Vitamin B12

[Eve]

Have been googling (yes, I know haha!) after being copied in on a letter from the hospital with some blood results.

My vitamin B12 level was 208 (MCV 97 - have other figures for stuff but not sure what else might be relevant). It looks like different places use different levels but that below 200 was under the normal range so I'm not worried it's too low but wondered whether it would be worth me getting some supplements or something to make sure it doesn't get too low? Am on a mission to deal with anything which might contribute to additional fatigue and such.

I don't want to be getting supplements and such if it's a waste of time.

Any advice welcome.

[Sqad]

That is a normal B12 level and if your HB and red cells are normal, then, you needn't take any supplements.

[Eve]

Sorted :) Thanks Sqad. Think others bloods are all fine, can't see anything for an RBC (?) but haemoglobin 145 and 224 platelets which, from what I can gather, are all good.

I do keep half hoping there are easier solutions which might lead to me being less knackered, hoping the biologic will kick in soon as that is meant to help with tiredness as well as the inflammation. The 10mg of methotrexate biologic maintenance dose isn't doing much and still flaring.

Keeping an eye as my GFR has dropped a bit and my ALT is creeping up again but not at worrying levels at the moment. On top of everything else I'm on antibiotics again for infected toe after podiatry (!!!), my heel is still really painful and just a little ball of pain at the moment so I could do with a breakthrough.

[slaney]

The B12 level is at the lower end of the normal range.

I'm not sure if supplements would help, as B12 is contained in pretty well all foods of animal origin, and it is unusual for dietary B12 deficiency to occur.
The most common cause of B12 deficiency is pernicious anaemia, an autoimmune disorder, in which there is a lack, not of B12 itself, but of intrinsic factor in the stomach. Only when B12 is combined with intrinsic factor can it be absorbed and be used by the body.

As you already have an autoimmune disease, my advice would be to repeat the B12 level in 3-6 months, perhaps with gastric parietal cell antibodies and intrinsic factor antibodies as well.

Have you got the result of the renal function tests yet Eve?

[Eve]

Hi Slaney, thanks for that. Renal bloods were all ok so that is a big relief albeit it's still unknown what is causing the fluid in my legs. GFR had gone up a bit though it had dropped down a bit to 62 on last bloods but that's not as low as it did go.

They have discharged me back to GP for some heart tests as they have ruled out my kidneys as causing the fluid in my legs, still there up to my knees. Had an ECG and got an echo in a few weeks.

I think they have done B12 tests previously which have come back ok I assume as nothing ever said, sure GP has done it before, can't think what it was to do with now, maybe the hairloss or palpitations or something, they keep checking my thyroid and sugar levels but they are always ok. It's vitamin D I tend to have a problem with.

Get my second biologic infusion next week :) |Fingers crossed it will kick in soon.