Can anyone help!!

[flatoutcooper]

Does anyone know where I can get help with b12 deficiency and diagnosing it,as I am 4yrs post op a RNY gastric bypass without a single injection and nobody from NHS barnsley cares.I'm type 1 diabetic since April 2014 also taking pancreatic enzymes and ommerprazole.I've got serious vitamin deficiencies and am immune suppressed and unable to eat.I've nothing in me mentally and physically left feel its to hard to carry on fighting...

[Polaris]

Hello flatout

I'm so sorry you feel so bad and shocked that you have been left for four years after gastric surgery without being checked or treated for B12 deficiency.

This is Dr Chandy's site which is interactive and will help assess your symptoms to report to your GP. It seems you should be treated on the basis of your gastric surgery as well as the fact that the medication for diabetes may also be depleting your B12.

b12d.org/b12-signs-symptoms...

Here is an extract from latest BCSH Guidelines, which your doctor should be made aware of :

bcshguidelines.com/document...

"h) Poor absorption due to gastrointestinal surgery or disease

(1) Patients who have had gastric surgery have a high prevalence of cobalamin deficiency (Sumner, et al 1996), and more recently, treatments for obesity including gastric banding and gastric bypass surgery also lead to cobalamin deficiency (Ledoux, et al 2006, Vargas-Ruiz, et al 2008). Recommendations for prevention and treatment of nutritional deficiencies have been published(Ziegler, et al 2009), which include monitoring of levels and prophylactic supplementation. Oral treatment may not be adequate(Donadelli, et al 2012) and lifelong compliance may be poor (Edholm, et al 2013). "

In case the above guidelines are not enough to convince your GP, it might be worth just pointing out the summary points of the latest research document Cmim BMJ- A.A. Hunt B12 :

Cmim/BMJ document. " Summary:

* Vitamin B12 deficiency is a common but serious condition

* Clinical presentation may not be obvious thus leading to complex issues around diagnosis and treatment.

* There is no ideal test to define deficiency and therefore the clinical condition of the patient is of utmost importance."

* There is evidence that new techniques, such as measurement of holotranscobalamin and methylmalonic acid levels seem useful in more accurately defining deficiency.

* If clinical features suggest deficiency, then it is important to treat patients to avoid neurological impairment even if there may be discordance between test results and clinical features.

Severe deficiency shows evidence of bone marrow suppression, clear evidence of neurological features and risk of cardiomyopathy.

It is important to recognise that clinical features of deficiency can manifest without anaemia and also without low serum vitamin B12 levels. In these cases, treatment should still be given without delay."

I hope the above will help convince. Very best wishes

[Gambit62 Administrator in reply to Polaris]

I know someone who went for decades after gastric surgery and was finally diagnosed as B12 deficient by a paramedic after he had a bad fall in public.

The level of knowledge of the effect of gastric surgery on B12 deficiency is ...

[flatoutcooper in reply to Polaris]

Thanks for your help.

[Gambit62 Administrator]

Omeprazole is an infamous contributor to B12 deficiency because of the effect it has in lowering stomach acid levels. Ironically the stomach problems that it is used to treat are common symptoms of a developing B12 deficiency that would be much more effectively treated by proper supplementation with B12.

So, basically you have at least 2 items in your medical history that put you at high risk of developing a B12 deficiency.

Hope you manage to get the treatment you need

[pvanderaa]

My aunt had the Whipple procedure done to her intestines and stomach and they immediately put her on b12.

I had a partial vagotomy procedure done to my stomach to reduce stomach acid and the resulting ulcers. They never tested my for b12 in any follow up and didn't advise me of the issues in having a B12D.

Why was the gastric bypass done?

[flatoutcooper in reply to pvanderaa]

A perforated ulcer due to being alcholic.also had pancreatitis 12 times

[pvanderaa in reply to flatoutcooper]

B12D can result from alcoholism as well as from gastric bypass