Thanks for your answer Nackapan ! Indeed, i got given a dose of 500mcg 3 times a week for a month, and then repeat exactly as you said! I don't know about the "thorough" i am not even sure i know what homocysteine is. Just that its a marker for future issues (thrombosis).
It seems you know your stuff so i will ask one more in case you know:
You mentioned other blood test results. I got them and everything was good except for platelets (MPV & PDW) which were both high. Is this an indication of anemia or something?
Ps: i am sure you understood this but i have Very little knowledge on blood tests (except thyroid since i am a hashimoto), so amy feedback will be very well received!
No, it was not on the current tests. But i have done it some times in the past and it's in the normal range (its always around 360 on a range of 160-970)
Oh so 360 is considered low? I thought thst it being i the middle, it would be a very good value. Thanks for your recommendation, i will test it as well. And if it comes yp again around 360 would you recommend that i supplemented with b12 only, folate only or both?
Having a level of 360 generally -( ng/L or pmol/L ? ) - gives you a known baseline which is useful. It could have taken a bit of a nosedive - so worth having checked again. I believe in Greece, you keep your own medical records - so easier to check back over time, see in what direction B12 is heading.
Methylmalonic acid (MMA) serum level can increase quite quickly if B12 deficient, as it needs to make a link-up with B12. If the deficiency gets addressed (in UK, this starts with a loading dose of 6 injections within a short period of time) the MMA should rapidly return to normal levels as it makes the links to move on to cell/tissue level. If it remains high, there could be a functional problem where it cannot easily reach tissue/cells in useful amounts- but for a diagnosis of functional B12 deficiency, first renal problems and later small intestine bacterial overgrowth (SIBO) would have to be ruled out to be certain.
It could be worth seeeing what both MMA and homocysteine are doing, but if I had to choose one, I'd go for MMA. Mine remained raised for three years despite frequent B12 injections, although homocysteine was "normal".
With B12 deficiency caused by pernicious anaemia (PA), an autoimmune condition , other autoimmune conditions can be a problem. Hashimoto's, Grave's disease, vitiligo, psoriasis come to mind although there are another 100 probably ! You could have an Intrinsic Factor antibody test (IFab) to see if you do have PA - but only 40-60% of those with PA will test positive. I'd start with another serum B12 test first.
If there is a B12 deficiency, this would want to be addressed before folate. Nackapan is absolutely right.
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