Vitamin B12 deficiency ?

[jules1955]

Hello everyone, well after blood tests showed my MCV at 105 ( Doctor said red blood cells too chunky ) I had more blood & urine tests and had results for Serum gamma GT - immunoglobulins - Serum iron - and serum folate all within normal range - but my Serum vitamin B12 = 148 ( normal range 187 - 883 ) so now have to have more blood tests. I know all these results as I check my NHS app.

The receptionist called and just said nothing to worry about but need more blood tests, she didn't know any results or why I needed more tests, was just told to call me to book appointment. Don't worry only routine. The thing is I do worry and I am on holiday next week - so more tests not until the end of July. Does anyone know what the next tests will look for ?

So is a Vitamin B12 deficiency serious ? Is 148 really low and what can cause it ? I had my Gall Bladder removed a few years ago ?

Anyone had B12 deficiency ?

[PMRpro Ambassador]

What they are probably looking for is evidence of another autoimmune condition called pernicious anaemia which affects your ability to absorb vit B12 from your diet.

nhs.uk/conditions/vitamin-b....

Have you been on a PPI - omeprazole or the like? They can also impair absorption of vit B12 because you need stomach acid for the process.

If you are feeling OK there isn't anything to worry about in the short term - so enjoy that holiday! In the medium term - once they know whether it is PA, poor diet or another cause such as a PPI it will be sorted - either by stopping the PPI and/or giving supplemental B12 or giving injections of B12 which deals with the lack of intrinsic factor in PA.

[jules1955 in reply to PMRpro]

Hi PMRP I did take Omeprazole for some months at the beginning of my PMR diagnosis, but haven’t taken it for a couple of years. Thank you for your reply x

[PMRpro Ambassador in reply to jules1955]

How is your diet? I don't know if a PPI can trigger a longer term problem - but they do have a reputation for problems of one sort of another for about a third of patients! My husband used to practically explode on them!

[jules1955 in reply to PMRpro]

I eat hardly any red meat and I don’t like milk but eat yogurt & cheese.Only eat eggs hard boiled with salad.

[PMRpro Ambassador in reply to jules1955]

Marmite? What vegans use to get vit B12.

[Karenjaninaz]

B12 deficiency has been implicated in dementia. Prednisone depletes B12.I take a tablet which dissolves under the tongue.

[pata63]

I had an undiagnosed B12 deficiency for a few years. I went to a to different GP who was recommended as better at differential diagnosis. He sent me to a psychologist because it was all in my head. It wasn't, but the psychological testing actually pointed me to the reality of one of the symptoms. I changed to a different GP who sent me for blood tests when I had my first consultation with him based on my symptoms. I got a call to come in as soon as the results came in. My B12 was 144 pmol/L ( 170 - 600 acceptable range ). Note the units may be slightly different from the ones your report is in.

This was all in December 2009 so a decade before any autoimmune issues arose for me. I was given 3 injections of B12 over the next 3 days, and sent for a test for intrinsic factor antibodies. That wasn't deemed to be the problem. I've been on monthly B12 injections since. I'm allowed to do them more frequently as needed but am generally good for 30 days or so. In my case I was eating plenty of meat fish and dairy products, but just unable to metabolize the B12 properly. In addition to B12 I was also low on Folic acid, even though I love broccoli, Brussels sprouts, asparagus, peas, chickpeas and brown rice. Now that I read the link PMRpro gave, this is the first time I had any idea that those could have been autoimmune issues. 😜 The rest of my bloods didn't give any hint of raised CPR, etc, and I was put on an elimination diet (no gluten) to see if something like Coeliac was behind the Folic acid being low, so I guess they ruled autoimmune causes out correctly. Or I've had autoimmune issues going on for a lot longer than I imagined.

[jules1955 in reply to pata63]

Thank you for reply, what symptoms did you have ? I just feel tired / fatigue and some days wake up knackered but put it down to PMR x

[pata63 in reply to jules1955]

Yes it is very difficult to untangle the fatigue of PMR from fatigue due to B12 shortage. From an individual perspective when you have fatigue you have fatigue.

My symptoms included fatigue and brain fog, but what stood out was losing my ability to do spatial reasoning, tell left from right when reading maps, imagine driving routes in my mind even though I had done them many times before, ability to remember lists of 7 or more things, complex logical tasks, and much of my arithmetical ability. The effects on my brain are still there, and were not completely reversed by the B12. But I can pass as normal now. Mostly. 😜

[Missus835]

I take a B12 supplement which absorbs under the tongue and only because I thought I would help with the fatigue. Doesn't seem to make much difference. Also I take rabeprazole for GERD which might be a factor in lack of absorption of B12. So far (fingers crossed) no actual B12 deficiency. All the best to you.

[jules1955 in reply to Missus835]

Thank you x

[Purple-Owl in reply to Missus835]

What is GERD?

[DorsetLady PMRGCAuk volunteer in reply to Purple-Owl]

Gastroesophageal reflux disease, or GERD, is a digestive disorder that affects the ring of muscle between your esophagus and your stomach.

[Missus835]

Simply put, acid reflux.

[Viveka]

In around 2010 ish I started with noticeable tingles in fingers, hands, toes, feet and was diagnosed with a B12 deficiency. I had injections for a few years but I was convinced it was to do with my vegetarian diet. A nurse told me I would be on injections for life but a doctor said I could try 1mg of B12 a day. I ususally take this every other day now and I am in the mid range of normal around 300. The doc says I am absorbing B12, so not pernicious anaemia, but just not as efficient as some people.

You can get 1mg B12 online as it is stronger than what you get in health shops so not usually available.

Pre-dated GCA diagnosis by a decade so unlikely to be connected and as I say with a few tablets a week I am fine. Still working on everything else.