Blood test results..interpretation/advice.

[Betwelvepatient]

I was diagnosed with B12 deficiency at the beginning of the month and have received a prescription for loading dose (I self administered without approval or support as the first appointment was nearly 2 months away).I've since had a further blood test which revealed no anaemia or macrocytic anaemia but I don't think they tested my IF for evidence of pernicious anaemia.

I have the following blood results in my patient record via the nhs app and wondered if 1. This could be a new name for it or if not, what an earth I was rested for and what it means.

I've used your support and advice from previous posts to get me to the point of feeling confident to request a gp follow up (this is happening today) but I would really like to be as prepared as possible as they have been very unsupportive and quite difficult since my diagnosis and subsequent fight for the correct treatment (every other day injections with neuropathy symptoms).

I appreciate any and all advice.

[FlipperTD]

I'm a scientist, not a medic.

The test you show is an anti-nuclear antibody test, and the result shows it's negative. It's a general screening test for auto-immune conditions, and it's not the same as an IFAb test, or a Parietal Cell Antibody test. However, 'Negative is good' in this case!

[Betwelvepatient in reply to FlipperTD]

Thank you so much for replying. It seems my GP is convinced B12 deficiency is not causing my symptoms and is determined to rule out everything else before they'll agree that it is.

[Cherylclaire Forum Support in reply to Betwelvepatient]

Please resist the (sometimes overwhelming) temptation to prove them wrong by deteriorating until symptoms become too obvious to ignore. A risky method of getting medical professionals to change their mind !

Ask for an IFab test - it seems a reasonable request. Non-dietary B12 deficiency is obviously caused by lack of extrinsic factor (food-sourced B12) but everything else warrants further investigation surely. Even those with a lack of B12 in their diet could potentially have underlying issues, after all.

A methylmalonic acid ( MMA ) test could reveal a raised/high serum MMA, meaning that either there is insufficient serum B12 for MMA to link up with to transport on to cell/tissue level or, once B12 injections have started, a link-up malfunction with the same resulting cell/tissue problems. An MMA test is difficult for GPs to request, easier to get if referred to secondary care (haematology the most likely route) -but is a good secondary test for those who have "borderline" serum B12 results or those who are not responding to B12 injections.

MMA can also be raised/high due to renal problems or small intestine bacterial overgrowth (SIBO) - any renal problem can be ruled out at the same time with a blood test, SIBO would require a fasting series of breath tests over 3-4 hours. That may also be difficult to get via NHS, but SIBO is a B12 deficiency cause with the bacteria also compromising the host's access to other vitamins. It is treatable with antibiotics -but can be tough-going to eradicate completely. Several types of antibiotics can also deplete B12 making treatment even more complex.

[Sleepybunny]

Hi,

It's possible to get a private IFA test in UK although NHS GPs may not accept it.

Some labs say to leave at least 48 hours after a B12 injection before testing IFA and some say leave up to two weeks after.

Link about IFA (Intrinsic Factor Antibody) test

If IFA test is negative (or normal range) then that does not rule out PA.

Search online for this document "NICE CKS Anaemia - B12 and Folate deficiency".

Read the Background Information section and Testing section.

Have a look at your ICBs B12 deficiency guidelines and see what they say about testing IFA.

I mentioned this on a previous thread of yours but has some useful info so I've put link again.

Link about useful tests for PA and B12 deficiency

(It mentions other tests besides IFA)

healthunlocked.com/pasoc/po...

Have you had a gastrin test?

Raised levels of gastrin associated with PA

labtestsonline.org.uk/tests...

Links about MMA

labtestsonline.org.uk/tests...

stichtingb12tekort.nl/engli...

[Sleepybunny]

Have sent you a PM (private message).