hot of the press so to speak and on the attached screenshot. The doctor's comments are below this message. They are not what I was expecting, especially as I inject B12 1mg only once a month, but data analysis works more than one way and unless I'm reading it wrongly, I can cancel out any sort of B12 issues. So the search goes on and I would very much appreciate your comments. And just for clarity, I do not drink in excess maybe 10 units a week on average. I also follow a strict wheat and gluten free diet, so I don't knowingly supplement my B12 intake from food.
Doctor's comments
"The small rise in MCV may not be of much significance, but rising MCV values may indicate one of three common possibilities - excess alcohol intake, low Vitamin B12 or low folate levels. Your other test results suggest that B12 and folate levels are within normal limits. However, if you do drink alcohol and you are drinking more than 21 units per week, it is possible that the raised MCV could be a sign of excess intake.
The Vitamin B12 level is elevated. This is not likely to represent significant overdose, as B12 is well tolerated by the great majority of people even in very high concentrations (as indeed are most water soluble vitamins). Excess levels are usually a result of supplementation or from following a diet rich in the vitamin. A few exceptions to this rule include those who suffer from a rare hereditary eye complaint known as Leber’s disease. Too much vitamin B12 in these individuals can lead to damage of the optic nerve, which might lead to blindness. Anyone who is allergic to cobalt should also avoid taking vitamin B12 - as the vitamin contains a significant amount of this element. Rarely, high dose supplements or injections of Vitamin B12 cause diarrhoea, itching, blood clotting and allergic reactions. Liver disease and myeloproliferative disease (disorder of the bone marrow) can lead to elevated levels of B12. Some practitioners advocate high doses of Vitamin B12 to help sufferers from Chronic Fatigue Syndrome (CFS) and to combat the development of Alzheimer's disease, amongst other conditions.
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Your doctor's comments are fairly well balanced, and I can'd disagree with them. I would however mention that the sensitivity to alcohol can vary considerably between individuals, so the '21 units per week' is only a rough guide.
Reduced thyroid function can be associated with a slight increase in MCV, and I either can't remember, or never knew exactly why this is!
Your posted results are very well presented but I'd like to see more of them; particularly the FBC/CBC because there are sometimes indicators within them to suggest that there may be some artefact in them.
Was your sample collected at the point of analysis, or could it have been delayed before testing, for example.
Oops! Jumped the gun! Just to add, do you have any earlier results? Has your MCV increased from previous analyses?
And now for the number crunching:
It's worth noting that the reference range for the MCV will be a (Mean +/- 2 SD) so it's a 95% range. Which means that 1 in 20 'normals' can be outside the range whilst still being 'normal' for themselves, which is why historic results can be useful.
Mean +/- 3 SD captures 99.7% of the 'normal distribution' and that gives a range of 78.1-100.8fl, and puts you in the upper outliers, but still potentially 'normal'. Needless to say, I wouldn't ignore it at this stage but I would look for an explanation.
If you've been injecting B12 regularly, I would expect your serum (total) B12 to be high.Mine when last tested were well above the range and I have regular injections.
Were you diagnosed with PA or another cause of B12 deficiency in the past?
I can't remember why you started to self inject.
In UK, people with the symptoms of B12 deficiency are supposed to be treated even if serum B12 is within normal range.
It's possible to have severe B12 deficiency symptoms with a normal range or even above range serum B12 result.
I'm not medically trained but if someone has symptoms consistent with B12 deficiency and the symptoms improve/disappear with B12 injections/B12 supplements then it would suggest to me that the person needed B12.
Links to forum threads where I left detailed replies with lots of B12 deficiency info eg causes and symptoms, UK B12 documents, B12 books, B12 websites and B12 articles and a few hints on dealing with unhelpful GPs.
Some links may have details that could be upsetting.
'Were you diagnosed with PA or another cause of B12 deficiency in the past?'
I was diagnosed as B12 deficient probably because of lifelong vegetarianism. I assume that, but the likelihood is high. All the doctor said after my annual health tests revealed the deficiency, was that I needed quarterly injections.
'I can't remember why you started to self inject.'
It was largely because of a service issue at my GP's surgery. Before the practice joined a local NHS service partnership, I couldn't get nurse appointments after I finished work for the day. Equally, my employer was very reluctant to allow me attend what they considered non-essential appointments during working hours. Perhaps unsurprisingly, I became ill. I complained about my GP's poor service and they immediately put me on a monitoring programme and began a bank of 6 injections over 2 weeks. I also told the doctor that I think I needed more injections as I was showing symptoms well before the end of each quarter. They disagreed. After the 6 injections, I decided to take control of my B12 related health and began self injecting 1mg/month and have done so without fail for the past four years. I am wholly transparent with every doctor I've had since doing so. None will shift from NICE guidelines.
I also have a gluten free diet after being diagnosed with food-related IBS , the food in my case being wheat and gluten. Further, I have post radiotherapy hypothyroidism, in other words, my thyroid gland has been deliberately made inoperative as it was producing too much thyroxine: hyperthyroidism. I am investigating this too and the bank of B12 tests are part of a wide investigation into my body chemistry.
Thank you for all of the information, much appreciated.
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