Hello and welcome to HCM,
Low transferrin levels indicate depletion of iron stores in body.
In this situation, the iron stores have to be replaced promptly else the symptoms of weakness, fatigue, palpitations, etc. appear.
Ferrous sulphate tablets have to be taken for atleast 3 months to replete the iron stores.
Low levels of vitamin B12 also leads to anemia but the mechanism of anemia is different.
Deficiency of vitamin B12 leads to neurological symptoms besides anemia.
Low back ache can be a manifestation of anemia.
However, low back ache is more commonly due to muscular strain and/or
spinal canal stenosis or some other problem of the
spinal cord.
Vitamin B12 deficiency does not lead to itchy skin lesion.
The itchy lesion can be due to skin lesion e.g.
fungal infection.
However, clinical examination is required to make a diagnosis.
If the vitamin B12 levels are low, it has to be corrected by giving vitamin B 12 injections.
Thanks and take care
Dr Shailja P Wahal