Been to the GP.

[Pheebs93]

Hello everyone,I went to the GP after still feeling really ill. Dizziness, heart palpitations and fatigue along with low mood and anxiety.

I had a blood test done the end of September time a few months after my symptoms started, which came back as a ferritin 6ugL, B12 as 300ng/L, Folate 4.1ug/L .

Today I went and saw the doctor after seeing no improvement. He was hesitant in believing any of my current symptoms are related to this, he said my b12 is fine, my folate is fine, it's just low iron and says that he doesn't think this is the cause of my symptoms.

I managed to get him to agree to do a full iron panel and a Holo TC, I will get my appointment through for this in the next couple of days.

Am I right in thinking he is wrong not to believe my symptoms are coming from this?

I'm happy he's agreed to test me though!

[Sleepybunny]

Hi Pheebs93,

UK guidance suggests that people who have the symptoms of B12 deficiency should be treated even if serum (total) B12 is within range.

Your serum B12 is normal range but I can tell you from personal experience that it's possible to have severe B12 deficiency symptoms with normal range serum B12.

Your folate looks like it is only just within normal range and ferritin looks like it is below range. Do you have the reference ranges? They are usually in brackets next to the actual results.

Some people have functional B12 deficiency, where there is plenty of B12 in the blood but it's not getting to where it's needed in the cells so the person develops B12 deficiency symptoms.

What's your diet like?

Do you eat B12 rich foods eg meat, fish, dairy, eggs, foods fortified with B12 ? Also folate rich and iron rich foods as well?

If yes to a B12/folate/iron rich diet then your results make me suspect there might be an absorption issue in the gut.

Has the GP tested you for PA (Pernicious Anaemia) and Coeliac disease?

These are both auto-immune conditions that can lead to B12 deficiency.

Coeliac UK website

coeliac.org.uk/home/

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

b12deficiency.info/what-to-...

PAS can offers support and can pass on useful info.

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

PAS (Pernicious Anaemia Society)

Based in Wales, UK.

pernicious-anaemia-society....

There is a helpline number that PAS members can ring.

PAS membership is separate to membership of this forum.

Testing for PA

pernicious-anaemia-society....

Unhappy with Treatment (UK info)?

Letters to GPs about B12 deficiency

b12deficiency.info/b12-writ...

Point 5 in above link is about being symptomatic for B12 deficiency with an in range serum B12 result.

Blog post below is about being symptomatic for B12 deficiency with an in range serum B12 result.

b12deficiency.info/your-ser...

Are your symptoms consistent with B12 deficiency?

Symptoms of B12 Deficiency (folate deficiency also mentioned)

pernicious-anaemia-society....

b12deficiency.info/signs-an...

cks.nice.org.uk/topics/anae...

Some UK B12 documents

NHS article about B12 deficiency and folate deficiency (simply written)

nhs.uk/conditions/vitamin-b...

Summary of BSH Cobalamin and Folate Guidelines

pernicious-anaemia-society....

BNF Hydroxocobalamin

bnf.nice.org.uk/drug/hydrox...

NICE CKS B12 deficiency and Folate deficiency (aimed at health professionals)

cks.nice.org.uk/topics/anae...

Local B12 deficiency guidelines

If you have the time and energy, I suggest tracking down the local B12 deficiency guidelines for your ICB (Integrated Care Board) or Health Board.

Read blog post below if you want to know why I suggest UK forum members find out what's in their local B12 deficiency guidelines.

b12deficiency.info/gloucest...

Two useful B12 books

"What You Need to Know About Pernicious Anaemia and B12 Deficiency" by Martyn Hooper

Martyn Hooper founded PAS (Pernicious Anaemia Society).

UK BNF treatment info is out of date in above book. See BNF hydrocobalamin link.

"Could it Be B12?: An Epidemic of Misdiagnoses" by Sally Pacholok and JJ. Stuart (US authors)

Very comprehensive with lots of case studies.

Many of us on this forum have met health professionals who have wrong ideas about B12 deficiency.

Misconceptions about a B12 deficiency

(From Dutch B12 website - units, ref ranges, treatment patterns may vary from UK)

stichtingb12tekort.nl/engli...

I can post links to lots of other B12 information.

Just let me know if you'd like me to do that.

I'm not medically trained.

[Pheebs93 in reply to Sleepybunny]

Hey sleepbunny,

Yes I have the ranges too,

Serum ferritin 6ug/L [23.0- 300.0] below low reference limit.

Serum Folate Level 4.1ug/L [3.1-20.5]

Serum B12 Level 300ng/L [187.0-883.0]

Haemoglobin A1C 39mmol [<48.0]

My diet was neither bad or good prior to blood test, although I do eat eggs everyday, I eat alot of dairy, some meat and vegetables.

Thank you so much for all that information, will have a good read through tonight.

Very grateful for your guidance, thank you.

[Nackapan in reply to Pheebs93]

Definitely get your ferritin levels up and a full iron panel done .Low ferritin causes loads of symptoms.

Get back to Gp after looking uo ferritin.

Hopefully iron will be prescribed then bloods redone.

See a different gp perhaos.

Just in addition to all the useful links Sleepybunny has given.

Meanwhile eat iron rich foods with vit c little and often to aid absorption.

And up folate rich foods.

Your symptoms 'scream ' low ferritin to me.

Non medic .

B12 shoukd be trialled or treated before folate supplements.

Hope you find answers soon.

Push for more tests and to get listened to.