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u/Background_Morning38

▲ 2 r/B12_Deficiency

Lab Experts Needed for follow up recommendations

Ok all you lab experts! Now that I’m 5 months in for weekly shots, I have a follow up appt tomorrow with my PCP who is usually great with letting me request labs, so I want to make sure I’m not missing any. What would you be sure are ordered and why?

I'm not 100% sure which I should be monitoring to watch impact of all of these treatments and how often, and if there are any new ones I should keep an eye on due to that as well (Vit E? Vit K?). Lab history is below for reference. It's pretty long thanks to all of the great folks in this group! 😄 

Here's the lab retesting list I have so far:

  1. B12
  2. Homocysteine - haven't tested since starting B12 shots
  3. CRP & ESR - to see how inflammation is doing
  4. Vitamin A - to check status
  5. Vitamin D - haven't tested since starting B12 shots

Future labs already scheduled by specialists:

  1. TSH, T3, T4
    1. Endo schedule retesting for 5/20/26
    2. Also scheduled retesting for 10/8/26 after that
  2. CBC for MCV, MCH & RDW
    1. Hemo scheduled retesting for 6/30/26; if worse will talk about infusion
    2. Scheduled retesting for 9/22/26 as next check in
  3. Ferritin, Iron Panel & Reticulocyte Count
    1. Hemo scheduled retesting for 6/30/26; she recommended waiting to retest to give pills a chance to work; I'm concerned I have functional anemia since my numbers went down after taking iron pills for 6 weeks but she said she's not
    2. Also scheduled retesting for 9/22/26 after that
  4. Vitamin D, Hemoglobin A1C with Glucose & Comp Metabolic panel
    1. Hemo scheduled retesting for 10/8/26

Diagnoses:

  1. Autoimmune gastritis
  2. Pernicious anemia
  3. Hashimoto’s
  4. Borderline anemia (per Hemo)
  5. Seronegative RA with Synovitis
  6. Vitamin D deficiency
  7. Anxiety (got bad when the medical bills started coming in)
  8. Hypertension
  9. Obesity (down 21 lbs. since B12 shots started!)

 

Meds & Supplements:

  1. Synthroid 125mg (started on 100 in 2019, increased to 125 in Jan '25)
  2. B-12 Cyanocobalamin weekly 1,000mcg (started 12/6/25)
  3. Hydroxychloroquine 400mg (started 1/25/26)
  4. HCTZ 50mg (started Oct '22, took Lisinopril for 3 years too but had bad side effects)
  5. Sertraline 25mg (started 2/5/26)
  6. OptiFerin-C 56mg (took Accrufer for 45 days then switched on 3/29/26)
  7. Vitamin C 1000mg (started 4/10/25)
  8. Magnesium L-Threonate 48mg (started Mag Glycinate on 1/10/26, then switched on 3/30/26)
  9. Vitamin D3 125mcg (started 10/22/20)
  10. Turmeric Curcumin C3 Complex 500mg (started 1/8/25)

 

Note that I'm working on switching to Hydroxocobalamin with a compounding pharmacy since my symptoms seem worse later in the week after my weekly shot. Just difficult to get here in the US. Hemo said she'll leave that to my PCP since she wasn't familiar with the Hydroxo version. She did say I might benefit moving to one shot every 5 days though.

Last Lab Date & Results:

  1. CBC 3/24/26
    1. MCV = 79
    2. MCH = 26
    3. RDW = 14.6
  2. Comp Metabolic Panel 2/3/26
    1. Sodium = 137
    2. Potassium = 3.7 (down from
  3. APCA+ = 25.8 - on /17/25
  4. Intrinsic Factor Abs = 1.1 on 11/17/25
  5. Vit B12 = 635 on 3/24/26 (was 120 on 10/28/25)
  6. MMA = 166 on 3/24/26 (was 721 on 11/17/25)
  7. Vit B6 = 8.1 on 10/28/25
  8. Gastrin = 18 on 2/3/26
  9. Pepsinogen I, serum = 46 on 2/3/26
  10. Pepsinogen II, serum = 4 on 2/3/26
  11. Homocysteine = 9 on 11/17/25
  12. RBC Magnesium = 5.6 on 12/31/25
  13. CRP = <0.5 on 12/31/25 (before B12 shots, fluctuated 0.5-0.8 since 2022)
  14. ESR = 38 on 10/28/25
  15. TSH with Reflex to Free T4 = 1.61 on 12/31/25
  16. T4 = 1.07 on 12/31/25
  17. T3 = 3.93 on 12/31/25
  18. TPO = 156 on 12/31/25 (was 531; I know this will never go away)
  19. TgAb = 5.6 on 12/31/25
  20. Uric Acid = 5.9 on 10/28/25
  21. ANA = Negative on 10/28/25
  22. Copper = 110 on 2/3/26
  23. Ceruloplasmin = 31.1 on 2/3/26
  24. Selenium = 168 on 2/3/26
  25. Folate = 21.5 on 12/31/25
  26. Vitamin A = 74 on 2/3/26
  27. Vitamin D = 51 on 10/28/25
  28. Tryptase = 4.6 on 10/28/25
  29. Zinc = 58 on 10/28/25
  30. Ferritin = 45 (was 33 before starting iron pills)
  31. Iron Panel on 3/24/26
  32. Iron = 42 (was 58 before starting iron pills)
  33. Transferrin = 291 (was 314 before starting iron pills)
  34. TIBC = 407 (was 440 before starting iron pills)
  35. Transferrin Saturation = 10 (was 13 before starting iron pills)
  36. Reticulocyte Absolute = 47.8 on 12/31/25
  37. Reticulocyte % = 1 on 12/31/25
  38. Immature Reticulocyte Fraction =  0.4 on 12/31/25
  39. Cortisol = 0.7 on 4/19/26
  40. Dexamethasone = 229 on 4/19/26
  41. Others
  42. Negative Celiac screenings, H. pylori antigen and Lyme antibodies
  43. Immunology - some allergies seem to have improved/gone away, which was surprising but Pneumococcal antibodies have a bunch of low numbers
  44. All Rheumatology testing was negative or in solid positive ranges
  45. Thyroid ultrasound shows some damage, monitoring
  46. Sacroiliac joint MRI negative
  47. Nothing found in STD and vaccine antibody tests

 

 

 

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u/Background_Morning38 — 3 days ago