Ferritin low - is this enough to flag PA?

[Blaaland]

Hi all,

Quick question - HB and B12 seem ok - but Ferritin is only 15 with a 13-150 u/gl range.

Is this the flag I’m looking for as my grandmother had PA and I identify with SO many symptoms on here,

Best wishes,

Ruth

[Nackapan]

I woukd discuss your low ferritin resistance and get iron prescribed.Low ferritin can mimic thyroid symptoms

Which can be similar to b12 def. % PA .

It's megobolastic anaemia which csn happen either PA

Mt ferritin did not drop as s sign .

My vit D dropped some time before perhaps the start of absorption issues

Mt ferritin did drop but I was on b12 injections by then

So treat whats been found first perhaps

[jade_s]

Do you have results for MCV, MCH, MCHC, RDW, MPV?

You can also get homocysteine & MMA tested, and IF and GPC Antibodies.

Have you been supplementing b12 or a b complex?

As Nackapan says, low ferritin is't directly related to PA. Ferritin is storage iron & is related to a different type of anemia. You would need a full iron panel before starting supplements.

Would you like to post the results you already have? Please also include ranges. Blank out any personal info if you upload pictures of results.

Family link suggests you're more likely to have PA so good for you for staying on top of it!

[Gambit62 Administrator]

of itself low ferritin won't be evidence of PA.PA is an auto-immune disorder that attacks the mechanism that allows your body to absorb B12. This can affect the absorption of other vitamins and minerals - most commonly iron and folate.

Ferritin is quite a good marker for iron status but it doesn't tell the whole story as there are other things that can cause low ferritin so iron deficiency should be confirmed before starting treatment. There have been a few cases of iron toxicity caused by using ferritin alone to determine iron status.

In your case your ferritin is still within range - that's no guarantee that it is right for you but it isn't suggestive of PA.

[FlipperTD]

Scientist, not medic.

The FBC is a useful set of numbers in a case such as yours. Ferritin isn't an indicator of PA.

Good luck.

[Blaaland in reply to FlipperTD]

Thanks for your advice and replies. My neutrophils and wbc are just within range and immune markers found so I may be looking in the wrong place.

Many Thanks to Nakapan, Jade and Gambit also for your help x

[Sleepybunny]

Hi,

From personal experience, I can tell you that it is possible to have severe B12 deficiency symptoms with a serum B12 result that is within normal range.

UK guidance indicates that people who are symptomatic for B12 deficiency should be treated even if serum (total) B12 is within normal range.

Link about "What to do next" if B12 deficiency suspected

b12deficiency.info/what-to-...

Unhappy with Treatment (UK info)?

Letters to GPs about B12 deficiency

b12deficiency.info/b12-writ...

If PA is a possibility, worth joining PAS who can offer support and pass on useful info.

PAS membership is separate to membership of this forum.

You do not need a confirmed diagnosis of PA to join PAS.

PAS (Pernicious Anaemia Society)

Based in Wales, UK. Has some overseas members.

pernicious-anaemia-society....

There is a helpline number that PAS members can ring.

Testing for PA

pernicious-anaemia-society....

HSE links about B12 deficiency

(Info is based on NHS info)

www2.hse.ie/conditions/vita...

Article about B12 deficiency in older adults (Irish research)

tilda.tcd.ie/news-events/20...

irishtimes.com/news/health/...

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.

Some of the info will be specific to UK.

healthunlocked.com/pasoc/po...

healthunlocked.com/pasoc/po...

healthunlocked.com/pasoc/po...

I am not medically trained.

[Blaaland in reply to Sleepybunny]

Thanks a million x

[Ghound]

Hi, I can only recount my personal experience, but for years I had recurrent iron deficiency anemia with low ferritin although no obvious cause. Eventually I began to have signs and symptoms which I realised fitted a diagnosis of PA.

I self inject B12 in addition to my official NHS injections but despite a good diet, unless I take regular iron supplements my ferritin levels always end up low.

For me, B12 and iron deficiency seem to go hand in hand.

As others have said, you need treatment for your low ferritin, but you should have this properly prescribed and monitored by a doctor.

Hope you're feeling better soon x

[Blaaland in reply to Ghound]

Thank you! I have numbness, tingling moving up the leg to the knee recently and occasionally in the hand with brain fog and breathlessness. Constant fatigue. I’m going to get back into the GP about taking ferritin tablets, but I do suspect low stomach acid so…. The interesting thing is I am on Effexor and Lyrica - they may have been causing or masking some symptoms so I have reduced gradually while I waiting the year dfor my next full blood count. Side effects from withdrawal also cause a host of issues so it’s very complex…. 🥴

Thanks for your reply x

[Dorus]

I think low ferritin and iron-related anemia could be loosely related to PA (but not caused by it) if your malabsorption issues are due to atrophic gastritis, as hypochlorhydria hinders iron absorption. It wouldn't be my first guess at all though. It's something you definitely should investigate with a doctor before you jump to any conclusions, as a lot of things can cause low ferritin.

[Blaaland in reply to Dorus]

Thank you x

[Sleepybunny]

UK has the BNF (British National formulary) which gives guidance on prescribing medicines/drugs.

BNF entry on hydroxocobalamin

bnf.nice.org.uk/drugs/hydro...

Ireland has the Irish Medicines Formulary

online.imfmedia.ie/

You might find a copy in local library reference section. Not sure if online IMF can be accessed by public.

Think book form may be available from a popular online retailer.

imfmedia.ie/