ACTIVE B12 results of 98.2 pmol/L does that 100% def exlude PA

[Worksop1]

As per title really, thinking the symptoms must be more to do with low iron levels but just want to be 100% sure before we should stop persuing GP for treatment for low B12...test was paid for privately after GP refused.

[Dilly_blue]

Hello - do you have symptoms of B12 deficiency (and if so, what), and what other blood tests have you had? Eg MMA, homocysteine etc.. Have you been taking B12 supplements or injecting B12 (or getting injections privately from a clinic?).

I have a functional B12 deficiency, and have a high active B12 level (but my Methylmalonic acid level is also raised, which shows that even though I have high levels of bioavailable B12 in my blood, it is not making it into the cells).

I am not sure about pernicious anaemia (with the active B12 levels that you mentioned), and am also not sure about whether the active B12 level you mention is abnormal (I don’t know much about the specifics of tests, sorry). Hopefully someone with more information will be along soon.

If you have B12 deficiency symptoms, with a normal (?) active B12 level, then it might be worth getting MMA / homocysteine levels checked to see if it is a functional deficiency. I am very hazy about this, but I think renal function and small bowel function should also be assessed? Good luck..

[Worksop1 in reply to Dilly_blue]

Yes he has symptoms, in fact all of them but these could also be low iron which we know he does have. GP is next to useless tbh and seems very reluctant to do much, he has another appointment this Monday for a coleiac test but he has none of the symptoms for that really.

[Gambit62 Administrator]

both active and serum B12 only measure the amount of B12 in your blood - they don't tell you how efficiently it is being used in cells.

drops over time would indicate an absorption problem but in terms of absorption problems you can't draw any conclusions from a single result.

PA is an autoimmune condition that destroys the mechanisms in the gut that are the main way that B12 is absorbed, leading to B12 deficiency.

Your result does make it unlikely you have a B12 deficiency but people do need different levels of B12 - hence its looking for significant changes over time that is the key to picking up absorption problems. Significant means a variation that is outside the normal accuracy range for the test.

[Worksop1 in reply to Gambit62]

Yes I do wonder if he needs more than normal to function, cant really keep going like this tbh so if the GP dosent do anything on Monday we have B12 shots ready and we can retest and maybe do some other tests privately...seems to be the only way we get anywhere.

[Marz]

You mention low iron. Do you have any results you can post ?

[Worksop1 in reply to Marz]

All we know is its low, we have other test results with more detail but not sure they are relevant...I'll dig them out!

[Worksop1 in reply to Marz]

THYROID FUNCTION ALL SEEMS NORMAL Your result is 6.1 pmol/L FT3 levels normal (normal range 3.1 - 6.8 pmol/L), Your result is 14.4 pmol/L FT4 levels normal (normal range 12 - 22 pmol/L), Your result is 0.97 mu/L TSH levels normal (normal range 0.27 - 4.2 mU/L)

CHOLESTEROL (FULL LIPID PROFILE) all came back normal and his GLYCATED HAEMOGLOBIN is is 35 mmol/mol which is also normal. Fully aware these tests are probably not relevant but we are going through all the options. One thought going through my head is maybe he needs higher levels of B12 to feel normal even though the results say his is not low...and im almost 100% sure the GP wont do anything to help him on that tbh.