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B12 deficiency.
I conduct lab tests for body checkup by blood samples every 6 months. My B12 is consistently around 180-200 pg/mL range for last 3 yrs.
This time too B12 was around 200. My CBC also shows low RBC (4.08), high-normal MCV (100.9), high MCH (33.5) and elevated RDW (14.8), although Hb is still normal at 13.7.
I am a vegetarian, so may be miss out on B12 from other foods, thus consistently low B12 may be. What should I do to manage this? Should I take any supplementation?
Answers (16)
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Your reading of your own reports is correct. A B12 of 180-200 pg/mL for three years is borderline-low, and the picture behind it is already visible in your CBC - high-normal MCV of 100.9, MCH 33.5, raised RDW 14.8 and low RBC count. That is early macrocytosis from B12 deficiency, and a normal haemoglobin does not rule it out; anaemia is the last thing to appear, not the first. Being a lifelong vegetarian explains it, so yes, supplement - I would start methylcobalamin 1500 mcg daily orally for 3 months, then a maintenance dose long term, since dietary correction alone will not fix a vegetarian diet. Before starting, get serum homocysteine (and vitamin B12 repeat plus folate); a high homocysteine confirms true tissue deficiency and also matters for your heart risk. If levels stay flat despite oral therapy, we look for malabsorption or pernicious anaemia with anti-parietal cell antibodies and give injections instead. Also worth noting - you are on isotretinoin 20 mg, so your lipids and LFT should be monitored alongside. Book a consult with me on Practo with these reports and I will set the exact dose and follow-up schedule for you.
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Tab mecodenz 5 one daily for 6 weeks.
Take more of fortified cereals, milk, cheese, paneer, curds, eggs, fortified soya milk, tofu, fortified almond milk.
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Diet
Take Neurokind M tablets 1 daily for 2 months and check b12 level and CBC after that
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Eat b12 rich food ,eat more green vegetables and fruits
Take T neurobion forte once daily for 8 weeks after food
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Vegetarians often get low vitamin B12 because plant foods do not make this nutrient.You can fix low B12 levels by eating dairy, eggs, fortified foods, or by taking a safe B12 vitamin pill.
Vegetarian Foods with Vitamin B12:-
Milk,
curd, and paneer
Regular dairy items are easy ways to get B12.
Eggs: One whole egg gives a small boost of B12.
Fortified cereals: Look at boxes in the shop to find breakfast oats with added B12.
Nutritional yeast: This yellow powder has a cheese taste and often has added B12.
Fixing a Low LevelTake a pill: If your blood test shows low B12, food alone may not fix it fast.
Watch caffeine: Do not drink tea or coffee right after your meals because it can block vitamin use.
Next Steps
feel free to consult me on practo for further evaluation and management
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If you would like to discuss your concern in more detail, please feel free to contact me on WhatsApp at nine one one nine two five five six nine nine.
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Need to take your drug history, and further evaluation for consistent low b12levels , take consultation
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Requires a proper assessment to understand the underlying cause and guide you.
Please book a consultation for a detailed evaluation, personalized treatment plan and further advice.
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Tab neurokind od one at night for 2 months. For b12.
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Yes,you need supplements, because vegetarian diet is poor source of b12 .only milk has some amount of b12 in veg. Diet .so better if you take supplements.
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Mr. Rohan Gumber
General Physician
1 yrs exp
Sri Ganganagar
If you would like to discuss your concern in more detail, please feel free to contact me on WhatsApp at eight six one nine six six nine nine zero six. Alternatively, you can connect with me through the Practo app for a detailed consultation
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Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
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Dr. Ashita Kuruvilla
General Practitioner
8 yrs exp
Kolkata
Need few more details for further evaluation. Please consult
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Dr. Gaurav Jaiswal
General Physician
7 yrs exp
Jhansi
Avoid fried and spicy food
Water intake more
Green leafy vegetables more
Fiber meal
Walk
Do connect and consult
Will help u
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Dr. Anuj Mothsra
General Physician
7 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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