seeking advice/ useful observations for 26yr old daughter ~ she's just been prescribed EOD b12 injections .

[tattybogle]

hi all , i normally hang around on thyroiduk forum as i have autoimmune hypo.

My daughter has asked if you guys would cast an eye over these results , as you know much more than me about b12 issues .

She's 26 , has just been prescribed eod b12 injections due to the following bloods/ symptoms . (no apparent thyroid issue's , we originally wondered if she was going hyperthyroid as symptoms fitted but TSH/ fT4 / fT3 all ok /checked twice, and TPOab negative)

just for info ~ she was recently prescribed propranolol due to palpitations / anxiety/ insomnia/ retching first thing in morning ...propranolol helped with those symptoms quickly , but further tests revealed low b12 and i've just noticed the folate / ferritin are also extremely low ;

B12 145ng/l ~ normal range >203ng/l

Folate 4.4 ug/l ~ normal range >4 ug/l

Ferritin 13 ~normal range 11-307

she's not veggie / vegan , the quality of her diet is generally ok/ good , but her appetite for last year last year has been increasingly poor, and she's lost weight , and as she's been so tired cooking has suffered and take-aways have increased.

She has tingling in fingers but didn't mention this to GP yet.

________FBC:

haemoglobin 130 [115-165]

white cell 9.2 [4-10 ] ..... was 10.1 in may24

platelet 244 [150 -400]

haematocrit 39.7 [36 -46]%

RBC 4.4 [3.8 -5.8]

MCV 31.3 [27 -32]

MCHC 347 [315 -345] .. was 340 in may24

RBC distrib width 13.7 [11.6 -14]%

neutrophil 4.8 [2 - 7.5]

lymphocyte 3 [1-3] .... was 4 in may24

monocyte 0.7 [0.2 - 1]

eosinophil 0.6 [0.2-0.5]

basophil 0.1 [0.0 -0.1]

___________Erythrocyte sedimentation 2 [0 -13] mm

___________Electrophoresis profile:

Serum total protein 65 [60 -80] g/l

IgG 9.31 [6-16] g/l

IGM 0.44 [0.5 - 2] g/l

IGA 1.78 [0.8 - 2.8]

____________renal profile :

serum sodium 1.41 [1.33 -1.46]

potassium 4,7 [3.5 - 5.3]

chloride 105 [95 -108]

UREA LEVEL 2.3 [2.5 - 7.8]

creatinine 61 [ 49 - 90]

__________liver function :

ALT 14 [ 0-35]

alkaline phosphatase 54 [30 -130]

albumin 45 [35 - 50]

globulin 20 [22 -40]

total bilirubin 6 [0-21]

__________ bone profile :

inorganic phosphate 1.17 [0.8 -1.5]

calcium 2.4 [2.2 - 2.65] adjusted calcium level 2.4 [2.2- 2.6]

____________ Hba1c level 35 [ 20 -42]

______________________________________________________________

Sorry for so many results.

Any insights/ advice would be appreciated , and some validation from others that she has a genuine reason for feeling so lousy in recent months would be much appreciated ... i'll get her to read / reply when she can .

thanks muchly . Tattybogle x

[deniseinmilden]

If her B12, folate and iron results are that low she will be feeling absolutely appalling, poor soul.

It's a wonder she is feeling able to exist and must be so stoic to carry on at all.

Please give her my heartfelt sympathy and wish her as well as possible ASAP!

[tattybogle in reply to deniseinmilden]

thankyou very much denise, that's exactly what she needed to hear . ta x

[Nackapan]

Just keep going on the b12 . She will need to find a frequency that suits her.My daughter still needs daily folate

to stay 'in range '

Her ferritin was in 'her boots ' at 9 .

That took longer to raise levels.

Perhaps get vit D tested too ,magnesium anything they will do and supplement accordingly.

She will improve

[tattybogle in reply to Nackapan]

Thanks Nackapan, yes will get vet D done

[Bellabab]

Worth having average blood glucose checked by HbA1C test that give the average over the precious 3 months. This is because diabetes type 2 can present with similar symptoms to B12 deficiency.

[tattybogle in reply to Bellabab]

thanks , forgot to include it on post ~result was HbA1c 35 [20 -42]

[deniseinmilden in reply to tattybogle]

That's a really good point!

And HbA1c of 35 is perfectly "normal" but is higher than I would have expected as she has been losing weight.

She sounds a lot like me at a similar age and I just wonder what the underlying cause of her problems is.

It's easier said than done, as she will need to see a specialist hospital for it (most are lousy or worse, to be honest) and there are very few that are good, but I would suggest getting her gastrointestinal tract investigated.

In the meantime you might be able to get her GP to do a fecal elastase test to check her pancreatic function.

It sounds like she might have hypochlorhydria/achlorhydria (low stomach acid) or possibly chronic pancreatitis - something anyway which is limiting the proper digestion of food and/or the absorption of vitamins and minerals.

Also, has she been checked for coeliac disease?

The critical thing to remember is that symptoms are your body's way of letting you know something is wrong. There's obviously something wrong and there's almost always an explanation/diagnosis to be found - which is needed to determine a course of action/treatment, with the aim of eliminating her symptoms!

The aim must be to be well again and it should be possible!

Good luck! xx