B12 deficiency, inconclusive results!

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I am awaiting surgery and the bloods taken at my pre op appointment indicated I have a B12 Deficiency with the level showing as 137 (I believe it should be 190+). I was supposed to start injections but I wanted more information from the gp about the treatment and what it meant. She ordered new bloods to test for coeliac and to see if I have pernicious anemia. However these came back with B12 level as 212?!? The doctor is now saying the first test could have been incorrect, but how do I know which was correct and what would cause a false result?

B12 doesn't fluctuate does it??

Very confused, does anyone have an experience like this? Thanks

1 like, 3 replies

3 Replies

  • Posted

    Regardless of the fluctuation of your B12 level between tests at 212 it is still very low and at best the serum B12 tests are notoriously unreliable as are the P.A/Intrinsic Factor tests which has a known accuracy of 50%.

    With a Vitamin B12 Deficiency you would probably exhibiting neurological symptoms.  Do you have any?

    Putting the tests aside for a moment can you say more about the operation you are due to have and whether you are likely to have a general anaesthetic using nitrous oxide.

    Take care now

    • Posted

      Thanks for your reply. I'm waiting for my gallbladder to be removed. I have very small stones but I experience a lot of pain in my side so they are removing because it may be the cause (I also have a mesenteric cyst but they don't think that contributes to the pain at the moment).

      Symptoms wise, I do get foggy days, I struggle with my memory, I have issues in my calfs where they feel tingly/painful. I have severe mood swings that I don't understand, I am always tired and have sleep issues.

      I am wary of the tests, had a third blood test yest and I know dr thinks if it's above 200 she'll class as normal and say first test was incorrect. But I'll be concerned as to validity.

      So confusing!

    • Posted

      I wish you well with the operation and I think it would be a good idea to mention your low B12 and symptoms to the anaethetist just in case they use Nitrous Oxide

      Nitrous oxide (gas and air) is the only anaesthetic I am aware of that interacts badly with B12

      Nitrous oxide is a super-oxidiser when it comes to B12 and converts it to a form that the body cannot use, so if you had an absorption problem and couldn't replace your the oxidised B12 with new B12 then it would be a permanent problem.

      Nitrous oxide isn't a local anaesthetic so suspect it isn't used for most day surgery but if you have any doubt then I would suggest that you contact the hospital/surgery where the operation was done and ask them to clarify.

      Any gastric surgery will impact on B12 absorption.

      As to your symptoms:

      "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.” 

      This simply means that if you are showing neurological symptoms your doctor should be giving you B12 injections until there is no further improvement and then every three months in accotrdance with the BNF guidelines. She should have a copy of this on her desk.  

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