B12 deficient but no anaemic?

Allergies, blood and immune system
1

Is this even possible?

I've had symptoms for years fatigue, heart palpitations etc.. And I remember a doctor saying a few years ago my levels were Borderline and gave me some frolic acid which I was naive to and didn't end up taking in the end thinking nothing of it.

A few years later (now) I have more symptoms and my fbc, kidney, thyroid, liver etc.. Has all come back normal. Even had a ECG and a chest X-ray and a blood test on my heart all come back normal but remembered my test for b12 from a few years ago so ordered the doctor to do that and it's come back yet again at Borderline 192. The doc said I wouldn't be expirencing symptoms as I'm not anemic and they are rechecking my levels in 4 weeks (now 1 week to go). I have tried to improve my diet as its not great and I was bulimic a few years ago but now I'm not. My docs unsure whether to carry out treatment as I'm only 25 (his words) or just diet change.

2

Hi Emma 

Who’s at greatest risk for B12 Deficiency?

Anyone at any age, can become B12 deficient. However, certain people are at an elevated risk. They include the following:

Vegetarians, vegans and people eating macrobiotic diets.

People who’ve undergone any gastric and/or intestinal surgery, including bariatric surgery for weight loss purposes (Gastric bypass).

People who regularly use proton-pump- inhibitors. H2 blockers, antacids, Metformin, and related diabetes drugs, or other medications that can interfere with B12 absorption.

People who undergo surgeries or dental procedures involving nitrous oxide, or who use the drug recreationally.

People with a history of eating disorders (anorexia or bulimia).

People with a history of alcoholism.

People with a family history of pernicious anaemia.

People diagnosed with anaemia (including iron deficiency anaemia, sickle cell anaemia and thalassaemia).

People with Crohn’s disease, irritable bowel syndrome, gluten enteropathy (celiac disease), or any other disease that cause malabsorption of nutrients.

People with autoimmune disorders (especially thyroid disorders such as Hashimoto’s thyroiditis and Grave’s disease) Type 1 diabetes, vitiligo, lupus, Addison’s disease, ulcerative colitis, infertility, acquired agammaglobulinemia, or a family history of these disorders.

Women with a history of infertility or multiple miscarriages.

Infants born to and/or breast fed by women who are symptomatic or are at risk for B12 deficiency."

List your symptoms, tell your doctor about any other of the above "causes" you can relate to (apart from the one I have highlighted) and ask for at least a trial of B12 injections and please, please, please take the folic acid as this is essential to process the B12. 

3

I will do 

my symptoms are, tiredness, weakness, dramatic weight loss two years ago six months after having my daughter) when i had my daughter i became aniemic but got given iron tablets so fixed that one. This was 2013. A year later had blood tests all were fine aprt from b12 was Borderline, is it possible for b12 to remain Borderline for three years? I've still managed to stay the same weight since but i get asked am i anorexic or have an eating problem all the time drives me insane. 

Also last few months been having shooting pain in my hands and feet, i wouldn't say there tingling or numbness, burning shooting pain in legs.. 

I have brought these symptoms up many of times and every doc has just passed it off as 'ooh theres a virus going round'', i'm sick to death of it then i get seen a hyprocondraiac or anxiety which i suffer with both but still, i'm still aloud to be ill. 

I will insist on the injections as i can't go on like this anymore. 

Is 192 low? i know levels differ everywhere?

4

You need to know the ranges from - to normally shown in brackets <   > after the test result.

The problem with test results is that they are based on an "average" person which means that probably 49% of us are below average and what might be an acceptable level for one person is not for the next.

A well known American "expert" says 

"However, it appears that these markers demonstrate B12 deficiency primarily in patients whose serum B12 is in the "gray zone" (a serum B12 result between 200 pg/ml and 450 pg/ml).  We believe that the "normal" B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebral spinal fluid (CSF) below 550 pg/ml

At this time, we believe normal serum B12 levels should be greater than 550 pg/ml. For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1,000 pg/ml."If you are dragging along at the bottom of the range your doctor should be treating you symptoms not looking at the computer screen.

Another quote for which I will not be "allowed" to credit the authorship goes as follows:

"False normal B12 results and the risk of neurological damage

 

“In the event of any discordance between clinical findings of B12 deficiency and a normal B12 laboratory result, then treatment should not be delayed. Clinical findings might include possible pernicious anaemia or neuropathy including subacute combined degeneration of the cord. We recommend storing serum for further analysis including MMA, or holotranscobalamin and intrinsic factor antibody analysis, and treating the patient immediately with parenteral B12 treatment.”  

5

Thanks for the info. I will ask on my next test And ask what the levels are and if they are still low will demand injections.