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Thyroid UK
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Feeling emotional after GP visit

after a 3 week wait to see a GP at my surgery, I left his consulting room in tears,

After posting my results on here a few weeks ago I thought I'd go and discuss my low B12  179  (130 -1100) 

As PA runs in the family (my mum, my sister and my grandma) I thought we could discuss this 

He said my B12 was absolutely fine!

He wasn't interested in any of my symptoms

always cold, memory loss, burning itchy legs and hands, headaches, sore mouth, chronic fatigue ...

I did say to him that I had done a small amount of research and that an optimal B12 is benificial to thyroid function (am I wrong?)  he said show me the proof...  He's made me an appointment for a week today to go back armed with information 

Any info would be so greatly appreciated 

Im feeling so stressed :-( 

17 Replies

So, the patient has to educate the doctor! They are so intent on 'within the range' that it doesn't appear to matter that the patient's result is at the low end instead of towards the upper part.

I am sorry you have been disappointed but we have to be determined to get well and our vitamins/minerals because we already have an autoimmune condition should be more or less optimum too.

I am sure our member Marz will respond to help you with your research on B12.


Thank you Shaws

I did say to him, you're treating the 'range' and not me...

I'm also hoping Marz will respond as I'm Hashimotos too 



Try to be positive. He has backed himself into a corner, because when you go back armed with the info, he will have no option but to treat. Most GPs simply say no!

There is a Pernicious Anaemia group here on Healthunlocked, and they can give you lots of info on protocols for treating low B12. If I remember rightly, low in range but symptomatic, especially neurological symptoms warrants a B12 trial regardless. And that is either NICE or the Haematology crowd's official line.



The above link will take you to the PAS forum and a thread with ALL the links you will need .....

Your GP should be sacked for being so ineffective.  Does he not even know the basics.

Some key points:-

B12 range starts at 500 in Japan = lower Alzheimers and Dementia.

Only 20% of the serum test result for B12 is available to be utilised in the cells - where it is needed.  Making your result even worse.

B12 - when low - becomes a neurological condition and it is NOT just a vitamin deficiency.

You need to know what is causing the poor absorption - most of the B12 is metabolised in the Terminal Ileum - so do you have any gut issues ?

Perhaps it would be good to write to your GP - maybe an e-mail before you see him next time as teaching him the intricacies of Low B12 will take a double or triple appointment.  Your post makes me want to SCREAM .....poor you - I am so saddened you have been treated so badly. 


Thank you Marz

My aim today is to find and print off any info I can to take back to him before next Tuesday but I'm not sure where to start, my mind is all over the place...

I do have a gastric band, would this make a difference ?

Thank you so much for your response, I so wish I had your knowledge 


By the way - was the gastric band due to being overweight? If you have been undiagnosed I wonder if the weight gain was due to that reason. Many posts are about weight gain.


Sammys19 - yes I do believe the GB will affect your B12 absorption or at least lower it ....

Yes it is difficult when there is so much information.  There is a sample letter you can write contained within one of the links ....


Such  helpful input from Tracy who runs the website - please try and read the above link then you are on your way ....

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The rapid response from Erlend Aasheim discusses low b12 after gastric band. Basically says shots are the surest route.

Don't be discouraged! Doctors must deal with a lot of bureacracy and information overload and that can lead them into being dogmatic. It is no reflection on the reality of your symptoms. It follows that if you have an issue, there must be a sensible way of understanding and addressing it.

I second b12deficiency.info also, and the PAS website.

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Yes, I was 19.5 stone when I had the band fitted and reached my goal weight of 10.9 three years ago, I have put on 3 stone with no change in diet in the last three years, but I do not have test results to refer back to 


My B12 was 169, same range, and my Endo has me on injections.  Talk about GP's being  Jack of all trades, master of none.  Feel for you Sammys19 and hope you can persuade your rather pompous sounding GP you need help.


Hi, no wonder you were upset, you have a cold and unfeeling gp. Have you looked at the bcsh guidelines that he is supposed to have read, bcshguidelines.com it discusses the flaws in the b12 test and states that doctors should treat the symptoms and not rely on the test result. Especially important if you have neurological symptoms. Show him a copy! Others will post other links too from b12 deficiency websites and the bmj. Good luck! :-)

Edit: I see Marz has already given you the b12 and pernicious anemia society website. Sorry! :-)

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I'd post this in healthunlocked.com/pasoc for advice.  I was under the impression that GPs would test for pernicious anaemia when first degree relatives are diagnosed with it.

Although your B12 isn't deficient it is very low and your symptoms may be due to low B12.  If PA is ruled out, as your B12 is within range NHS is unlikely to prescribe injections or tablets but you can supplement methylocobalamin sublingual lozenges to raise B12 levels.



This links parietal cell antibodies (pernicious anaemia) interfering with absorption of Levothyroxine:


Although improving B12 levels will improve your general wellbeing I'm not aware that it will improve thyroid function but these links may have information:



I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.


'....after a 3 week wait to see a GP at my surgery, I left his consulting room in tears...'


Nothing useful to suggest. Just wanted you to know that you're not alone in having a first class tool for a GP. Mine has all the charisma suavity and smarts of a woodlouse.

Keep you head to the sky and forge on Sammys19. Hope the wise ones have helped.


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First laugh of the day... Your right he is a tool 

Thank you :-)


Thank you everyone, you've all been very kind and helpful, my printer has been on overtime today...

Will be keeping everything crossed for next Tuesday 

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I agree with what others have said about him being a complete tool and advice given is good. I know he asked you to bring in evidence but I do agree with Marz that he is unlikely to read or take in anything much there and then. So I agree that it would be more effective to email him as I used to do with my old GP. You should be able to do this by just putting his full name in lower case (unless it's a very common name) and adding @nhs.net after it. If you can do this then add all the links by email and only take the most salient points that Marz has outlined in print form. 

I know he has asked you to prove it but I've had doctors like him just bin things I've brought while I'm sitting there and more or less tell me to get a life. I hope he shifts from tool-like to somewhat decent but I am worried about all the printing ink possibly going to waste on deaf ears. The main thing is to get what you want and probably need from him ie a trial on B12 injections. So reminding him about the gastric band and poor absorption might be the key point you need to make I feel. 

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All patients should be put onto B12 injections once a gastric band is fitted as the ileum is no longer accessed following the procedure. 

PA can run in families. 

Once you have one auto immune condition it is common place to get more. Hashimotos and PA often are seen together. 

It is difficult to determine what caused the B12d, you may never get to bottom of it as tests are so bad. 

The methylmalonic acid (MMA) and homocysteine tests are more indicative of whether you are low at cellular level. The doctor can do these tests but you may have to do some arm twisting! Otherwise you can get them done privately. St Thomas's do them. 

Remember that supplements will skew test results. 

I'm sure that you have all info you need in links given above. GL. 


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