Help with great nieces blood work please.

[EllaNore]

I have to start this over. I messed this whole thing up. My niece has low white blood cell count, and some other low readings. I gave her the list of symptoms for B12 deficiency before she got all these blood tests done. She marked off just about every symptom on that B12 deficiency list. So I asked her to get all of these tests and they did it for her. But her B12 seems to be fine. But her white blood cell count is low her calcium is high and some of her other thing are borderline low. I was wondering if anybody could make heads or tails out of this. Thank you very much for helping us.

[EllaNore]

B12 levels pretty normal.

B12

[EllaNore in reply to EllaNore]

Things look good here too I think.

More tests

[EllaNore in reply to EllaNore]

Low WBC not RBC. So sorry to get that mixed up.

Low RBC

[EllaNore in reply to EllaNore]

Calcium?

Calcium

[EllaNore in reply to EllaNore]

Neutrophils absolute is borderline low. Her lymphocytes are also low not that low but they are on the low side and that also points towards B12. So it seems she might be borderline B12 deficient with a normal B12 count. Is that possible?

Or could this be an iron deficiency? Come to think of it, I don't see Folate in her tests.

Neutrophils absolute

[Scott-rock in reply to EllaNore]

you need to get her calcium and parathyroid hormone checked at the same time also vitamin D ,

There’s a condition called hyperparathyroidism and hypercalcemia, which has very similar symptoms to b12 deficiency.

The relationship between calcium and parathyroid hormone is like a seesaw when in balance they are stable but if one goes up the other should go down. So if parathyroid hormone is mid range or high and calcium is also high then she needs treatment, it’s harder to get treatment if calcium’s normal and parathyroid hormone is high .

There’s a really good UK support group on Facebook hyperparathyroidism uk action 4 change.

This is actually one of my comorbidities, and likely caused by the pernicious anaemia. I was cured by surgery to remove three of the four glands. Mostly it’s just one gland affected that need’s removed.

Unfortunately there are many conflicting conditions that have the same or similar symptoms to b12 deficiency and it’s difficult to get answers. Unfortunately many doctors find a simple answer and don’t keep looking for the root cause!

[EllaNore in reply to Scott-rock]

Thank you very much Scott Rock, I will tell her all of this. I will suggest that they test her thyroid. Thank you so much I'm very grateful for this information. I know somebody who had her thyroid removed, does that automatically lead to B12 issues? Does everybody with hyperthyroidism or thyroiditis have B12 deficiency? And vice versa?

[Scott-rock in reply to EllaNore]

it’s not thyroid , it’s parathyroid completely different .

[EllaNore in reply to Scott-rock]

Thank you I don't know anything about parathyroid or any of that. I should probably do some reading. Thank you so much!!

[FlipperTD in reply to EllaNore]

Hi. Scientist, not medic.

Looking at the results, then the WBC is a little bit low and that's a knock-on of what goes into it; the neutrophils and lymphocytes being the main ones.

Has she had these repeated? It's always interesting to see if things change, and why were these tests done in the first place?

When you see the wide 'normal' range for these tests, the total white cell count is very wide; lower to upper bound is about four-fold. We think of white cells being 'blood cells' but the white cells are 'on their way somewhere else', to fight infections and so on, so the reported number can vary quite a bit over time.

It's also worth noting that the ranges quoted are typically '95% ranges' meaning that 95% of normal folks have results within the range, meaning that 5% [one in 20] whilst being normal, can have a result outside the range whilst still being normal.

The 95% range also means that the more things you measure, the more chance you have of finding something on the bounds, whilst still remaining normal.

Be guided by a doctor you can trust, and listen to what they have to say, and consider repeating the FBC to see if anything's changed.

As for the calcium, it's still normal. Has she had her thyroid function checked? I don't see any results here.

Good luck!

[EllaNore in reply to FlipperTD]

Thank you very much flipper TD for your response. My niece contacted me because her and her daughter are suffering symptoms that nobody could figure out. They both have chiari. And they both suffer from certain symptoms so I sent her the symptoms of B12 because it's questionable that it runs in the family. And she marked off so many of the symptoms that I suggested that she get this blood work done to rule out B12 which I think they did rule out. It seems pretty normal to me. But she had so many of the symptoms that I was surprised to see her blood work come out so good. So that's what let us down this path. I don't know how many different blood tests they've had in the past I know that they've had some because my niece said she was going to go see if they ever ran B12 before. So I know she has other blood work I can ask her to send it to me or I can ask her to look a particular things and tell me if they've changed or are the same.So you think everything looks pretty normal then? Even the white blood cell count? Do you think it's just that maybe she might have a minor infection or something? She's got good doctors they're willing to do anything. They're the ones who told her to ask the family if they have any rare diseases that they should look into. So even the doctors are concerned and willing to test them for anything. So her doctor actually told her to ask.

[FlipperTD in reply to EllaNore]

Hi. Thanks for the background. Virtualy everything looks normal, and what isn't is only slightly abnormal so that's why a repeat FBC would be interesting. We can very easily worry ourselves into something terrible but many times it isn't. Even with her slightly reduced WBC, then the infection risk is likely to be low.

Good luck.

[EllaNore in reply to FlipperTD]

Okay thank you so much flipper TD. I really appreciate your knowledge. So glad you're here to help.

[Gambit62 Administrator]

Unfortunately the symptoms of B12 deficiency overlap with a huge number of other conditions.

The test that is obviously below range is WBC rather than RBC so affecting ability to fight infection, so nothing pointing at B12 as an issue in the test results. suggest follow up with her doctor

[EllaNore in reply to Gambit62]

Oh my gosh how stupid of me! B12 brain! it's not her RBC it was her WBC. What was I saying? I'm so frustrated with this stupid deficiency that I read things wrong. But something is not right with the WBC being low and the high calcium right, lymphocytes etc? I'm so upset that I read that wrong when I was looking right at it. I'm so upset that I read things incorrectly lately and I get things mixed up I'm so sorry. Thank you for correcting that. I should mention that both my niece and her daughter, whose blood test results these are Have chiari.

Thank you so much gambit. I better not give any more advice on here. I get things mixed up. I feel so stupid. But something is not right with her results. That I know.

[Technoid]

The results seem to suggest something other than B12 deficiency. The low White Blood Cell Count, Borderline High Normal Calcium and Lowish Lymphocytes and Eosinophils all look worth investigating to me.

[EllaNore in reply to Technoid]

Thank you technoid I got the RBC in the WBC mixed up for some stupid reason I'm so frustrated about that. What the heck? They both suffer from Chiari which is where your brain comes out of your skull, I believe at the spine. A possible infection?