B12 test results

[Catty2]

I had radio active treatment in 1999 for an overactive thyroid, so I take 100mg daily and 25mg 3 times a week.

I going through the menopause taking HRT and I have sleep apnea controlled by a CPAP.

But I still feel tired and generally unwell.

I had my a blood test for B12 , folate and ferritin taken.

Below are the results, although they are not below range they are at the lowest end.

Serum folate level (42U5.) 4.5 ng/ml [3 - 20]

Serum vitamin B12 level (XE2pf) 191 ng/L [180 - 640]

Serum ferritin level (XE24r) 53 ng/ml [15 - 200]

Serum TSH level (XaELV) 1.25 miu/L [0.35 - 4.94]

My mum has Pernicious anemia so it is in the family.

I was wondering as I won’t be offered B12 injections,is there any supplements that would be worth taking to try and increase my B12 levels.

I’m based in the UK

Thanks Sharon

[SlowDragon Administrator]

Your B12 and folate are both extremely low.

Before starting on any B vitamin supplements your GP should do full testing testing for pernicious anaemia, especially as your Mum has PA

Suggest you post on PAS healthunlocked too

Just testing TSH is completely inadequate

You need TSH, Ft4 and ft3 testing together

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or thyroid antibodies or vitamin levels

thyroiduk.org.uk/tuk/testin...

For thyroid including antibodies and vitamins

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )

monitormyhealth.org.uk/thyr...

Essential to test vitamin D as well. Ask GP to test

vitamindtest.org.uk

Ferritin is low. Ask Gp to do full iron panel test for anaemia

[SeasideSusie Remembering]

Catty2

I was wondering as I won’t be offered B12 injections

What makes you say you wont be offered B12 injections?

Do you have any signs/symptoms of B12 deficiency? Check here: b12deficiency.info/signs-an...

and here cks.nice.org.uk/anaemia-b12...

If you do then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia.

Pernicious anaemia is in the family, a sure fire reason for your GP to test for PA as your result is so low.

I think the Serum B12 test is also known as Serum Cobalamin test (happy to be corrected), in which case this is important:

cks.nice.org.uk/anaemia-b12...

•There is no gold standard test for measuring vitamin B12 deficiency, but the likelihood of deficiency can be determined by measuring serum cobalamin. ◦A serum cobalamin of less than 200 nanograms/L is sensitive enough to diagnose 97% of people with vitamin B12 deficiency.

As your result is 191ng/L, as well as the family history, then I think you should push your GP for further investigation.

[Catty2 in reply to SeasideSusie]

The hardest thing is to actually get an appointment, but I will push and even ask for a referral if they can’t help me.

The reason I stated they won’t give me injections is because my notes say no further action.

But when I read the notes from the pathology lab it said:

B12/folate level 

Serum folate level 4.5 ug/L [3.0 - 20.0]

Serum vitamin B12 level 191 ng/L [180.0 - 640.0]

Consider repeat testing in 3/12 if B12 deficiency

is strongly suspected.

Methylmalonic Acid (MMA) testing can be performed

to assess active tissue B12. Consider testing if

strong clinical suspicion of B12 deficiency in

patients with low/normal results.

Sharon