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.
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Twitchen
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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:
"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.
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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