More tests before I start supplementing?

[dinkyoodle]

Hello

I've dipped in and out of the thyroid community but have a question regarding b12.

Sorry I don't have results to post as stupidly I didn't check what I was given before leaving the surgery and it was only the summary sheet.

Anyway, my B12 is 'borderline' again (this was the case 6 years ago) but the GP stated no further action needed and to maintain a high b12 diet with OTC supplements if I wanted. The only thing he wants to treat is Vit D deficiency.

I am wondering why my b12 is low again.

I am symptomatic (tired, irritable, brain not working) but could also be vit D or possibly thyroid as I haven't seen results . We have hens so I eat a lot of eggs- defo not due to lack of dietary intake I would say! I am also gluten free due to thyroid.

So two questions:

-Should I consider further testing or just see if symptoms resolve with supplements? GP unlikely to facilitate this given he is not concerned and I don't have much money for private testing so it really needs to count if/when I do decide to do it.

-How would supplementing affect blood results if I was to retest in a few months?

I know it's hard to comment without figures but I hope I'm making sense to some extent. Asking now as I really want to get B12 in me asap.

Many thanks 😊

[Nackapan]

As you've had your b12 tested the only thing that might be worth getting a is the IFAB ( Intrinsic factor anybody test) as yiuvecan autoimmune orobkem already.It dies pick up 50% of thise with PA.

Ask on the grounds its not dietary

And you have an existing autoimmune disease.

It can be done after supplements but the more I read ideally before.

Then try b12 supplements

You may just need topping up from diet.

My sister needs daily b12 as absorbs but not enough from food.

Go by symptoms.

Do get a copy of your results.

Folate usually tested at the same time as b12 and if needed a supplement after b12 .you are right as so many things overlap

[Hidden]

Could you elaborate on what happened 6 years ago? Was it dietary then or another reason?

[dinkyoodle in reply to Hidden]

6 years ago (after 1st baby), I felt unwell and found to have underactive thyroid, anaemia, low vit D and low B12. Taken thyroxine since then (125mcg now).Thanks for replies, I understand it's tricky with so little information.

[dinkyoodle in reply to dinkyoodle]

I did also take sub-lingual b12 and vit D and iron but don't remember having many repeat bloods to check how well I responded. I did feel better in terms of symptoms 😃

[Nackapan in reply to dinkyoodle]

Well theres your answer

[dinkyoodle in reply to Nackapan]

I guess the tricky thing is knowing what actually contributed to me feeling better as so many things we're being addressed a the same time including ferritin and thyroid improving 🤷

[Nackapan in reply to dinkyoodle]

Yes always is.Symptoms overlap with many things

So get the IFAB test.

See if raising vit d helps first.

My vit d dropped to 21 prior to my b12 plummeting dramatically a yesr after .

No idea why but in my case was the start of absorption problems.

I go by bloods what to supplement apart from b12

As once I injections testing levels not needed

[Hidden in reply to dinkyoodle]

Thanks, no problem. But looking back on your posts in the Thyroid forum it looks like an absorption problem was suggested then.

Did your GP identify what could be causing the absorption issues?

I think you need to suspend all supplements and wait a few months to test again, tbh

[dinkyoodle in reply to Hidden]

Thanks Firefly, I am not currently taking any supplements but I really want to get some energy back so eager to start. What do you think would be the benefit of waiting a few months before retesting?I dont remember the GP considering absorption issues, maybe I didn't even discuss it. As is the case currently, I'm in range so he isn't worried. I find it so hard trying to fight my own corner when I don't feel like I fully understand it to articulate myself well 😔

[Hidden in reply to dinkyoodle]

You need to be off any b12 supplements for at least 6 months before a test. Otherwise the test is completely meaningless.

Once you start supplementing you cannot go back. So you'll need to self treat and self diagnose.

Were you off any b12 supps 6 months before you recent test?

If its in a multivit its unlikely to make much difference but any specific dose of b12 would.

[dinkyoodle in reply to Hidden]

Yeah, I haven't supplemented for about 3 years. Only taking levo and paracetamol for all the headaches I get. Thanks for you patience explaining to me. So maybe I should suggest to GP we rule out PA or absorption issues before I start OTC supplements and see what he says?

[Hidden in reply to dinkyoodle]

I think that sounds like a great idea. You may have to push them.

Ask for a printout of your blood test and post it here again. You seem to have a complex no. of things on the go and Im sure a clever sciency person could help make sense of it. Best to cover all bases before supplements, unless you're severely anemic or unable to function.

Good luck!

[ktwing in reply to dinkyoodle]

Just jumping in to say - a negative IFAB doesn't rule out Pernicious Anaemia, but a positive test does confirm it. Many GPs don't realise this, but it's important for you and them to know that B12 deficiency caused by absorption issues is actually quite difficult to rule out!

[Nackapan in reply to ktwing]

I agree. If a past b12 test has been done and you can compare s real advantage.

Diet should be given yo Gp too.

And assuming thf diet had changed you can rule out dietary

[Nackapan in reply to dinkyoodle]

Your last b12 level once you've got your print out is your current b12 status. Remember it's not thr most accurate test as serum b12 tests give thr total b12 .

Active and inactive

Your baseline. As not on b12..

If this is lower than your last b12 a few years ago you know you are not absorbing as well.

Also check/ compare folate ferritin ect

I had no previous b12 .to compare to.

Everyone operates at a different level.

Mine was very low so very clear .First one ever.

Othing else was found

So print outs of great value.

Of course some people with 'within range ' results have b12 deficiency symptoms

As the way the ranges are set there will be people that can't function at the bottom of the 'normdl' level set.

I still think as you've sn autoimmune condition diagnosed already and they often are not alone having an Intrinsic factor antibody test is s good idea .

Yes tell Gp what you eat.

Get printouts and compare

Headaches/ migraine a major symptom for me also vertigo

Balance issues fatigue

Not a problem for me until b12 deficient .

Separating symptoms very difficult

I wish you well