B12 Deficiency or Underactive Thyroid at Play? - Thyroid UK

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B12 Deficiency or Underactive Thyroid at Play?

HealthStarDust profile image
16 Replies

Recently, my FBC came back with:

Mean cell haemoglobin level 32.7 pg [27.0 - 32.0]; Above high reference limit

Only just above the range. Am I right in thinking this confirms anemia? I have been supplementing with B complex, so my blood serum tests show they are quite healthy (upper quarter in ranges).

On labs test online it states it could be anaemia or as a result of underactive thyroid. See here labtestsonline.org.uk/tests... at least I think MCV is the same as the above result.

Grateful for any thoughts. I’m curious.

FYI diagnosed with hypothyroidism (Hashimoto) this year.

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HealthStarDust
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16 Replies
MEguy profile image
MEguy

Don't the B vitamins (b12?) help to make red blood cells?

HealthStarDust profile image
HealthStarDust in reply toMEguy

At this point, it’s all over my head!

helvella profile image
helvellaAdministrator

Mean cell haemoglobin is different to mean cell volume.

Low B12 results in individual red cells which are larger. Thus a higher MCV.

Mean cell haemoglobin would often also be high alongside high MCV - but not always.

A bigger red cell can carry more haemoglobin. So a high MCV implies the possibility of higher haemoglobin.

HealthStarDust profile image
HealthStarDust in reply tohelvella

Thank you. So much still to learn.

Interesting. My MVC is Mean cell volume 99 fL [78.0 - 100.0].

helvella profile image
helvellaAdministrator in reply toHealthStarDust

Have you had a B12 test?

HealthStarDust profile image
HealthStarDust in reply tohelvella

Blood Serum? Yes. Increasing ever since supplementing B Complex and separate B12 spray etc. when needed.

Latest results:

Total 687 ng/L [211.0 - 911.0],

Active B12 126 pmol/L [42-210].

I hope GP hasn’t missed something again. Bad enough they missed iron deficiency and messed up hypothyroidism diagnosis! Do any one of them know how to interpret any blood tests? I’m meant to be just the patient. 🙄

Looking at historical tests, it appears both MCH and MCV have been increasing.

Edit: MCH has come back just slightly over range twice in recent times.

Cornwaller profile image
Cornwaller

Your mcv is high - albeit just in range. This can be an indication of b12 deficiency and is not a symptom of hypothyroidism. However, b12 deficiency is a common co morbidity of hypothyroidism. Your treatment with sprays seems to have given you an adequate b12 serum level. It would be prudent to keep an eye on your bloods and also to monitor your symptoms see B12d.org. Unfortunately hypothyroidism and b12 deficiency have a wide range of shared symptoms, however some such as a sore or swollen tongue, high mcv and pale slightly lemon tinted skin are generally associated with b12 and not hypothyroidism. Unfortunately, again, everyone's symptoms profile is different but the B12d.org site is a good starting point for evaluating your symptoms.

HealthStarDust profile image
HealthStarDust in reply toCornwaller

Thank you sharing so generously with your knowledge. Honestly, I am blown away by this forum soemimes!

Noelnoel profile image
Noelnoel in reply toCornwaller

high mcv and pale slightly lemon tinted skin are generally associated with b12 and not hypothyroidism

That’s true of white-skinned people only and since the world is made up predominantly of people whose skin is a variation on brown then that symptom doesn’t apply

I in no way say this maliciously but it would be prudent to think a bit harder about what you say. Know that your audience is diverse

Cornwaller profile image
Cornwaller in reply toNoelnoel

"That’s true of white-skinned people only" Really? Could you give me the reference that paleness and yellow tinting of the skin is only available to "white skinned people".?

Could I suggest that paleness and yellowness is a description of the skin's appearance relative to the normal condition of an individual's skin and not an absolute description that that a person looks, literally, pale lemon.

Dr Joseph Chandy (Kayyalackakom) in his seminal book "Vitamin B12 deficiency in Clinical Practice" uses the phrase:

"Pallor, yellow lemon complexion " eg p 58 - which is essentially identical to my phraseology and similar descriptors are widely used throughout the literature.

As you no doubt know Dr Chandy was born in Kerala, southern India. Perhaps you should also chide him to think a bit harder about what he says and to enlighten him with a reminder of his diverse audience?

Noelnoel profile image
Noelnoel in reply toCornwaller

Suffice to say, I don’t know the dr’s work or where he obtained his shade of skin but I do know what I saw written here and it doesn’t apply to me

I only wish you had owned your mistake and apologised for misrepresenting the doctor. “Essentially” is not the same as exactly. I’m a reasonable person and would’ve accepted your apology graciously

After my second child I had a very painful case of mastitis. My GP said: I can’t see any redness, your skin’s too dark. He only needed to have said: it’s often difficult to discern inflammation on a darker skin but I can feel the heat and swelling. Job done, no offence taken

HealthStarDust profile image
HealthStarDust in reply toCornwaller

I’m sure Black and Brown folk suffer from unconscious bias against people who share their identity. So, pointing out this Doctor’s identity is not necessarily helpful.

Noelnoel is correct to point out the differences in spotting signs and symptoms. Without accepting these, we have no way of eradicating let alone tackling health inequalities.

HealthStarDust profile image
HealthStarDust in reply toNoelnoel

The same is true for things such as Addison Disease where hyperpigmentation may not be as noticeable on a Black or Brown person’s skin. This is an accepted in the medical community at large. How that plays out in daily practice, not so much.

Well done for speaking out.

Noelnoel profile image
Noelnoel in reply toHealthStarDust

Hi HealthStarDust

Thank you for your comments. It’s noteworthy that you did so

FancyPants54 profile image
FancyPants54 in reply toCornwaller

A swollen tongue and/or a scalloped tongue are symptoms of hypothyroidism. So that's a cross over symptom with B12. Maybe it is more prevalent in people who have both conditions. Before I was diagnosed with hypothyroidism I had a very scalloped tongue and kept biting my tongue because I didn't seem to have room to put it out of the way!

Cornwaller profile image
Cornwaller in reply toFancyPants54

Thank you for the correction, you're quite right. So another shared symptom!

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