Macrocytic anemia (high MCV), high folate, high B12?!

Age 28, active female

Anemia progressively worsening despite supplementation with iron, folate, and B12

RBC low: 3.46
Hemoglobin low: 11.2
MCV high: 99
RDW high: 14.7

This points to macrocytic anemia, due to folate or B12 deficiency

However,
Folate high: >24
B12 high: >1100

Thyroid panel (TSH, FT3, FT4) is normal

Any help would be greatly appreciated! Tweet