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Anemia w/Low Vit D/Folate & Normal B12
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Anemia w/Low Vit D/Folate & Normal B12

A week ago, I was diagnosed with Anemia secondary to Iron Deficiency. My symptoms of headaches, extreme fatigue and difficulty concentrating came out of nowhere, hence my trip to the doctor. My ferritin was extremely low -- 3.4 out of a range of 4.6-204 and my hemoglobin was slightly low -- 11.3 out of a range of 11.7-16.0. (Everything else on the CBC was OK.)

My folate levels were also low...I don't recall the actual numbers.

Oddly enough, my B12 numbers were fine.

My doctor has me supplementing iron 3X daily, vit. C once daily, and folic acid once daily.

A couple of days ago, my Vitamin D came back as low (23...should be at least 30 per the doctor's office). They have me taking 50,000 units twice weekly.

I saw the hematologist on Monday and he said that my symptoms _could_ be from my gastric bypass, which I had in July 2011. However, he said that it generally takes 2 years or more for people who has this surgery to have these symptoms and that he was going to consider all possibilities.

Yesterday, I spoke to the hematologist's office and they said my iron levels were within range. I asked why I was having these symptoms and the lady said she did not know and that the doctor would tell me at my appointment on Wednesday next week.

Just out of curiosity, does anyone here have any insight into why I would be experiencing the symptoms of anemia, with concurrent folate deficiency, especially with normal B12 levels? I had a hysterectomy with one ovary removal in July of this year and can exclude the possibilities of pregnancy and menses as a cause. Everything I've read online seems to lump B12 and folate deficiency info together. The text also centers around pregnancy. However my B12 levels are fine and it is now medically impossible for me to be pregnant.

I'm just wondering why this came on so suddenly and why the two deficiencies came together. Also, why did my iron came back as normal so quickly, yet I am still feeling so lousy? FYI: My celiac testing came back negative.

Additional symptoms: frequent thirst (especially upon waking), frequent urination, and deep pain behind the left rib/breastbone (in the side/back) upon lying down and on certain movements.

My blood sugar and thyroid are normal.

Thanks a bunch!

"Why is B12 deficiency so under-diagnosed?

B12 deficiency is often missed for two reasons. First, it’s not routinely tested by most physicians. Second, the low end of the laboratory reference range is too low. This is why most studies underestimate true levels of deficiency. Many B12 deficient people have so-called “normal” levels of B12.

Yet it is well-established in the scientific literature that people with B12 levels between 200 pg/mL and 350 pg/mL – levels considered “normal” in the U.S. – have clear B12 deficiency symptoms. Experts who specialize in the diagnosis and treatment of B12 deficiency, like Sally Pacholok R.N. and Jeffery Stewart D.O., suggest treating all patients that are symptomatic and have B12 levels less than 450 pg/mL. They also recommend treating patients with normal B12, but elevated urinary methylmalonic acid (MMA), homocysteine and/or holotranscobalamin (other markers of B12 deficiency).

In Japan and Europe, the lower limit for B12 is between 500-550 pg/mL, the level associated with psychological and behavioral manifestations such as cognitive decline, dementia and memory loss. Some experts have speculated that the acceptance of higher levels as normal in Japan and the willingness to treat levels considered “normal” in the U.S. explain the low rates of Alzheimer’s and dementia in that country."

Excerpt from B12 deficiency: a silent epidemic with serious consequences by Chris Kresser
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