HB levels in blood

[PAapr22]

Dear community

I understand pernicious anaemia causes low haemoglobin level in blood. Not sure low.

Can haemoglobin carry on reducing 2 months following b12 injection loading ?

Should hb levels increase after loading or does it take a long time?

What has been your experiences of HB levels in blood with PA?

Before loading b12 and PA diagnosis, mine was 119.8g/l and after loading and daily 12k mg solution 2 months later has further dropped to 118 g/l? Note male Healthy range 130-180g/l. White count etc all fine

I saw the GP today and whilst he was a very nice chap he could not explain why this is happening, little about PA and also why sudden pins and needles and sever pain in arms came. I’m seeing a neurologist soon for this following all your great advice on my previous post. I will also be SI when the kit arrives.

Kind regards.

[Gambit62 Administrator]

PA/B12 deficiency doesn't necessarily change Haemoglobin levels. It can cause a type of anaemia in which your red blood cells are larger and rounder than they should be making them less efficient at carrying oxygen.If you have a B12 absorption level this may also affect your ability to absorb iron, so could result in iron deficiency, which would affect Haemoglobin levels. It can also cause a type of anaemia in which your red blood cells are smaller than normal.

If you think you have an iron deficiency please work with a medical practitioner on diagnosis and treatment

[PAapr22 in reply to Gambit62]

Thanks Gambit62. Aware of the sizing of blood cells. I’m Thalassaemia trait carrier which means blood cells are slightly smaller. This may impact haemoglobin concentration. Also as I’m only a trade carrier sometimes anaemia levels can be inflated. So I did post before about how this would conflict levels.

There’s not a solid understanding - Smaller blood cells from trait but larger blood cells from PA. What’s the impact on HB movements ? I need to do research

[Gambit62 Administrator in reply to PAapr22]

the marker if you have conditions leading to both smaller cells and B12 deficiency would be RDW (red cell distribution width.

[FlipperTD in reply to PAapr22]

Hi. Scientist, not medic.

Your thalassaemia trait will reduce your MCV and MCH, and likely slightly increase yur RBC because in many cases there's no anaemia but it depends on the thalassaemia gene combination; it's complicated. Megaloblastic change in thalassaemia trait will cause a rise in MCH & MCH, and this will resolve on treatment. Likewise, iron deficiency will cause a fall in MCV and MCH, which will recover on treatment.

The 'take home' here is that the Thalassaemia Trait is always with you, and you need to make sure you understand about the blood changes. An ignorant practitioner could easily simply put you on iron, assuming 'low MCV= Iron Deficiency' and it'll never work.

It is however possible for a Thalassaemia trait person to become Iron Deficient, so take care out there. Never take iron without good advice and blood test evidence; an Iron Panel would be helpful.

Good luck & be safe.

[PAapr22 in reply to FlipperTD]

Thanks flipperTD. That’s very clearly articulated and so will have a look at that Iron panel forum for my own understanding.

I have not been advised to be put on iron. However I did not have an iron level test-My folate was ok at 6.7 ug but obviously main indicator of PA was the +IF AntiBody test and b12 at 54ng/l.

Not sure what these really mean for me despite reading up on them -

just the haemoglobin concentration below range (recent test still below);

haematocrit below range (recent test still below);

mean cell volume below range (recent test still below);

eosinophil below range ( recent test now ok);

basophil below range (recent test now ok).

So this indicates thalassaemia trait is reducing those MCV MCH levels as it naturally shows a lower reading. Red blood cell count is 6.11 is ok at upper end range as you say, but b12 loading is not fixing the haemoglobin level or will ever do so !?

So not a lot more I can do apart from testing ranges, fix b12 maintenance and check storage levels… rule out gastroenterology issues, neurology issues, and finally see a blood specialist.

[Scott-rock]

I have the opposite issue, my HB is now slightly elevated at 182. It’s been increasing since I was started on testosterone replacement therapy. A known side effect. Two years ago it was 160 g/l. Has anyone had venesection to keep it at a normal level?

[PAapr22 in reply to Scott-rock]

Interesting. It’s all very confusing and if haemoglobin levels are low or high what does that really mean. I wonder if ranges are not always correct for different people.