Anemia question

[EchoWS]

Hello there,

I've been tested multiple times over the years and gets results similar to my most recent results which follow. I am hypothyroid and have psoriatic arthritis and Drs say that these results are typical for people with these conditions and not to worry about them overly. I have chronic insufficient sleep issues as well. What do you think of these results? Mean Cell Volume and Mean Cell Hemoglobin. I take b-vitamins so maybe not enough or should I ask for something more? Would anything in addition to folate and B12 help this?

Thank you.

January 2023 -

Haemoglobin concentration 146 g/L [115.0 - 155.0]

Haematocrit 0.447 L/L [0.33 - 0.45]

Mean cell volume 103.5 fL [80.0 - 99.0]; Above high reference limit

Mean cell haemoglobin level 33.8 pg [27.0 -33.5]; Above high reference limit

Mean cell haemoglobin concentration 327 g/L[320.0 - 360.0]

March 2023

Haemoglobin concentration 149 g/L [115.0 -155.01

Haematocrit 0.444 L/L [0.33 - 0.45]

Mean cell volume 101.1 fL [80.0 - 99.0]; Above high reference limit

Mean cell haemoglobin level 33.9 pg [27.0 -33.5]; Above high reference limit

Mean cell haemoglobin concentration 336 g/L[320.0 - 360.0]

[Jaydee1507 Administrator]

Do you have any vitamin results to go along with those? Ferritin, folate, B12 & D3?

You might be as well to ask on the Pernicious Anemia forum here on HealthUnlocked as they are good with full blood counts.

[EchoWS in reply to Jaydee1507]

Thank you, I will ask there. Posted vitamin results below though need newer ones.

[Jazzw]

With those results I’d say you have a clear indications of macrocytosis, which can be due to B12 or folate deficiency. So those are what I’d want testing next, to make absolutely sure deficiencies aren’t the cause.

Sometimes there are other causes of macrocytosis—drugs such as hydroxyurea, methotrexate, zidovudine, azathioprine, antiretroviral agents, valproic acid, and phenytoin can cause it. Alcohol can do it too.

You say you take B vits—what and how much do you take?

[EchoWS in reply to Jazzw]

L-5 methyltetrahydrofolate 400mcg,

B12 methylcobalamin 500mcg

Also take a B vitamin as well but should be more consistent with it. Will do the vitamin test through the blood testing company. Just nervous about getting enough blood with the at home test kit.

[Jazzw in reply to EchoWS]

OK. Interesting—that should (I would say anyway) be enough of each.

I edited my post afterwards and added some other causes of macrocytosis. Do you take any of those drugs by any chance?

[Jaydee1507 Administrator in reply to EchoWS]

400mcgs folate is a relatively small amount for some people. I need 1800mcgs a day but I do have MTHFR genes.

It's always best to test vitamins at least annually and D3 should be tested twice a year.

Medichecks and Blue Horizons offer a blood draw service for an extra charge of around £35 if you struggle with finger prick tests.

What are your latest thyroid bloods looking like?

[gabkad in reply to EchoWS]

If you are on medication for the psoriatic arthritis, the folate dose is 1 milligram per day which is 2.5 times the dose you are currently taking.

[EchoWS in reply to gabkad]

I'm on Cosentyx which I don't think would cause problems. I have taken methotrexate which does require more supplementation. But haven't been taking the last 3 months. And only took between 10 - 15 mg per week. Maybe with more supplementation numbers will improve. When taking folate is it better to take split dose morning and evening or does it not matter?

[gabkad in reply to EchoWS]

Folate is water soluble so it doesn't matter. Some people think that taking vitamins later in the day is preferable because it is during the night that our bodies repair themselves.

[EchoWS]

Other results 9-2022

Ferritin 49 ng/ml reference interval 15-150

Vitamin B12 - 1022 pg/ml reference interval  232-1045

Folate(Folic Acid) Serum 12.4 ng/ml reference interval >3

Don't have newer D3 results but usually lower end of scale. I took liquid D3 for awhile which seemed to help, got to 46.3, but don't know what brand of that to get here. Taking daily D3/K supplement.

[Jaydee1507 Administrator in reply to EchoWS]

So to make your hyroid hormone work the best it can it pays to get key vitains to optimal.

What units is the D3 test?

Ferritin needs to be around 100. Recommend focusing on iron rich foods, chicken livers, pate etc

Folate, people report feeling well when it is t 20. You can buy a separate 400mcg folate to add to what you're taking. I'm assuming you already are taking a B complex.

I'm wondering if you're able to use the oral B12 that you're taking. Suggest asking on the PA group here on HealthUnlocked.

[Batty1]

I have hypothyroidism and psoriatic arthritis and also being treated for PSA with Cosentyx and Otezla and I have been battling anemia for over a year.

You need a complete Iron panel. I pay for my own testing its just less hassle then begging like a test junkie from my doctor.