B12 Anemia?

[Jnette1]

Does anyone know if it is possible to have B12 anemia with a normal CBC?  I have had extreme fatigue, headaches, neuralgia, tender abdomen, and hip pain to name a few things for the past several months. I had great relief of the hip pain and neuralgia symptoms after a B12 shot. Also, my endurance was better. My CBC is normal though. So, I have thought that that means B12 anemia isn't a possability. Is this correct?
Thanks!

[Jnette1]

Hi Kinnd,
That is very helpful. I will ask my doctor to check the serum level as well as the methymalonic acid and homocystine. I also have a high ANA, so am wondering if I could have auto immune pernicious anemia. My guts hurt and are often bloated. I do have an appoinment with a gastro nurse-practitioner (dr. was all booked up) coming up, so hopefully I will get some answers in that department.
Thank You Again!  

[Bhupinder Kaur, MD]

Hi,

You see Vitamin B 12 deficiency can occur without any significant anemia and with a normal CBC. However, the RBC’s are larger in size which is known as macrocytosis.
There are some tests which can pick up Vitamin B12 deficieny before actually the anemia develops. Diagnosis of vitamin B12 deficiency is typically based on measurement of serum vitamin B12 levels; however, about 50 percent of patients with subclinical disease have normal B12 levels. A more sensitive method of screening for vitamin B12 deficiency is measurement of serum methylmalonic acid and homocysteine levels, which are increased early in vitamin B12 deficiency. Contrary to prevailing medical practice, studies show that supplementation with oral vitamin B12 is a safe and effective treatment for the B12 deficiency state. Hence, you may not need injections and oral therapy may suffice.

I hope that helps. Please do keep me posted.

Best Regards.