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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 45911
Experience:  Board Certified Physician
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Fasting b12 came back 200. Repeat test non fasting came back

Customer Question

Fasting b12 came back 200. Repeat test non fasting came back 239. Have symptoms of numbness in big toe have other symptoms which could be attributed such as joint pain toes, thumbs and elbow which come and go but are very painful at times. What would you advise as I have just received a text from Gp to say no further action. Would I be in order to speak with him. Many thanks. Margaret
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. David replied 3 years ago.

Dr. David :

This is Dr. David

Dr. David :

have you been tested for gout?

Dr. David :

you could have gout or arthritis in your big toe and fingers and elbow causing pain.

Dr. David :

you should get xrays of your joints to check for arthritis

Dr. David :

and blood testing to check for gout

Dr. David :

which is a condition where too much uric acid is in your blood stream

Dr. David :

and you get uric acid crystals in your joints

Dr. David :

causing pain.

Dr. David :

you would be order to speak with him and follow up for another appointment.

Dr. David :

and get more testing.

Dr. David :

do you have other questions?

JACUSTOMER-05o1icqf- : No test for gout. I did realise that condition but concerned regarding numbness in toe, tiredness and have had trouble with stomach for yours and on ppi. I have a good diet and watch what I eat. Have been told that I have a fatty liver ( lfts are normal) I was told this after gall bladder removal for dysfunctional problems Cholesterol 6.5.
Dr. David :

I see

Dr. David :

you want to try to get your cholesterol below 5.2

Dr. David :

have you ever had testing to check for H Pylori bacteria infection in your stomach?

Dr. David :

this bacterial infection in your stomach can cause worse stomach acid and stomach ulcers.

Dr. David :

fatty liver is more common if you are overweight.

JACUSTOMER-05o1icqf- : Yes had eradication therapy three times. Since gall bladder removed stomach not as problematic though still have to take ppi's sometimes but have tried not to use them.
Dr. David :

I see.

Dr. David :

you might need follow up testing to see if the H Pylori is still there or not.

Dr. David :

this could still be causing your stomach acid.

Dr. David :

for some people, Manuka Honey can help excessive stomach gastritis issues along with acid blockers.

Dr. David :

do you have other questions ?

JACUSTOMER-05o1icqf- : What do you think about b12 result ie 200 fasting and 239 non fasting with no action to be taken which means gp feels all ok
Dr. David :

normal B12 values are 200 - 900 pg/mL (picograms per milliliter)

Dr. David :

so yours is in normal range

Dr. David :

I don't think the B12 is causing your toe numbness issues.

Dr. David :

hello?

JACUSTOMER-05o1icqf- : Ok but called for repeat as the first was considered under range. Range from lab 211 upwards I wondered whether test difference was due to second nit being fasting
Dr. David :

no, fasting would not affect B12 level.

Dr. David :

different labs have different ranges.

Dr. David :

http://www.nlm.nih.gov/medlineplus/ency/article/003705.htm

Dr. David :

in the US, we consider 200-900 as normal.

Dr. David :

I would not stress about the 200 level on the first test.