Hi, I've been wondering for a while if my symptoms (many and varied) might be thyroid related so have just got results from a private blood test but need help to work out what I need to do to feel right again. I originally posted these on the thyroid community of HU but they suggested my B12 and folate were low and possibly causing most of my symptoms and I should post here for more help and advice....
A gastric bypass will make it much more difficult for your body to absorb several things - including B12. As will PPIs like omeprazole.
You could try taking sublingual B12 - 1000 ug a day - and see how that works. If your symptoms recede and your B12 level rises then you could drop back to one a week and see how that goes.
If it doesn't work then you may have to look at getting regular injections. Indeed, I would ask the doc for that first of all.
Thanks fbirder, I'll ask the GP again but was told about 6 weeks ago that my B12 level was 'perfect' by a new registrar who decided I was depressed, which I have been in the past but most certainly am not at present.... If I can't get anywhere with the GP I'll try the sublingual B12.
Your B12 test results are low and, as Vitamin B12 is absorbed through through the ileum, gastric surgery will have affected absorption. It's, therefore, essential that your GP ensures levels do not drop lower and should treating with B12 injections for life as per the guidelines below :
See the BCSH B12 deficiency guidelines on page 4 :
bcshguidelines.com/4_HAEMAT...
(Bottom of page 10) under Poor absorption due to gastrointestinal surgery or disease.:
Patients who have had gastric surgery have a high preva- lence of cobalamin deficiency (Sumner et al, 1996), "
..............
Also latest BMJ research document :
cmim.org/pdf2014/funcion.ph... :
(Page 2). Box 1 Common causes of vitamin B12 deficiency:
* Gastrectomy—partial or total
(Page 5 ) under Summary of treatment and management of vitamin B12 deficiency
"Prescribe lifelong maintenance parenteral vitamin B12 treatment with hydroxycobalamin 1 mg intramuscularly every three months if no neurological deficit, or every two months if there is neurological deficit to all those with irreversible malabsorption or after gastric surgery, pernicious anaemia, and any other irreversible cause "
Have you looked at b12 symptoms lists? My understanding is that people who are symptomatic for B12 deficiency in UK are supposed to be treated even if b12 blood levels are within range.
See page 8 and page 29 in the BCSH Cobalamin and Folate Guidelines. page 29 is a diagnosis flowchart showing recommended process doctors should follow with someone who may have B12 deficiency. page 8 gives details of UK b12 treatment.
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