Hi all
Originally diagnosed 2017 b12 was 71, iron was 8 and folate was 2.
I’ve had a couple of folic acid lows which have been treated.
Things have got gradually better, however the last couple of months have been awful.
Racing heart, flooding periods, pins and needles, exhaustion etc.
Would only let me upload one pic but:
folate 8.6 range is 4-27
Iron is 55 range is 30-150
TSH 1.85 range is 0.27 to 4.2
Latest bloods show the attached. Any insight would be appreciated.
Is your doctor acting on the low iron results?Prescribing iron
Then looks like s maintenence dose needed
Do you take s daily maintenence dose of folic acid ?
Childbearing aged women are recommended to take 400mcg daily.
I got breathless and heart palpitations and shook alot until iron and ferritin level rose.
Hope you get it sorted and get back on track.
The dr who reviewed my blood results said everything is normal and I’m not anaemic.
I looked at those bloods and thought very much not normal, they’re all borderline to the enth degree.
I do take 400 folic acid a day but miss the odd day.
Interested to see your opinion is ferritin is low at 55 yet they brand it ‘normal’.
I’ve put an appointment request through the really good dr I actually saw.
What is your ferritin count?
55
For a PA/B12D person the concensus is that ferritin should be around 100. The ferritin level indicates the level of iron stores so your iron stores are probably depleted without the blood count necessarily indicating iron depletion. It is now more widely recognised that ferritin can be low without clear indications of anaemia. The symptoms are more or less the same. To treat ferritin D without anaemia I had both a ferritin infusion and then heme iron. It brought about a very marked improvement in energy, dizziness and anxiety. The latter was the most unexpected change, but it was very significant.
So interesting.
Looking back over older blood tests the best I felt was when my result was in the 90s and taking iron on the regular.
Scientist, not medic. This is however my field.
Your next post suggests that your results above aren't normal. Sorry, but you're wrong there. You have one result outside the reference range; the MCH, at 32.9. Please note that reference ranges are indicators; they describe a range that 95% of 'normals' fit into. This means that a further 5% of 'normals' can be outside that range but still normal, so 1 in 20 who are normal may be outside that range. 99.7% of normals lie within 3 Standard Deviations [SD] of the mean. That would take your MCH result within the range, which would actually go up to 33.25 you'd be well inside a 3SD range.
It's worth remembering that normal results don't mean that everything is normal. That's why we have doctors to interpret the results along with our general physical condition. "Treat the patient, not the numbers" is a sound approach.
Looked at another way, if you measure enough numbers you're going to find something outside the +/- 2 SD range. I'm with your doctor on this one! Your doctor will see dozens, if not hundreds of results, so it's fair to expect that they won't panic over one MCH result in a field of very normal results.
The FBC magic numbers for red cells, to take note of, are Hb [if that's OK, there's not that much going on]. MCV? Ditto. RDW will tell you if anything is changing.
It would be interesting to note if you ever had an FBC performed when you were healthy, because we're all different, and some folks simply run higher numbers than others.
Don't panic.
Thanks!
Not panicking by any stretch!
I don’t disagree with you at all, hundreds of people day in day out and am a firm believer that if anything was truly off my bloods would be a mess as they were at original diagnosis.
Just checked back over previous tests.
The FBC when I was severely deficient were similar, although low iron and low folate and or b12 can fake a more normal result? Tbh I’ve felt good for the last few years so my knowledge has diminished.
Other FBC tests are less borderline.
The reality is all I can do is wait and see if it resolves or not.
Just out of curiosity and value you’re opinion as your knowledge is incredible, do you disagree ferritin is low and iron could do with some attention?
Thanks!
Oh, now you're talking. I tend to favour iron and ferritin at lower levels rather than higher, as Iron is a scarce element and we're good at scavenging it. The only reliable way of getting rid of it is either bleeding profusely, or giving birth.
Ferritin isn't as simple as it's an acute phase reactant, so a raised ferritin might not be what it seems.
That's why we have doctors!
Hi,
I'm not a scientist or a health professional.
Your MCV is fairly close to the top end of the normal range.
Your MCH is above normal range.
Your MCHC is close to the top end of the normal range.
Your RBC distribution is quite close to the top end of the normal range.
Your ferritin is below half way in the normal range.
Have you got results for full range of iron tests?
Low iron can lead to small red blood cells (microcytosis).
Low B12 (and low folate) can lead to enlarged red blood cells (macrocytosis).
In a person with both low iron and low B12 (and/or folate) red blood cells can appear to be normal size on full blood count (FBC) as effects of low iron can mask the effects of low B12 (and/or folate).
A high RBC distribution result might mean that there is mixture of small red blood cells and large red blood cells.
Link about iron tests
See section on what test result means.
labtestsonline.org.uk/tests...
Link about full blood count (aka complete blood count)
labtestsonline.org.uk/tests...
Links about Macrocytosis
Aimed at patients
patient.info/allergies-bloo...
Aimed at health doctors
patient.info/doctor/macrocy...
Link about non anaemic iron deficiency
Aimed at doctors
patient.info/doctor/non-ana...
"Originally diagnosed 2017 b12 was 71"
Are you getting enough B12?
Should be some useful info in my replies on this thread below including UK B12 documents and links for those struggling to get treatment.
Help Needed! Have I got Pernicious Anaemia?
healthunlocked.com/pasoc/po...
Thanks for your time.
Just ferritin was tested no further iron/ferritin tests.
The last time I had flooding periods, hair loss, weight loss etc etc my folate was 2 and that was 2 years ago but it’s currently well within normal at 8.6. I’m due a b12 but I’ve held off because of all this I’ve got going on.
I’m slim and very fit, run/yoga but my resting heart rate is between 90 and 115.
I’m frustrated after feeling really good for a few years bar the folate a couple of years ago but obviously pleased my bloods aren’t on th floor.
Some UK forum members find they need far more B12 than NHS treatment allows.
Some get extra B12 injections from private GPs, some go to beauty salons, some try high dose oral B12 but this doesn't work for some (didn't for me) and some as a last resort turn to SI (self injection).
You mention a neurological symptom "pins and needles".
Do you have other neuro symptoms?
With neuro symptoms present, I would expect you to be getting B12 injections from NHS every 2 months at least.
How many loading injections did you have when treatment started?
See treatment pattern for those with neurological involvement in Indications and Doses section in BNF entry for hydroxocobalamin.
Search online for "BNF hydroxocobalamin".
Delayed or inadequate treatment of B12 deficiency increases the risk of permanent neurological damage. In severe cases there can be damage to the spinal cord. This can sometimes occur in people whose serum (total) B12 is within normal range.
See thread at bottom of my other reply for more info.
NICE have published info on iron deficiency anaemia.
Search for "NICE anaemia iron deficiency".
If you have time, worth putting any thyroid results on Thyroid UK forum on HU along with an outline of your story. Thyroid UK is an active supportive forum. It's common for forum members here to also have thyroid issues.
It's possible to have thyroid symptoms with normal range TSH.
thyroiduk.org/signs-and-sym...
Have you had other thyroid tests besides TSH?
thyroiduk.org/testing/thyro...
Marz is a forum member here who knows about thyroid issues.
Have you had Vitamin D levels checked?
Quite common for forum members here to have Vit D deficiency.
Had the loading doses and do get top up b12 when I feel it’s needed.
Vit D should be fine - never been low and spend lots of time abroad, supplement in winter.
Dr was going down the thyroid route but that’s well within normal range, will read your links though.
Thank you!
How often do you inject B12? That one test result out of range could be caused by low B12. What does "when I feel it's needed" mean? Ideally we are injecting before we get back any symptoms.
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