serum in the liver/blood

[shevie]

Could someone please explain to me just how a sample of blood taken from, say, my arm, can be used to determine how much serum there is in my liver? I can see that it tells us what is in my blood, but my liver is at least 2 feet away!!

[Gambit62 Administrator]

the serum test is only telling you about what is in your blood - as you say - it doesn't tell you what is going on in your liver.

If you have an absorption problem then there could be B12 stored in your liver but because the recycling mechanism relies on the ileum and there is a problem absorbing B12 through the ileum it isn't going to be useful so whether or not there is B12 in your liver is pretty irrelevant.

However, the likelihood is that if you have a problem absorbing B12 then, because that takes quite a while to manifest as a deficiency, the chances are you will have fully depleted any B12 in your liver because body will have picked up on low levels, told the liver to release the B12, which it does through bile into the ileum, where it isn't absorbed and ends up passing through the gut and then being filted out and wee-ed away by the kidneys, so a low blood serum is likely to mean no B12 in the liver.

[Frodo]

I've been wondering about storage in the liver too. If the B12 injections 'wear off' quickly in the initial stages, what I'm wondering is whether it is possible that the body is building up stores in the liver again (saving for a rainy day) before repairing all the neuro damage and so there is less available for that? (If the mechanism is working properly.) A bit like the way it builds up extra fat stores after someone has been on a starvation diet (or so I read somewhere).

Just speculating.

And if the mechanism isn't working, does that mean some people have never had stores in the liver??

[pram69]

I have been pondering this question ever since I was diagnosed in 2005 (a year after a blood test that showed I had enlarged red blood cells!). How can my GP tell me that my levels of B12 are high when he doesn't have an idea of what is happening with my liver stores and I still fell like rubbish?

[shevie]

My understanding of my present situation is this;

I have PA/B12d, doesn't matter which

I am on 8 weekly jabs.

I get a jab, and 1000mcg filters through to my blood. approx 98% of this, 980mcg, gets peed out before any use can be made of any of it.

The remaining 20mcg looks for red blood cells that are in the process of being made (about 2.5 million a day) and helps build them, making them nice and well shaped and STRONG! Anything that can be spared to mend something is sent to the area of greatest need.

At the same time as this 20mcg is swooshing around my body at a zillion miles an hour , anything not already busy cell building or mending fences, gets trapped by a b12 fishing net in my liver.

At the same time as I make blood cells, I also lose them (they only live 40 days) so we get a turnaround of 2.5million per day. So, unless i get another injection the next day or the next, these new cells only get the b12 they need by calling upon the liver to send some down. The liver duly does this, by squirting some of the b12 it has, into the bile duct and into the stomach where it combines with intrinsic factor and then passes to the ileum and it subsequently diffuses through the wall of my bowel and into the blood vessels to help out said cells. But oh dear, OOPS! I have either got NO intrinsic factor, or I do have some but its being slaughtered by Intrinsic factor antibodies, or I am unable to transfer the b12 through the walls of my bowel, so at the point the b12 is squirted into my stomach all is lost. That means that I have just made 2.5million cells that are struggling and WEAK. And I will make another 2.5million tomorrow and the next day and the next day and so on and so. So, the stores in my liver are useless to me, and this explains why those with nasty symptoms require jags every other day. And if the situation has been allowed to go on and on and on and on the resulting damage may be too great to mend anything.

fao.org/docrep/004/y2809e/y...

The above article explains the 'negative equity' my, and your, liver is most likely struggling with