Hey ,

When it comes to vitamin B12 I don’t think this is a bad result at all! I usually aim with my clients for a B12 value above 600. The value on your most recent blood test was 583 ng/l. We can for sure tweak this a bit more. Your MMA result is below the 2. Perhaps we can bring it down a bit more, but the conclusion here is that your vitamin B12 enters your cells and this is really great news, especially because your hair mineral analysis showed evidence for elevated mercury. We know mercury can bind to serum B12 making it less available for the cell.

I know MMA can vary from person to person as well. In a large study with over 18,500 people living in the US, those of European ancestry (non-Hispanic) had higher MMA levels compared to those of African or Hispanic ancestry, despite using more vitamin/mineral supplements and having better kidney function (click here if you would like to compare yourself with the research findings).

I think, when it comes to nutrients that need some attention, iron is for sure on the list. We need iron to transport oxygen. An iron deficiency can therefore influence every cell that needs oxygen for metabolism. Funny enough, all cells in the body need oxygen, except the red blood cells.

Here are some ideas for raising your iron levels
• Focus on Iron-rich foods, like liver, lamb, turkey, or other organ meat
• Cook in a cast iron pan if you have one.
• Or use a supplement. I would use a liquid iron supplement (like this liquid iron supplement from Pure Encapsulations) since they are in general easier to absorb by the body and are less likely to cause constipation. Go low and slow and feel how your body reacts to it. At the time of your latest blood test, we do see your immune system was dealing with something, but your inflammation marker (CRP) was low. If you would split the dosage over different meals, it would be easier on the body as well. 
• Vitamin C enhances the absorption of iron because it is needed by the enzymes in the stomach to cleave iron out of foods.

Here is a video from the B Better library which talks about how to correct an iron deficiency.

I would also focus on getting your folate up a bit higher in the reference range. Your serum folate was low last year. Folate also plays a role in the production of red blood cells.

I am curious about the histamine issues: are you feeling you are making progress on reducing the histamine from food sources?

Hey ,

CRP or C-reactive protein is a marker for inflammation. In this case, lower is better! I aim personally with my clients to have CRP below 1. It will raise on occasions in order to help heal the body.

With the supplements: are liquid forms causing you less full? In this case I would go for liquid forms as much as possible.

Vitamin C
If you feel acids still cause some problems there are two other benefits to the liquid liposomal Vitamin C. Vitamin C or ascorbic acid is still acid. But with the liposomal form the vitamin C is encased within liposomes, (microscopic droplets surrounded by a lipid bilayer – which also makes it more absorbable). It might therefore be easier on the stomach. Another benefit is: you could spread the dose easier between two meals.

The liposomal form is best absorbed with foods.

Iron
Cast iron pans leach some iron in foods, which in your case can be a benefit. People who deal with an iron overload should avoid cast iron pans for the same reason.

One last thing I would like to mention about iron: correcting an iron deficiency while you are anemic can take a while. It can take a couple of months before ferritin (the storage form of iron) goes up.

This doesn’t mean you don’t feel better sooner, but iron is used to produce hemoglobin and will be used to supplement hemoglobin first.

Once you start with iron supplements, I would recommend you check your hemoglobin and red blood cells after a week of 4-6 to see if you are responding to the treatment.

Folate
I recommend getting your folate up in the upper half of the reference range. Folate (just like B12 and vitamin D) is needed to produce red blood cells.

No folate = no red blood cell production.

There is an important nuance I would like you to understand. When your capacity to transport oxygen is reduced, you are anemic. This can happen in several ways:
• Sometimes this is caused by red blood cells not having enough hemoglobin. 
• In some cases the shape doesn’t allow red blood cells to travel through the thinner blood vessels because they are too big. This can happen with a folate or B12 deficiency.

The way the anemic picture presents in your case is that there aren’t enough red blood cells. Which is a third type of being anemic. It looks like this is a big contribution to the cause of your low hemoglobin.

If you aren’t supporting red blood cell production, but you do supplement with iron, the iron won’t be used to create more hemoglobin since there aren’t red blood cells to store the hemoglobin. It is still beneficial to use an iron supplement since you are low on iron. But it won’t fix your anemic picture.

This is why it is just as important to support red blood cell production while supplementing with iron.