Thyroid UK

B12 advice

Hoping somebody can give me some advice. Have at last found out my blood test results (had to request the figures because they had just been filed marked "normal - no action).

B12 is 268 (they quote range as 120-625 so say I am mid range)

Folate is 10.8

I am just wondering (hoping) if this could be the reason for my tingling arms, hands, legs, feet and on occasion face.

Do these seem a bit on the low side? I was about to order some B12 tablets, but thought it worth asking on here first:)

Many thanks.

4 Replies

If you are symptomatic then you should use the new BCSH treatment guidelines to try and get some second line tests done and some treatment. Have a look at the guidelines and the diagnostic flowchart called algorithm 1:

And also note this specific recommendation:

"Serum cobalamin level of greater than 148 pmol/L (200 ng/l) in the

presence of a strong clinical suspicion of cobalamin deficiency should be evaluated further with MMA, tHcy or HoloTC and a trial of hydroxocobalamin given to ascertain any clinical improvement (Grade 1C)."

And if you don't have anaemia or macrocytosis (many docs think these have to be present):

"Neurological presentation (peripheral neuropathy, sub-acute combined degeneration of the cord) may occur in the absence of haematological changes, and early treatment is essential to avoid permanent neurological disability."

"The absence of a raised MCV cannot be used to exclude the need for cobalamin testing since neurological impairement occurs with a normal MCV in 25% of cases(Lindenbaum, et al 1988) (Healton, et al 1991)."

It is best not to supplement until you've had some second line tests done.

H x


Thank you hampster1, but my GP will not do any more tests, he is satisfied that they have checked everything.

On the LFT there were two results that I thought were rather high:

Serum Alkaline Phosphatase (ALP) was 91 (range 25-92) and Serum Potassium was 5.1 (range 3.5-5.0), everything else was well within normal range.


These are brand new guidelines, the GP won't of seen them so it's well worth a try. x


I was advised that anybody who is hypothyroid should take 1000mcg B12 per day and also that my above range LFTs would settle when I was adequately treated (had TT and have had trouble with replacement since). Hope that helps.


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