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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18905
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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hello, I have low ferritin,10.4 and high b12 731. I have

Customer Question

hello,
I have low ferritin,10.4 and high b12 731.
I have been perscribed folic acid adn to have bloods re checked in a month.
all cbc's are good liver function test good and I have graves disease which is now normal after being treated with carbimazole....what would this indicate.
Thanks
Submitted: 4 years ago.
Category: Medical
Expert:  Dr. D. Love replied 4 years ago.
Thank you for using JustAnswer. I will be glad to assist you today.
It will help if you could provide some further information.
If available, could you also provide certain other lab tests:
  • folic acid level (also may be called folate)?
  • complete blood count (CBC), particularly the hemoglobin (Hgb), hematocrit (Hct), and MCV?
  • iron profile, including serum iron and percent saturation?

 

 

Customer: replied 4 years ago.

CBC is normal


Hemoglobin is normal but on the high side of normal


and I was told that everything else was normal but I am not sure exactly what tests were carried out

Expert:  Dr. D. Love replied 4 years ago.
Thank you for the additional information.

There are several considerations regarding these lab tests.

First, if they checked a folic acid level and it was normal, it is not clear why they would have placed you on a folic acid supplement. Folic acid deficiency is usually due to inadequate oral intake, so a low folic acid level is usually treated with supplementation, but if the level is normal, this is a mystery to me.

The ferritin is a measure of iron stores in the body. If the ferritin is low and the iron profile and CBC are normal, then that indicates that you are early in the process of becoming iron deficient. As the iron levels in the body decreases, the first response of the body is to use up the iron stores. After the stored iron is depleted, then the blood levels of iron will drop and the person will become anemic. Iron deficiency is a common finding in women, since they lose blood on a regular bases due to periods, so the usual response is to simply improve iron intake.

The elevated vitamin B12 is usually not a worrisome finding. It can be due to the body simply trying to absorb any nutrients that are important in making red blood cells in response to the iron deficiency. The vitamin B12 level can be increased in a variety of other conditions that directly or indirectly affect red blood cell metabolism, such as myeloproliferative disorders, CHF, or diabetes, but there would typically have been other findings on exam or blood tests. In the absence of these other findings, there is no reason to be concerned about a high vitamin B12 level.

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Customer: replied 4 years ago.

I have just been doing some research and I have a mitrial vlave prolapes which I had an echocardiogram fro 5 years ago and was found to be minor, I haven;t had it looked into since, my heart rate is about 48 beats at rest and can raise to about 90 when anxious or exercising.


I read that MVP and high b12 is common along with cobalt( is this a routine blood to be screened for), I also take risperdone for bi polar, any thoughts?

Expert:  Dr. D. Love replied 4 years ago.
There is no reason for concern in this situation.

The fears about mitral valve prolapse that was prevalent a decade or two ago have proven to be unfounded. When the mitral valve prolapse is minor, as in your case, there is no evidence that it causes or is associated with any clinical problem, so there is no reason for concern or further monitoring. If there is an elevated vitamin B12 level in someone with minor mitral valve prolapse, it would be considered and managed the same as finding an elevated vitamin B12 level in anyone else.

There is no issue with the fact that you are taking risperidone. If the vitamin B12 level were low, there would be a potential issue, as vitamin B12 deficiency can cause a variety of neurologic symptoms, including many that may be misinterpreted as mental health problems, but there is not a similar concern with an elevated vitamin B12 level.

Customer: replied 4 years ago.

I am considering increasing my risperdone by 0.5 mg as i have been quite anxious, with all the results I have given you( ferritin, b12 and mvp), also I am conerned about the low heart rate which increases with exercise and I am fit and well in every other way with do you think with what i have given you I am healthy enough for an increase?

Expert:  Dr. D. Love replied 4 years ago.
You are correct that the primary concern is the low resting heart rate. None of the other clinical data would be an issue.

From the perspective of the low heart rate, one of the possible side effects of risperidone is dizziness associated with drops in blood pressure, and there would be a greater risk of this side effect in someone with a low resting heart rate. This concern is not sufficient to say that it should never be done, but it does mean that it should be done cautiously and with close monitoring.