Brief Answer:
Those numbers are not likely responsible for your symptom list

Detailed Answer:
Good evening from XXXXXXX Ohio, USA. My name is Dr. Saghafi and I'm a neurologist. Your question is whether or not the labs of B12 and ferritin you present could be low enough to be responsible for your list of symptoms.

The short answer to that question is "not likely." And when I say, not likely, I really "not at all likely" just to be clear on my end....

Of course, it would've been a bit more complete in the analysis if you'd provided the laboratory ranges of normal since each lab differs slightly but I can tell you that a level of 336 for B12 would likely be considered normal in any laboratory in the US or Canada...and anywhere else for that matter. Ranges of low normal are anywhere from 150-180. I usually start getting a little worried in my patients when their B12's start hitting in the lower 200's. At 336, I may perform a couple of corroborative tests such as a homocysteine and methylmalonic acid in serum but it is rare that 336 comes out to be truly LOW.....Not only that but the only symptoms of the list you've presented that would be remotely related to B12 deficiency would be "slight confusion", "disorientation" and "numbness in big toe" but even those symptoms don't really go well with any B12 deficiency because logically put, if you had a B12 deficiency and had not yet corrected it....your toe would be numb ALL THE TIME...not PERIODICALLY....so that in and of itself is not consistent with the problem described. Also slight confusion is hard to gauge as to what you might mean....,however, B12 deficiency is known to be a mimicker of patients who appear to present with DEMENTING SYMPTOMS....or people who are cognitively impaired, usually moderately to severely impaired, but at the same time have something else to explain the B12 deficiency such as alcohol ingestion issues or something else which reduces B12 in the system on an ongoing basis, such as gastric bypass patients, etc.

Let's mention a little about the ferritin. Normal ranges for ferritin are from about 18-160 in women. And although it is true that your level of 21 is clearly pushing the lowest end of that scale the problem is I can't fully interpret its meaning in the absence of other tests which are usually obtained in conjunction with ferritin such as total iron and total iron binding capacity. Also, I always get Zinc levels in serum when contemplating iron deficiency. So again, just as in the B12 case could a ferritin of 21 be responsible for any of the list of symptoms from above? And my answer to that one...is still NOT LIKELY....but to be fair I would want more information before making a final decision. For example, do you carry a diagnosis of ANEMIA and if so, is it CHRONIC or acute..meaning, have you had the anemia for some time or is it relatively recent that you developed the problem? You are saying that the symptoms have been going on for months therefore, if we wanted to make the ferritin at all contributory to the problem it would have to be at its level for at least that many months if not more....meaning that the levels you have are probably chronic and again, symptoms that come and go like the numbness in the toe wouldn't really be expected to "COME AND GO" if due to an actual nutritional deficiency which was UNTREATED...makes sense, right?

Finally, I don't recommend self medicating even though these items are probably not prescription and carry few risks but the idea that you'd be taking something that either is of little overall value to your symptoms that you're trying to understand in place of really seeking the right answers is what concerns me.

Have you seen a specialist of some sort such as a NEUROLOGIST? If you could get to one of those.....well, there's one here in XXXXXXX a mere 2000 miles from you? HAHA!,,, then, at least they could do a good examination on you (which I'll bet will be normal since your writing and thoughts don't seem confused, disoriented, encephalopathic, or otherwise off kilter neurologically) and rule out a neurological condition which would automatically take B12 off the table as a culprit.

They could then, talk to you a bit about your Ferritin levels and what if anything to do about that with respect to your symptoms.

If this information has been helpful would you do me the favor of some written feedback and a STAR RATING of the answer? STAR RATINGS are very helpful to physicians because folks pay a lot of attention to a doctor's rating by his patients when deciding to ask a specific question or return to him/her for service.

Should you have NO further questions or comments to place- CLOSING THE QUERY would be as greatly appreciated as well.

And of course, in the future I'm happy to answer more items for you personally by going to the following website and writing to me:

bit.ly/drdariushsaghafi

This query has required 37 minutes of physician specific review, research, and final draft documentation for envoy to this patient.

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