’d rather take action now and try supplements than wait and hope for the best.
There are other iron tests besides ferritin, which is a stored form of iron in the body.
Has your GP considered ordering a full panel of iron tests?
Iron Studies
labtestsonline.org.uk/tests...
It's possible to get these tests done privately in UK .
Not even vaguely. When I asked her about tests for anaemia the only ones she was willing to order were B12 and folate. She was so patronising and unhelpful (even ‘forgetting’ to request an urgent ENT referral) that I had to switch surgery. I’ll make an appointment with my new GP next week.
Scientist, not medic.
Eosinophils borderline, don't panic. It's your immune system tackling something. Insect bites, pollen, just about anything. Don't worry.
Everything else is plumb normal. Your MCH is 28.8 [Hb/RBC] and that's very normal too. So at least these results are good!
Good luck.
Psychologist & Nurse here Absolutely agree with Flipper TD. Your results are completely normal. Nothing to worry about at all.
New blood test results - confusing please help!
Blood Test results - Please Advise...
blood test results - help with interpretation please!
