I have low vitamin B12 with high hemoglobin and high hematocrit. Is it polycythemia?

Hello,

Welcome to icliniq.com.

I have gone through your history and reports. (attachment removed to protect patient identity).

You had a complaint of left-side abdominal pain with a headache. Hence gastritis can be a possibility and for that antibiotics and antacid courses are prescribed.

Sometimes the upper gastrointestinal infection can lead to poor absorption of vitamin B12 and so deficiency can occur but here your B12 value is borderline in the report. So further workup can be done at that time by measuring homocysteine and methylmalonic acid measurement for confirming B12 deficiency.

Anyhow you completed the course of B12 injection so no need for measurement of homocysteine. Your stool frequency is increased and it seems to be stress-related irritable bowel syndrome (stress and anxiety lead to headaches as well).

Yoga, meditation, and exercise will be beneficial in reducing stress. Consume more fruits and green leafy vegetables.

If needed psychiatrist help can be taken. If stress and anxiety are not related then USG (ultrasound) abdomen or endoscopy-like workup can be planned only if gastrointestinal symptoms worsen.

In your attached CBC report values are within limits. In polycythemia (which you are suspecting) Hb is greater than 17.5, WBC count and platelets also can be high, RBC values are high and HCT is more than 55% usually. So here polycythemia is not a possibility. Repeat CBC after completing your antibiotic course. Lack of sleep, hypoglycemia, smoking, stress, irregular meal habit, migraine, etc., are some other causes of headache.

I hope this helps.