Absolutely pig-sick of the trivialising of the injuries which can be caused by b12 deficiency - and it stems from ignorance and denial.
My lashing-out is in response to an email I received last night, where, yet again, the writer completely either misunderstood the metabolic pathways or completely ignored them because they were too busy looking to throw out the same old garbage relating to previous studies based on the same misconceptions that the serum b12 is reliable and that anaemia presents primarily. A grim determination to prove that patients' symptoms are initially related to anaemia and only anaemia and that the blood levels were supportive evidence of this.
What is it with some people who have to go around trying to prove to patients that they are not ill? Denial, vanity, stupidity. apathy, laziness? A fear that patients will sue their backsides off? Because what they don't seem to recognise is the fact that most patients don't want to sue - most patients simply want competent medical care. Which is exactly the same as every other patient who is recognised as being ill, gets. That's it. End of story.
Absolutely no one should have the influence to insist patients are not ill when patients are reporting, and in many cases proving, that they are. No one should have the right to deny those patients the access to correct care and the opportunity to improve their health as much as possible, by throwing selective studies founded on unreliable blood tests back as evidence whilst ignoring the biochemistry which contradicts those studies. No one should be having treatment founded on guidelines which in themselves have no research to support their effectiveness in halting the illness progression never mind reversing the neurological damage.
Do these same people think this illness will not or is not, impacting on them? Do they think it is selective? Because if they cannot appreciate what is happening or how to put it right, then essentially their behaviour means they are shooting themselves in the foot!
Anyway, in light of the BMJ article some patient and medical reference information is going to be brought forward and reviewed. When they do it and if they change it, and to what extent, remains to be seen.
... and just to add: if I have to see the title 'B12 deficiency anaemia' one more time my head is going to blow off. Until they start having an individual illness described as 'B12 deficiency neurological damage' then I think the 'anaemia' bit should bite the dust!