Which Consultant?

[HARBY15]

I am currently on the eight week injection regime (persuaded my GP to change from 12 weeks) Because I continue to have numbness in lower leg areas, the GP was not sure wether I should see a haematologist or a neurologist. He is arranging for me to see a haematologist, is this the right choice?

[Secondchance]

It is pot luck I think. I saw a neurologist who knew nothing about the effects of B12 deficiency. The guidelines recommend haematology referral but many here have had a variety of experiences. Good luck!

[Gambit62 Administrator]

Personally if the neuro symptoms are the ones that are bothering you then I'd go with a neurologist.

B12 deficiency isn't a blood disorder - B12 is used by a number of systems in the body so it's really a cross-discipline problem so referral should really be to whichever specialist is most approrpriate.

it can be very confusing as one of the symptoms of B12 is a blood disorder and it is blood tests that are used for measuring but it isn't anaemia that causes the neurological symptoms of B12 deficiency.  Also it is pretty clear that blood tests don't tell the whole story with B12 as the ones that are generally done don't tell you what is going on at the cell level.

Looking at secondary markers - eg elevated MMA and homocysteine levels can help to clarify if there is still a problem with B12 levels at the cell level but they aren't specific tests for B12 because there are other factors that can be involved in elevation.

It is possible that B12 isn't the only thing that is going on which is why I would go with a neurologist if those are the symptoms that are causing the most problems.  The only downside is that knowledge of B12D is generally pretty poor but that applies to all disciplines.

[jillc39]

yes - it has been for me. but ring first to check whether he/she is interested in PA  I had to phone seven different ones before I found one who would help me.

[pugdogs10]

There is one good thing about seeing a haematologist you do get all the blood tests done and these can throw light on some things (make sure you get a printed copy).

Some things are just a matter of trial and error and although it may take longer the haematologist can always recommend a referral to a neurologist or other appropriate specialism. In my case I did opt for the haematologist and it worked out well for me ,,, hope its the same for you.

[HARBY15]

Thanks to all who replied, very helpful

[Aivlys]

I notice that you are only about a mile from me so the chances are you will be referred to same hospital where GP referred me. I saw a haematologist and although he did say it was ok to have 8 week injections rather than 12 he thought I should have blood tested for B12 before each injection to ensure I wasn't at toxic levels! He did take blood tests but couldn't print out results and the test for PA intrinsic factor ( I think) was never sent to GP and I still don't know what the results were. I asked about seeing a gastroenterologist to find out why I was having absorption problems but he said I didn't qualify for a referral. I don't know why. I've never been offered a neurologist, it has always been assumed my tingling fingers are due to poorly controlled type 2 diabetes.

Luckily I am now seeing a GP who is a bit more sensible and has even agreed to me having my June jab a bit early so I can cope with my daughter's wedding.

Good luck!