Endoscopy

[catherinejordan]

If endoscopy and colonoscopy come back ok does that mean you don't have PA ?

[Gambit62 Administrator]

I am not an expert but I would imagine that the damage that would be evident from PA would take a while to develop so answer would be that it wouldn't be conclusive.

However, PA isn't the only cause of a vitamin B12 deficiency - and the symptoms of PA are the symptoms of a B12 deficiency - other causes include: lowering stomach acid levels, particularly as you get older; drug interactions; gastric surgery affecting the ileum (though damage would probably have shown up in the procedures) and genetic abnormalities that affect the ileum (which again, would probably have shown in in the procedures.

[fbirder in reply to Gambit62]

When they say it was OK, did they specifically state that there were no signs of gastric atrophy? My gastro didn't mention it originally, it was only when I later mentioned it he said 'Oh, yes. You have gastric atrophy'.

He'd been looking for a gastric bleed and was interested in my polyps. He seemed to think that gastric atrophy was a given.

[clivealive Forum Support]

Hi catherinejordan,

I too am not a medically qualified person but I was interested in your question.

Do you think you might have PA?

Causes of P.A. or b12 deficiency are many and various including:-

Are any of your symptoms similar to those of P.A. or b12 deficiency?

Are you vegan or vegetarian?

Do you partake in extreme sports?

Have you had gastric surgery?

If you could give a little more detail I'm sure some of the more learned members of this community will be able to help.

I wish you well.

 

[catherinejordan in reply to clivealive]

Had gastric surgery in 1999 and suffering  strangly for years with odd symptoms.  Dizziness foggy head ... aches pains pins and needles palpitations headaches tiredness..to name a few. I wasn't started on b12 injection  1 year ago. But still not sure I'd diagnosed I was told ill need injection  for life

[Gambit62 Administrator in reply to catherinejordan]

Sounds like the gastric surgery is the source of your problem - 99% of B12 is absorbed in the ileum which is frequently affected by gastric surgery - so you haven't been able to absorb B12 for a significant length of time.  

The body is generally very efficient when it comes to recycling B12 so normal RDA is very small but the recycling depends on the liver releasing stored B12 into the ileum in bile for re-absorption so if the ileum isn't working properly it is gradually going to leak away so it can take years and even decades - which appears to be the case for you - for a full B12 deficiency to occur.

As you can no longer absorb B12 in the gut you need another way of getting B12 into you which is generally injections as these are the most efficient way.

People vary a lot in how they respond to injected B12 so if you are still feeling bad despite now having the injections ... and as clive frequently says they are for life ... then the likely explanation is that you are not getting them as frequently as you need.  UK uses 3 months for maintenance shots and personally I've never met anyone who actually manages to go a full three months.  Lots of people - myself included - need to supplement daily - though that doesn't necessarily mean injecting yourself - many people find that sublingual tablets and sprays work for them, I find that nasal sprays work for me and others find skin patches work for them.  It can also be worth trying different forms of B12 (comes as cyano-, hydroxo-, methyl and adenosyl).  methyl and adenosyl are the forms closest to those used at the cell level which some  people find work better for them.  

I personally use a mix of forms as I find they work on different symptoms for me.

You can find a full list of symptoms of B12D here

pernicious-anaemia-society....

and you may find it useful to let your GP know about these materials

pernicious-anaemia-society....

Hope this helps you understand a bit more about what is going on.

[clivealive Forum Support in reply to catherinejordan]

I too had gastric surgery - 40 years before you, in 1959 - but wasn't diagnosed with P.A. until 1972.

My then doctor, when I went back for the test results, asked whether I wanted the good news or the bad.  I said "give me the bad news".  She said "you are going to die, and you're going to die within 2 years"

I was already a 31 year old "Zombie" with a sick wife, a mortgage and two children under five, so I asked "So what's the good news then?"

She said "You're not going to die within two years if a) you eat raw liver three times a day, or b) have b12 injections every four weeks for the rest of your life".

Your "history" of surgery and time scale catherinejordan matches mine so I would say you do have P.A.

Well, much as I love cooked liver with onions, bacon, mashed potatoes and gravy, I didn't fancy it raw, so I opted for the Cytamen (cyanocobalamin) injections and after 44 years there is life after P.A. and I'm still "clivealive" coming up to 75.

By the way, my original doctor is also still alive and is now a Dame of the order of the Bath having moved on from general practice to become head of the Prison Psychiatric Service.  She was my family's GP for nearly a decade and we were so sorry to see her leave.

[fbirder in reply to catherinejordan]

Can you tell us exactly what sort of surgery you had?

It is possible that they removed the part of the stomach that contains the majority of the Gastric Parietal Cells. These cells have two jobs - release acid (which helps liberate B12 from the proteins in food) and Intrinsic Factor (IF - which is essential for the absorption of B12 further down the gut).