The pediatrician called this evening with the results of Miss A's follow-up blood work. Important to note when reading this post is that Miss A first spiked a fever last Tuesday night, and she still has a high fever. Today was the 8th day of it and she fell asleep very early so I imagine tomorrow she'll be sick again too. We took her to the dr. Monday, they thought it might be the flu and did her follow-up blood draw to check B12 and folate levels. And now you're up to date.
Miss A's B12 levels are not low. In fact, they're twice the normal level. Her folate levels are also high. Her red blood cells are still enlarged. Her dr. doesn't know what to make of this combination of results, so he's referred us to a pediatric hematologist.
Naturally I consulted Google. I prefer to have more information than less, so the frightening aspects of Google don't bother me. What does bother me is when I find almost nothing, despite using all sorts of scientifical terms like "cobalamin" and "macrocytosis" and "haptocorrin" and "serum" and other words that contain multiple instances of every vowel, including Y. The other problem is that when people talk all scientifical that is almost as boring as when people use marketing lingo, so I find myself zoning out partway through the articles I actually paid to download because I was desperate for anything that didn't point me to a page all about leukemia.
Basically the blood work is telling me Miss A has the body chemistry of a lifelong alcoholic.
Those of you who work at hospitals or smarty-pants schools or departments of health, or those of you who just know anything about blood work or science or Google or pediatric alcoholism or excessive vowel use, feel free to weigh in on my blood work conundrum.
Spring Consignment and Yard Sales–Tips and Tricks for Getting the Best Deals
-
Spring is around the corner and this is the most exciting time of the year
for my frugal family–consignment sale and yard sale season! I have been
faithful...
Posts
I am no help at all. But I'm hoping for good (i.e. easily fixable in pleasant ways like feeding her more ice cream) news. Keep us posted!
ReplyDeleteThere may not be a specific number for high or low B12 - it can also depend on the levels of other stuff in the blood:
ReplyDelete(from Wiki)
One possible explanation for normal B12 levels in B12 deficiency is antibody interference in people with high titres of intrinsic factor antibody.[29] Some researchers propose that the current standard norms of vitamin B12 levels are too low.[30] In Japan, the lowest acceptable level for vitamin B12 in blood has been raised from about 200 pg/ml (145 pM) to 550 pg/ml (400 pM).[31]
There is confusion in units of B12 deficiency when given by various labs in various countries. Where units are presented as pg/liter, or pg/L, they are likely in error.[citation needed] Where they are presented as pg/mL or pmol/L, they are likely correct. The ranges for these two units are similar, since the molecular weight of B12 is approximately 1000, the difference between mL and L. Thus: 550 pg/mL = 400 pmol/L.
Serum Homocysteine and Methylmalonic acid levels are considered more reliable indicators of B12 deficiency than the concentration of B12 in blood, see for example research at the St. Louis University.[32] The levels of these substances are high in B12 deficiency and can be helpful if the diagnosis is unclear. Approximately 10% of patients with vitamin B12 levels between 200–400pg/l will have a vitamin B12 deficiency on the basis of elevated levels of homocysteine and methylmalonic acid.[citation needed]
What is the lab calling a high level of B12?
ReplyDelete(from wiki)
However, a recent research[citation needed] has found that B12 deficiency may occur at a much higher B12 concentration (500–600 pg/mL). On this basis Mitsuyama and Kogoh [31] proposed 550 pg/mL, and Tiggelen et al.[52] proposed 600 pg/mL. Against this background, there are reasons to believe that B12 deficiency is present in a far greater proportion of the population than 39% as reported by Tufts University.
Also, as concerns the folic acid...
ReplyDelete(from wiki)
"Large amounts of folic acid can mask the damaging effects of vitamin B12 deficiency by correcting the megaloblastic anemia caused by vitamin B12 deficiency without correcting the neurological damage that also occurs", there are also indications that "high serum folate levels might not only mask vitamin B12 deficiency, but could also exacerbate the anemia and worsen the cognitive symptoms associated with vitamin B12 deficiency".[
In other words, analyze those lab results yourself - don't just accept the doctor's interpretation of them.
ReplyDeleteI did read one thing about a genetic mutation in the gene that produces the enzyme which converts the b12 into its usable form for the body. Your levels would show super high because the b12 is just sitting in your blood not being converted, but you would have all the signs of b12 deficiency.
ReplyDeleteWe use a lot of supplements with Miles...
OMG, I know I'm not supposed to be laughing but I am, about the pediatric alcoholism part.
ReplyDeleteBack to being serious, I know this is nerve wracking and that you're doing all you can to help her out. I'm sure you'll find out if there is a problem soon. Thinking of you.