B12/ PA

[debbie177]

Hi. Could someone please tell me the difference between B12 deficiency and PA. IVE HAD THE LOADING INJECTIONS AND BEEN TOLD TO HAVE ANOTHER IN 3 weeks. That's it no more info from my GP.

TIA Debbie

[Lisahelen]

Do go to the PAS website it will outline the difference for you.

as i see it true PA is where the body cant ingest the vitamin, and deficiency is just a person lacking in it.

[Gambit62 Administrator]

Pernicious Anaemia is an autoimmune response that attacks the mechanisms the body uses to absorb most of your B12 - either the binding agent (intrinsic factor) or the specialised cells (parietal cells)

PA is one potential absorption problem - there are many others - including reducing levels of acidity in the stomach as you get older, drug interactions and surgery affecting the ileum (no cells = no absorption).

An absorption problem will result in a deficiency. This can take a long time to develop - years or even decades - because the body is quite efficient at recycling B12. However, the recycling mechanism depends on the liver releasing B12 in bile into the ileum for it to be reabsorbed - but that will become less and less efficient and the absorption problem gets worse.

The symptoms of PA are the symptoms of B12 deficiency.

Just to add to the confusion many medics have a tendency to use the terms Pernicious Anaemia and B12 deficiency as if they are interchangeable so easy to get very confused.

Good background reading - to which others can add:

Pernicious Anaemia - the forgotten disease (Martyn Hooper)

Could it be B12? - Sally Pacholok

[debbie177 in reply to Gambit62]

Thank you yes it is confusing. I am also vitamin D deficient. Remember being K deficient before my gallbladder op. I also have BAM Bike Acid Malabsorption. Is there any advantage to me finding out if it's PA. If so how would I go about it?. x

[Gambit62 Administrator in reply to debbie177]

Personally I think you can drive yourself mad trying to get to the bottom of what caused the absorption problem - and the treatment is the same whatever the cause.

Only advantage might be in terms of genetics and whether other members of the family need to be made aware - but that would apply to other cuases of absorption problems as well so back to going round in ever decreasing circles - particularly as the tests for PA 'proper' are at best 50% accurate, ie you can have the tests for IF or PC Antibodies done and come back as negative but that isn't conclusive and if the test was done again it could come back as positive and only if they come back positive is it anything approaching conclusive ... and even then there can be circumstances that give rise to a false positive.

May be worth asking for a colonoscopy to see if there is anything going on in the ileum that would explain things though by the sound of it your absorption problems are quite extensive and not just B12 so may be more general

[debbie177 in reply to Gambit62]

Just had a precancerous polyp removed and an MRI of small bowel showing signs of inflammation but inconclusive apparently Seeing Gastro in Oct. thank you for your help x

[Gambit62 Administrator in reply to debbie177]

Sorry to hear about the polyp - hope they managed to get it all. Cancer is a higher risk if you are B12 deficient.

Unfortunately there is a correlation (no causal link established) between B12 treatment and higher rates of cancer/larger tumours - probably pre-cancer due to deficiency but then the B12 helps the cancerous cells reproduce as well as healthy cells - though it definitely helps the healthy cells more.

Mention this as Drs often don't understand that a correlation isn't a causal link and think that B12 is dangerous if you are experiencing problems with cancer ... really it just means that you may have to be more wary of cancerous tumours for a while so if you are seeing an oncologist it may be worth mentioning - but don't take any crap about the B12 being the cause.

[clivealive Forum Support]

PA is for life and I've had it for 43 years having monthly B12 injections - now aged 74

Hopefully your doctor will explain why you have had your shots when you go back and it may be that you are just a bit low for one reason or another - e.g. diet...

I wish you well