Pre diabetes?

[Plavers]

I think I’m very lucky so far with my ET Journey, no real side effects except itching and tiredness.

However, Just a couple of moans from me today I’m afraid. I’m not overweight, I eat a lot of fruit and vegetables, olive oil. I weigh around 12 stone (that’s around 168 pounds ) and am 5’11” tall (180 cm). My BMI I believe is 20.

I’ve got very little of my original stomach as half was taken away in an operation when I was two and most of the rest when I was 16 when I had a colonic transposition with my oesophagus. Which basically meant I didn’t put on weight easily because the absorption period was reduced. Last week. I had a routine blood test with my GP and now they say I need my B12 and folate levels checked again. Then today I get a follow up txt saying I’m in danger of being pre-diabetic and need to make lifestyle changes.

My Mean corpuscular volume (MCV): 110 fL Reference range: 84 to 98

Mean corpusc. haemoglobin(MCH): 34.8 pg Reference range 27.5 to 32.0

And my Platelet count: 448 10*9/L (a little higher that normal)

Has anyone else had this happen, is there a link between ET and pre- diabetes? Or is it just because I love M&S Toffees too much? And, supplementary question, do the other results mean I’m going to need B12 shots?

Thanks so much for reading, I know this is a small matter compared with some of the complications some of you have, but it’s concerning me.

Paul 74yrs 👍

[hunter5582]

Sorry to hear about the new worries.

Vitamin B deficiency anemia (B12 or B9/folate) can be an issue if you have the deficiency. You would need to look at all of the erythrocyte numbers to assess whether Vit B-anemia is an issue. The elevated MCH/MCV may be indicative of something like macrocytic anemia but you should not assume that is what is going on. You need to proper assessment to determine that.

I also have prediabetes along with PV. While the two are not directly related, there is a commonality in the role that inflammation pays in both conditions. It is worth noting that some medications can cause diabetes as well. This is another issue that needs a proper assessment. Note that while prediabetes is often managed by a GP, your case is more complex because of your medical history. This will likely be about more than diet and lifestyle changes. You likely need an assessment by a gastroenterologist and/or an endocrinologist. You will also want ensure collaboration with your MPN care team.

Note that you may need to be the hub for case collaboration. We often need to be our own case managers to ensure holistic care. Like you, I have a somewhat complicated case. More than just a MPN going on. While I have a wonderful care team, I usually need to be the conduit for information sharing and effective collaboration.

I also consult with an Integrative Medicine doctor who looks at the whole person and how body systems interact. This doc is also competent in both Western medicine and complementary health interventions. She recommended Berberine for the prediabetes. I am giving it a try.

Wishing you all the best.

[Plavers in reply to hunter5582]

Thanks so much for your response Hunter, you’re so right about being our own hub. My Colonic transposition is often greeted with a look of questioning my sanity as it’s not really performed that often these days. Paul

[Amethist]

your high MCV is suggestive of B12 deficiency. I hope your Dr also tested your B12, folate, iron etc.

as you have mentioned a history of stomach issues, operations etc, B12 injections would be the most reliable way of obtaining B12.

In uk the Drs usually/ are supposed to give a loading dose of 6 injections in a 2 week period. Then they often test your B12 levels , which is a big mistake. They should instead look at your symptoms and how they are improving. B12 numbers straight after injections are worthless.

Really suggest you get the book, Could it be B12 ?, by Sally Pacholok.

Here are the updated NICE guidelines ( that Drs frequently ignore) nice.org.uk/guidance/ng239

treatment should always be based on symptoms not a blood test.

Suggest you look at the symptom list below and make a note of what is relevant to you. Then you can see what is improving with your treatment and what is not.

theb12society.com/signs-and...

Neuro symptoms can become permanent if insufficiently treated.

The idea of treatment is to continue injections, every other day, until your symptoms go away, or stop improving. For some this can take several years.

Maybe get a copy of the book for your Dr too, as they are taught very little about vitamins 😉

Wishing you all the best.

There are several excellent B12 groups in uk plus there is a B12 site on health unlocked if you want extra advice.

[artydutch]

have a look at CluB12 website in the UK. There is increasing evidence that the lab ranges are incorrect and miss many who are deficient. I was picked up by the doctor of the above website. I learned to self inject and had daily injections for 6 weeks and now inject once or twice a month. For me it has made a huge difference and improved how I felt.

I had been on proton pump inhibitors since 1994 and had bile backflow into stomach after gall bladder removal. This prevented absorption of B12.

Good luck and hope B12 improves how you feel.

[Plavers in reply to artydutch]

Thanks artydutch very useful advice. Paul

[Innessant]

Pre diabetes is VERY common and you can even tip over into the diabetic range without any symptoms . I did....My advice: cut out the carbs and sugar and do resistance training . No medication is needed .

[Plavers in reply to Innessant]

Thanks Innessant, already started the resistance training, feel better for doing it already. Paul

[SoledadBarcelona]

Hello,B12 must be checked. Pay attention that in blood count is normal to test, but, MPN patients have cronic deficiency due to it and maybe a MMA (methilmalinic acid test) is better. If you have a genetic test, you can check it.

I don't know what traitment are you taking because, for exanple, Interferon can provoque diabetes for this you have to limit fruits per day, and general speaking all foord with hight glycemic index . In addition, ot works very well for MPN patients.

There is no specific information about whether M&S toffees are dangerous for cancer patients. However, some imported sweets and drinks may contain banned additives that are linked to cancer and other health problems.

[Plavers in reply to SoledadBarcelona]

Thanks SoledadBarcelona for your reply. I’m on holiday for two weeks then lots of tests booked. Paul

[SoledadBarcelona in reply to Plavers]

A book can help you. Happy holidays!library.fabresearch.org/vie...

[Janis12]

Hi, my late father had his duodenum removed when he was in his forties due to a perforated ulcer (he nearly died). He was told that he would never feel terribly well again but to live a normal life. He was very slightly built to start with but as a side effect of the operation he would experience malabsorption syndrome so like yourself had less pipework to soak up the nutrients. Later in life he developed type 2 diabetes despite being slim and eating a good diet (he was a chef all of his working life). A young dietition gave all the regular diabetic advice without taking into consideration my fathers malabsorption syndrome. As a result of this he became malnourished and quite ill. Once we realised what was happening we asked to be seen by a more experienced dietition who immediately told him to eat everything...meat, carbs, dairy including cream and sweet treats as and when he fancied. Although he had heart disease and bladder cancer he lived until he was 88 years old. Be careful about the standard diet advice for your situation, I would strongly recommend seeking out a more experienced clinician. Good luck.

[Plavers in reply to Janis12]

Thanks so much Janis12, that’s just the advice I wanted to hear. It’s like red meat, I know we are supposed to cut down on our intake but there are times when it’s the only thing that will slow my digestion system down. Many thanks Paul