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Odd B12/Iron Bloodwork!

Hello everyone this is my first post here. I figured I would post it on this thread since it relates.

I have felt awful the past 3-4years. Had tons of blood work done been to rheumatologist, endocrinologist, etc. everything typically comes back normal. Rheumatologist just said “you probably have CFS“ and there’s not much you can do about it. I’m thinking a big part of my problem is some type of an iron deficiency.

I can’t figure out what in the world is going on with my iron related bloodwork. I am on testosterone replacement therapy and in the past I was referred to do several phlebotomies to lower my hemoglobin. This ended up tanking my ferritin levels. After reading that secondary erythrocythemia induced by hormone replacement therapy does not have the side effects of true
erythrocythemia I am not concerned about this as much so I’m more focused on my iron/ferritin.

It’s been almost a year since I’ve done a phlebotomy so I could get my iron levels and ferritin increased.

The following Labs were taken 4/29/18

Total iron 71 range 50-180

TIBC 382 range 250-425

% saturation 19 range 15-60

Ferritin 29 range 29-345
(This is too low)

Transferrin 265 range 188-341

RBC 5.9 range 4.2-5.8

Hemoglobin 17.1 range 13-17

Hematocrit 50.5 range 38-50

RDW 13 range 11-15

MCV 87 range 80-100

Platelets 192 range 140-400

B12 serum 1941 range 200-1100

Folate serum 9.6 range >5.4

Methylmalonic Acid 3.6 range 1.6-29.7

MMA Normalized 1.6 range 0.4-2.5

Homocysteine 4.6 range 0-15
(This seems too low I am doing a methylation Test to check Methionine, cysteine,SamE,etc.. levels)

Pregnenolone <5 range 22-237
(This was concerning I recently started supplementing with 15mg transdermal pregnenolone by Life-Flo)

Liver,lipids and Jak mutations are normal

EPO 14.2 range 2.6-18.5

I recently got a b12 unsat binding test to see if I need to supplement with B12 and the results confuse me. They are very low yet I have high B12 serum and normal MMA.

Vitamin B12 Blood Test, Unsaturated Binding Capacity:

Result 481 range 725-2045

These are my mutations:

MTHFR GT risk allele G (A1298C)

MTHFR AG risk allele A (C677T)

MTRR GG risk allele G (A66G)

MTRR CT risk allele T (C524T)

MAOB C risk allele T +/+*(male)

COMT AG risk allele A (V158M)

COMT CT risk allele T (H62H)

GSTP1 GG risk allele G (lle105Val)

APOE CC risk allele C (Arg176Cys)

Any help is appreciated. Thank you!
Oops I should probably note that I just read the test could be skewed if supplementing with b12. At the time I was using 1mg adenosylcobalamin and 1mg hydroxocobalamin. Last dose was maybe 36hrs prior to blood test.


Senior Member
Pacific Northwest
Yes, serum B12 will be high if you've been supplementing with B12. You might also check trace minerals, amino acids, other B vitamins and antioxidants, as they all are involved with methylation and glutathione.

Have you checked thyroid and adrenal function, and DHEA?


Senior Member
I recently got a b12 unsat binding test to see if I need to supplement with B12 and the results confuse me. They are very low yet I have high B12 serum and normal MMA.

Vitamin B12 Blood Test, Unsaturated Binding Capacity:

Result 481 range 725-2045

Have you read this thread? Here's the relevant statement from richvank's post in that thread.

Having a low number for the unsaturated binding capacity could mean that you have a lot of B12 in your blood, or it could mean that you don't have enough transcobalamin.

Since you were supplementing with B12 and had high B12 serum and normal MMA, I'd guess that the first explanation probably applies.

If for whatever reason you still want to boost your B12 binding capacity, lithium might help.

Release of Vitamin Binding Proteins from Granulocytes by Lithium: Vitamin B12 and Folate Binding Proteins

Evidence that Lithium Induces Human Granulocyte Proliferation: Elevated Serum Vitamin B12 Binding Capacity in Vivo and Granulocyte Colony Proliferation in Vitro
I am not sure about the B-12. However, the ferritin is really low. I had issues with this during my pregnancy. My levels were 6 and I was having severe POTS symptoms. I did a lot of reading on it and ferritin levels need to be at least 80 to see improvement from POTS, fatigue, and hair loss if you are having symptoms. I am not cured from CFS/POTS by getting my ferritin up, but it decreased my POTS (palpitations) significantly, helped my sleep a bit, and slightly improved fatigue levels. It also seemed to help with exertion recovery (can climb stairs without getting out of breath now).
Thanks. I’m going to get my ferritin levels checked since the last bloodwork was from 6months ago. Hopefully they increased.
I read people with CFS can have elevated TNF and Leptin. I was starting to think I had an allergy to lecithin as I exhibit a lot of symptoms to that. Also I had several heterozygous TNF mutations. I decided to rule it out by getting a TNF and leptin Test. Luckily everything seems good. Results are attached.


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