Why is Dr. Numbers requesting VitD & Folate blood retests 5 weeks after supplementing?

[Clutter]

Was severely deficient 5 weeks ago, given scrip & given blood form to retest in 3 months. Requested repeat scrip & note attached to it saying I should retest now. Isn't it a bit soon?

[helvella Administrator]

Not answering your question, but may I check that you are being given a folate supplement but not B12?

It is usually regarded as better practice to look at B12 before folate as supplementing with folate can mask some of the clinical signs of low B12.

Rod

[Clutter in reply to helvella]

B12 was 363 (190-900) & no argument about serum test being inaccurate or hypothyroid px requiring B12 high in range would persuade her to prescribe so I'm self supplementing with sublingual spray.

Folate was 1.9 (2-14.5) so Folic Acid 5mg daily is prescribed. PiL recommends this dose for 4 months.

[helvella Administrator in reply to Clutter]

Last time I looked there was no suitable licensed B12 product - only injectable hydroxocobalamin available on NHS. I she was not going to give that form, then it probably is not worth arguing. The problem I see, given your sensible supplementation, is knowing where you are in terms of B12 into the future.

[Clutter in reply to helvella]

The retest form requests VitD & BF. I'm pretty sure B=B12, so I'll be able to see if its improved or not. The spray tastes of apricots, quite delicious, so I'm suspicious how good it actually is

If it isn't improved I may go the injection route, but I would really have liked to be shown how. I daresay YouTube will oblige.

[helvella Administrator in reply to Clutter]

You won't! Because both the standard "serum B12" and the new "Active B12" tests will not provide useful results while you are taking B12 supplements. I think the Active B12 people suggest one month without supplements - but am not sure what gap is appropriate for the standard serum B12 test.

I'd not be happy self-injecting without proper advice.

Yes - the taste of every B12 tablet I have taken has been wonderful! Probably entirely the fruit extracts added, but mmmmm....

Rod

[Clutter in reply to helvella]

I've only been supplementing B12 since 1st Dec so I'm happy to continue a few months more. Will bear in mind the month off before testing. Hopefully NHS will have moved to 'Active' testing sooner, rather than later.

[Moggie]

How much vitd are you taking? I was on 50,000iu daily and was retested after 6 weeks so I suppose it depend what dose you are on. How deficient were you?

Moggie x

[Clutter in reply to Moggie]

VitD <10. 40,000iu daily loaded for 7 days & 2,000iu daily for 3 months - currently at end of 1st month.

[Moggie in reply to Clutter]

Then - going by what my GP did - a test after 6 weeks seems pretty standard as this is how long it will take for the loading dose to take effect. Is she going to test your calcium as well?

Moggie x

[Clutter in reply to Moggie]

I doubt it. Calcium hasnt been mentioned unless she has access to calcium result from endo appt. in May. She wanted to know how I came to have ferritin, VitD, B12 & folate tested in first place - I said I requested because i felt so ill and Dr. C. obliged during Sept review to discuss COPD & spirometry. Dr. C. declined to test cortisol because "I patently don't have Cushings".

Then she prescribed VitD & folate and told me to eat plenty of fresh greens to boost vitD. Here's me thinking eggs, dairy & sunshine are reqd for vitD.

Endo said calcium was ok in May, but also said July FBC was okay so calcium, ferritin, vitD, folate & B12 etc. would be too, so I take that with a pinch of salt.

I shall be requesting print outs from Endos in future although I've always verbally been given TFTs with lab refs.

[Moggie in reply to Clutter]

Please insist on a calcium test when she tests your VitD - you cannot give someone such a high dose of vitD without testing their calcium. My GP automatically tested calcium every time (I have been on the 50,000iu dose more than once).

Moggie x