Is this classed as low folate?

[tnefeh]

I'm a little confused about my blood test results. I'm not sure if I am posting in the right group!

MCH and MCHC were slightly high which can indicate macrolytic anaemia. GP said I don't have that because my B12 and folate levels are fine (which are the usual causes). However, I posted the results in the thyroid group who said my folate levels are actually low. So does this mean I might actually have macrolytic anaemia?

I've put the 'abnormal' test results in bold:

Haemoglobin 133 - reference range 115-165

Platelet count 242 - reference range 150 - 450

Red blood cell count (RBC) 4.20 - reference range 3.8 - 5.5

Haematocrit 0.382 reference range 0.37 - 0.48

Mean corpuscular volume (MCV) 90.8 reference range 80 - 100

Mean corpus haemoglobin (MCH) 32.1 reference range 26.5 - 31.5

Mean corpus haemoglobin concentration (MCHC) 352 reference range 300 - 350

B12 - 570 - reference range 200 - 900

Vit D - 117.2 - reference range 50 - 150

Folate - 6.8 - reference range 3 - 12

Ferritin - 9 - reference range 10 - 120 - diagnosed by GP with iron deficiency and prescribed ferrous sulphate tablets

Any input, suggestions or advice would be appreciated! thank you

[Technoid]

The folate range you stated seems to differ from common folate test ranges but according to the stated range, your folate is almost dead centre of the normal range. Those who think your folate is "low" are probably going by the more common ranges. FlipperTD might have some insight.

[tnefeh in reply to Technoid]

thank you! yes that's why I was so confused why people were saying it was 'low'. mine is in ng/ml but the reference range is different if it's in nmol/l

[am111]

your Hb is 6 when the range is 11.5-16.5, which means you are definitely anaemic. Your ferritin is very low and that may be the main cause of your anaemia. When you supplement with iron, it can start using up folate and B12, so it might be wise to supplement simultaneously with these as well even if they show up fine right now.

[tnefeh in reply to am111]

I accidently wrote the wrong number for the haemoglobin, it is actually 133 and the range is 115 - 165 so it is in range. Sorry! do you think it's worth re-testing the folate and B12 now I've been taking iron for a while to see if they are any lower? thanks for your help!

[am111 in reply to tnefeh]

You have normal Hb. I think the only thing low was ferritin and you are taking iron. Retesting folate and B12 now does make sense to see if they are getting depleted. However, note that if you are on any kind of B12 supplementation, serum B12 will show up high and will not be reliable. (I don't know about folate).

If you have a thyroid problem, iron, B12 and folate can take a dip, so it is prudent to test and also be on these regularly, else they may get depleted in the future. I had all these deficiencies, but now that I am on regular Levo dose and my TSH is in range, I no longer need supplementation of iron as it has come fine now and possibly B12 as well, although I still do take B12 just to be on the safe side.

BTW, do you have any symptoms or are you just worried because of your blood tests, which are not too much out of range, as iron deficiency will typically show up in Hb and if your Hb is fine, you may not need anything (although some twice-weekly dose of iron may not be harmful in any way).

[FlipperTD]

Scientist, not medic.

The results you give don't add up. Were these data all from the same sample? Your MCH is actually 31.7, and your MCHC is 34.8 from the Hb, RBC and MCV results. Whilst the 31.7 is above the reference range, the range is only a 95% range, meaning that 5% of normals will be outside the range. Don't panic. You are NOT anaemic. You are NOT macrocytic either. Your folate is normal.

I hope this helps.

[tnefeh in reply to FlipperTD]

Yes they were from two different samples! One of the samples had MCH and the other had MCHC. That's great that I'm not anaemic! I think it's really helped posting on here to get some clarity. So I will just focus on treating the iron deficiency which is iron deficiency without aneamia

[FlipperTD in reply to tnefeh]

Lots of folks have low iron. It's a symptom of something else. Either chronic blood loss, or poor intake, but you're coping at that level. Don't overdo any replacement because 'Enough is good, more is not better'. Iron in excess is toxic. So, keep in touch with your GP.

[tnefeh in reply to FlipperTD]

I'm actually not coping I'm very ill. GP says under 30 is iron deficiency and under 10 is severe iron deficiency. Thankfully the prescription tablets have been helping!

I have a thyroid disorder too and in general thyroid specialists like iron to be around 100 before patients start to see improvements in their symptoms. Excess iron is very bad though I agree! So won't want it to go much higher than that

I also have other deficiencies and recently had a low faecal elastase test result which GP thinks is pancreatic exocrine insufficiency, I'm waiting to see gastro to confirm. That causes malabsorption so would explain my deficiencies. So the low iron is probably because of that!

[Mixteca in reply to tnefeh]

As you're clearly severely deficient in iron then a full iron panel should be done. Seeing an iron specialist afterwards would be your other option. The tablets might take a long time and may not resolve the problem if absorption is an issue.