B12, folate & ferritin or something else

[Neverendingsaga1]

Hello,

I’d be really grateful for some advice, I’m a long term mumsnet user although I rarely post.

I have consulted my GP and I’m due for another set of blood tests in a month.

I’ve not felt well for many years now. My symptoms have mainly been fatigue, my energy levels are always low even with at least 8 hours sleep, stomach issues which I was told after tests (including a colonoscopy) are consistent with IBS-D. I often feel nauseous however this fluctuates.

I have always had an anxious personality and I do tend to worry about my health especially as I age (I’m 45). I do have a stressful job (NHS) and have recently increased my hours from part to full time.

Over the past 6 months it feels as though my symptoms have worsened, I have been experiencing what I think is reflux and my nausea has increased, some days I feel sick to my stomach & due to this & trying to work through it I admittedly do not eat regularly enough & due to tiredness I often do not cook healthy meals, I definitely do not often enough foods with good nutritional value.
I have been experiencing lightheadedness on standing & the past few days strange brief head rushes that can cause me to panic briefly (the fear of fainting although it’s not happened yet).

I feel drained, I have started getting more physical symptoms of anxiety & my nausea definitely worsens at work although also happens at the weekends.

I thought it might be perimenopause related as I have noticed some brain fog, word finding difficulties, I get symptoms of thrush/UTI in the few days before my period & my breast tenderness has increased. I’m very emotional the week before my period & can be irritable, I’ve always experienced this to some degree but it feels like things have definitely ramped up. I’m not on any hormonal contraception, my cycles are longer on average 35 days but can be up to 42 days on occasion. My periods have definitely got heavier, often with large clots in the first few days.

My GP has tested my hormone levels which I did question and unsurprisingly these were normal. I have also been referred for an ultrasound incase of fibroids, my CA125 level was normal.

My bloods have however showed my B12 levels as 210 which I have been told is borderline, my folate is 3 and my ferritin 29.1. All other bloods are normal.

I have been advised they will retest my bloods in 4-6 weeks and check intrinsic antibodies.

Interestingly my B12 was 214 last year & my folate 2.5 although they were marked as normal & I wasn’t offered any follow up.

Does anyone have any advice? Could all these symptoms be due to my B12, folate & ferritin levels or should I be asking for further investigations?

All of this has started to affect my mood as I so rarely feel well & when I do it’s such a relief but also so brief.

I will add that I have cut out all alcohol for several years as it made me feel worse. I sleep well but I suspect this is due to the Amitripyline I am prescribed for migraine (20mg at night).

GP has just prescribed lansoprazole for reflux, I also use gaviscon advance.

I know nobody can tell me exactly what is going on & I will follow up with my GP but I wondered if anyone had experienced similar, any help or suggestions would be greatly appreciated.

Thanks so much.

How were your Thyroid levels?

Just briefly posting that I’ve had borderline b12 and folate and experienced similar symptoms. Do you get pins and needles/burning tongue sensation? That might be another clue. If they are retesting your bloods, I’d hold off supplementing for now as b12 in particular can stay in your system for 4months and give you a false high if your body isn’t actually absorbing it.

PPIs (such as lansoprazole) can also affect absorption of
minerals so definitely worth thinking about supplementation once your next set of blood results are back.

Serum free T4 level 14.8 pmol/L [11.0 - 23.0]
Serum TSH level 0.87 mU/L [0.27 - 4.5]

You could just start taking supplements but you might need something high strength. The GP will probably see those results as normal or ok

I've had off Thyroid levels and they dont really do anything about it, or they havent anyway, low but still in range.

Its almost certainly peri as well

Thank you givemeanother, yes mildly tingly in fingers, tongue has sore patches on and off.
I did think I should probably hold off until after next tests, I didn’t realise that about b12 levels.
I’ve not taken the lansoprazole yet and will be mindful of that thank you!

Thanks Soupyspoon, I did think from what I’ve read they are unlikely to treat unless next tests shows levels reduced further which is frustrating because I do feel I have a lot of symptoms of deficiencies.

Blood tests aren't supposed to be used for diagnosis of peri as hormone levels fluctuate. Additional fatigue could be down to peri, as could additional gut issues. Track how you feel across your monthly cycle.

Have a look at histamine in the diet. Consider low histamine diet and acid watcher diet.

Have you had an endoscopy? Have you been tested for coeliac disease?

www.mumsnet.com/talk/general_health/5407574-severe-reflux-have-you-tried-the-acid-watcher-diet

@Neverendingsaga1 I also agree with the other posters that peri is probably part of this as well. If GP won’t give you vitamin supplements after your next tests, you can always self-supplement. There is a wake up vitamin b12 group on Facebook with lots of useful advice on how to do that.

My folate was 4.2 and I now take folic acid supplements and also a sublingual b12 (dissolves under your tongue). It has helped a lot with my symptoms. As did HRT!

You need to eat properly, three meals a day and lots of protein. How do you expect your body to work if you don’t feed it real food ?

Thank you I will track my symptoms and take these along to the GP.
I have been tested for celiac a few years ago which was negative but not had an endoscopy.
I will take a look at the diets you suggested I know I need to start with my diet.

Thank you, I will take a look at the group & I will start supplements if blood tests remain as they are.
I think I will consider discussing a mirena coil & see if that helps. I’m glad supplements have been helpful for you.

This is very true, thank you, I will definitely make a start at trying to improve my diet.

Maybe your hormones levels have never been optimal for most of your adult life. This is a long time to feel so unwell.
I would second the suggestion of trying HRT alongside any supplements you require. This may well solve a lot of issues.
The quickest change you could make would be to try your hardest to build up healthier eating habits and at a rhythm that suits your body. Maybe you do better on 5 small meals a day or on 2 substantial meals a day.

Thank you, I think that might be possible, on reflection & reading these posts I suspect it’s a mixture of anxiety, hormones, low vitamin levels & poor diet. I feel completely drained as it’s all a vicious cycle with eating due to worrying about gastro issues & trying to manage work around these.
I did think eating more often but smaller meals with more nutrients would be a start, I sometimes find I end up eating too heavily at night.
I will discuss the hrt options with my GP & I’m definitely going to get some supplements.
I think partly it’s that work is so full on & then with 2 children at home I just do what I can to get through the day without making my needs a priority, I do need to change that.