Should my niece be treated for pernicious aneamia or at least b12 deficiency please

[poppppy]

My neice had vitamin b12 result of 265 ( range is 211 to 911) and iron was low at the time . She was given iron tablets on prescription at time . Her ferritin was 14 (10 to 291 ) . HB was 130 (115 to 165 ) .

I know they are in range but was thinking is she heading for pernicious anaemia . And do u find those low end of range are ill and need treatment .

She has had symptoms of dizziness . Feeling like she may fall over since before these results . She was diagnosed hypothyroid with high tsh at the time and low free t4 . But still has same symptoms.

Do you feel its worth her getting a vitamin b12 injection .

If so where would she buy it . I have a medical background so would inject it .

She has bought vit b12 tablets recommended on thyroid forum . But your recommendations also would be so welcomed

Thank you so much for your time and expertise. Really appreciate any help thank you

[Nackapan]

I would personally wait.Her symptoms maybe due to hef low iron and ferritin.

Was her vit D and folate okay.?

As you know it's safer for first b12 to be done in s clinical setting.

Also if other tests needed like IFAB needed best before any b12 injections.

[Babatunde_Eskavita in reply to Nackapan]

Good point Dr! xxx

[poppppy in reply to Nackapan]

I will check what her folate and vit d were thank you . And ask if they will do an IFAB . Dont know what that is . I will search engine it . Thqnk you for your help

[poppppy in reply to Nackapan]

Thank you . I have found ifab. Intrinsic factors antibodies blood test . To test for pernicious aneamia . Doubt gp will do it . But may ask. Thank you

[Babatunde_Eskavita]

Yes, it is very important. Hehehe

[Gambit62 Administrator]

If she has had B12 done in the past and it was significantly higher that would be evidence of a B12 absorption problem - significantly higher means >20% higher - so roughly 330 or more.

Otherwise suggest you wait and see. If previous readings were around 265 then that would indicate that is just the right level for her - levels tend to be pretty constant in a given individual without an absorption problem - the 20% is about the accuracy of the serum B12 test - you get that variation from measuring the same sample several times - so unless the variation is outside that range it isn't a significant variation.

[poppppy in reply to Gambit62]

Thank you . I get you . Thank you . I was thinking that may be her norm could have been top of the range etc . But don't think it was ever done in her past . I will ask her . So thank you .

[WiscGuy]

The excellent article "The Many Faces of Cobalamin (B12) Deficiency", written by Dutch researchers/clinicians and published in the Journal "Mayo Clinic Proceedings " (US), covers this situation. Look at patient profile C, the third of six brief patient profiles in the article.

ncbi.nlm.nih.gov/pmc/articl...

I suggest clicking on "PDF" in the upper left corner to get a more usable format of the article.