What's the Source of My Problem? Frustrated With Doctor's Response.

[srmika]

Hi all,

Back in August I found out my B12 level was 267 and I was fortunate to be started on loading doses shortly thereafter. I am finally starting to feel better and have two weekly loading doses left (I live in the U.S., so it works a little differently here). I've been pushing my doctor to discover the source of this problem, so requested blood work for Intrinsic Factor. That came back normal, so she doesn't feel the cause is the auto immune disorder. So, I pushed to learn more -- do I have a problem with gut health that we need to fix? What can I do to keep my levels up and wean myself off of the injections?

She said my deficiency is likely because I'm a vegetarian and eventually I'll move to oral supplements. But here is why I'm frustrated with that response:

-- I turn 40 in two weeks and have been a vegetarian since I was 16. I've never encountered a problem like this in all of that time.

-- I eat eggs and dairy and take a multi-vitamin with 200% of the recommended B12 dose, so I should have plenty of B12 in my diet.

-- In the year prior to my diagnosis, I had terrible stomach problems that I suspect started with an antibiotic that wrecked my gut flora. I became lactose intolerant and, I believe, gluten sensitive. To me, it seems these things are all related. I've told my doctor this, which is why it's especially frustrating that she's falling back on the vegetarian excuse.

My doctor is typically very helpful, but unfortunately she has a VERY unhelpful nurse who is reluctant to even ask her my questions, so I'm not confident the communication has been great. I have a blood test scheduled for Dec. 1 and plan to just make an appointment to see her after so we can have a face-to-face discussion about all this. In the meantime, does anyone have any advice that might help? Or any experiences that might be worth sharing?

Thanks so much!

[Gambit62 Administrator]

a) A negative result from the IFA test is not conclusive evidence that you don't have PA - the test is notoriously prone to false negatives (about 50% of the time)

b) push back on the vegetarian assumption - the facts you outline above about diet and supplementation should be conclusive that the problem has to be absorption not diet related

c) PA is one possible cause of an absorption problem - the most common one - but there are others - including h pylori infections, drug interactions, gastric surgery affecting the ileum, lowered levels of stomach acidity (frequently mistaken for high stomach acidity as symptoms are very similar ... and PA will also result in this).

[srmika in reply to Gambit62]

Gambit62, you are awesome! Thank you! I appreciate you confirming my suspicions and also providing specific things to ask about. This is just terrific and I really, really appreciate it!

[blondie2505]

You could have a false negative for PA but also you mention all the stomach issues after antibiotics ....i would investigate a yeast overgrowth as this can cause malabsorbtion problems due to yeast eating your nutrients..

[srmika in reply to blondie2505]

Thanks for this! I've heard a little bit about that from a friend. I will definitely look into it further! Any advice on how to treat it? She did an elimination diet... So far I have been focusing on taking probiotics, limiting wheat intake, and upping my fermented food intake.

[blondie2505 in reply to srmika]

That's all good but depends how out of whack the yeast overgrowth is. ..The problem is it can be very difficult to get rid of as you have to eliminate all forms of sugar for a very long time and slowly reintroduce new foods it can take anything from six months to twoyears onwards you cannot cheat or it won't work because you end up feeding the yeast..I would take a look at lisa Richards ultimate candida diet it's about thirty six pounds to buy ...It breaks everything down for you easy to understand and pretty much covers everything about the diet ...how abd why you get yeast overgrowth eg high sugar diet..steps. .antibiotics ect.

[srmika in reply to blondie2505]

Got it. Thank you so much!

[Marz]

Glad you have ideas to work with.

Many of us bump along the bottom of the B12 range for years - being told the results are normal. I am one of those having had several bowel operations involving the Ileum and beyond over 40 years ago.

I now live with a pair of long legs that look good but feel as if they do not belong to me 😊😊 Have had various diagnoses over the years but now feel that it is B12 related - having learned so much from others who know more than me.

Hope you soon find the support you deserve ........

[srmika in reply to Marz]

Thank you so much! I do feel very grateful that my doctor was willing to treat me even though I was at the bottom of the "normal" range.

Glad you have those nice, long legs, at least!