Vitamins B12, D3 and Folate

[Ceppo]

I've been looking closely at the recent test results and wonder if there is an issue that is not being picked up and how to progress it during this time when it is difficult to speak to a doctor or anyone.

Vitamin D3 will be insufficient in the 40s not tested since July.
Currently taking 2,000 a day and I can get a postal test for that.

My main concern is B12. I do feel I have some symptoms eg leg or foot cramps in bed. (Magnesium level is OK) and recently a spate of optical migraines - visual disturbances.

B12 is at the lower end at 271 ngl (211-911)
Folate is 12.7 (3.0-14.4)

So how to approach this: ask for a dr consultation about this 'satisfactory' test labelled with no action. Ask to speak to DN who didn't notice this could be concerning when she skimmed the latest tests. Or have other tests done privately such as for Intrinsic Factor to check if I'm not absorbing B12. My diet is full of B12. Couldn't eat more.

It seems important to nip this in the bud at an early stage or understand the cause but I can't believe how challenging it feels to find the way forward.

So I'd appreciate some advice from my valued mentors before I jump in to ask for an investigation.

 

[Supergardener]

I've been looking closely at the recent test results and wonder if there is an issue that is not being picked up and how to progress it during this time when it is difficult to speak to a doctor or anyone.

Vitamin D3 will be insufficient in the 40s not tested since July.
Currently taking 2,000 a day and I can get a postal test for that.

My main concern is B12. I do feel I have some symptoms eg leg or foot cramps in bed. (Magnesium level is OK) and recently a spate of optical migraines - visual disturbances.

B12 is at the lower end at 271 ngl (211-911)
Folate is 12.7 (3.0-14.4)

So how to approach this: ask for a dr consultation about this 'satisfactory' test labelled with no action. Ask to speak to DN who didn't notice this could be concerning when she skimmed the latest tests. Or have other tests done privately such as for Intrinsic Factor to check if I'm not absorbing B12. My diet is full of B12. Couldn't eat more.

It seems important to nip this in the bud at an early stage or understand the cause but I can't believe how challenging it feels to find the way forward.

So I'd appreciate some advice from my valued mentors before I jump in to ask for an investigation.

You mention you have optical migraines, do you take ramipril for high bp, it gave me optical migraines every day, stopped it and they disappeared completely along with a lot of other awful side effects which were put down to my nerves !!!

 

[Ceppo]

No I don’t. No medication.
I have them from time to time. But wondering if there is a connection

 

[DCUKMod]

I've been looking closely at the recent test results and wonder if there is an issue that is not being picked up and how to progress it during this time when it is difficult to speak to a doctor or anyone.

Vitamin D3 will be insufficient in the 40s not tested since July.
Currently taking 2,000 a day and I can get a postal test for that.

My main concern is B12. I do feel I have some symptoms eg leg or foot cramps in bed. (Magnesium level is OK) and recently a spate of optical migraines - visual disturbances.

B12 is at the lower end at 271 ngl (211-911)
Folate is 12.7 (3.0-14.4)

So how to approach this: ask for a dr consultation about this 'satisfactory' test labelled with no action. Ask to speak to DN who didn't notice this could be concerning when she skimmed the latest tests. Or have other tests done privately such as for Intrinsic Factor to check if I'm not absorbing B12. My diet is full of B12. Couldn't eat more.

It seems important to nip this in the bud at an early stage or understand the cause but I can't believe how challenging it feels to find the way forward.

So I'd appreciate some advice from my valued mentors before I jump in to ask for an investigation.

Ceppo - I think it's important to understand that the "normal/acceptable" range is based on the whole population, hence the ranges can be fairly wide for certain levels. The ranges don't usually highlight where any optimal range might be, but then that optimal state can also be quite personalised.

In my personal experience, my GP is quite happy if any given test is "in range", irrespective of where in the range that might be. I would always suggest covering any concerns you have off with your GP as sometimes a suboptimal test result can be as a result of an underlying condition.

If, you feel you are not at any given optimal point for you, then you could consider doing some research into that, to understand how things might possibly me improved. When it comes to a nutrient, vitamin or mineral, depending where you are in the range, you might consider supplementing with that, but if you are considering that or you do it already, please ensure you are aware of the downsides too. In some cases, being above range is just as potentially dangerous as being deficient.

In most instances, as well a scientific papers, there are usually reliable sources of information out there on the internet. An example might be the Pernicious Anaemia Society, or the Vitamin D Council.

Finally, I would probably urge you to look back through any previous test results you might have, to understand if anything is changing. For example, on my broad bloods panel, my serum calcium levels are always right at the bottom of the range. Needless to say, that's not something that thrills me, but when I look back through all my results, it seems like "that's just how I am", even when the other influencing factors are in great shape.

It's not always as simple as "bigger is better" or small is beautiful.

 

[Oldvatr]

As a UK diabetic, you should be offered an annual checkup which should include a Whole Blood panel check. If your hemoglobin is within the range, then the B12 is working. since it is necessary for making red blood cells, along with folate which is why those two are necessary, ( with iron of course)

If you are supplementing B12, then be sure it is a B12 specific formulation since normally multivitamins or brewers yeast does not include B12. Also, take a Vitamin C supplement and the folate at the same time as the B12 since thee are all required to make hemoglobin If you have developed a problem, then your doctor will probably react to any hint of anemia. Mine does!

There are moves to include D3 supplements for vulnerable patients, but diabetics are not part of this normally. It is usually the housebound, the frail, and on certain medications to qualify. D3 needs to be combined with vitamin K2 as well, These supplements are currently derived from animal products but they are becoming synthesised from slime and bacterial sludges soon at a very high price.

 

[Ceppo]

Thanks for your replies. Lots of interesting points points made.
I agree that if its in range it will most likely be passed over by the DN who reviewed it. I'm not actively thinking of supplementing the B12. Rather wondering if this is a flag up for deficient absorbtion from the gut. There is a test for this. If that was so then regular injection is the remedy. Something to be done via a GP rather than supplementation.

 

[DCUKMod]

Thanks for your replies. Lots of interesting points points made.
I agree that if its in range it will most likely be passed over by the DN who reviewed it. I'm not actively thinking of supplementing the B12. Rather wondering if this is a flag up for deficient absorbtion from the gut. There is a test for this. If that was so then regular injection is the remedy. Something to be done via a GP rather than supplementation.

For minor deficiencies, or boosting levels, B12 can be supplemented by tablet (over the counter or prescription).

I'm not advising your shoud supplement, nobody here can, but just making you aware.