Intrinsic Factor test v Haematinics

[Advice1]

would like to ask if anyone is aware

haematinics in blood test is enough to

without the Anti-IF antibodies test to find out if you really have PA

conclusively that B12 is or isn't being absorbed properly?As my GP failed to provide the Intrisic Factor test which was requested.

[Sleepybunny]

Hi,

Just wondered if you had thought bout getting IFA (Intrinsic factor antibody) test done privately?

Has GP explained why IFA test was not done?

This link to a flowchart in BCSh Cobalamin and Folate Guidelines mentions when IFA test should be ordered in UK. My understanding of it (I'm not a medic) is that anyone who has the symptoms of B12 deficiency should have an IFa test.

stichtingb12tekort.nl/weten...

Has GP seen this flowchart?

Link to whole "BCSH Cobalamin and Folate Guidelines" document below.

b-s-h.org.uk/guidelines/ click on box that says "Diagnosis of B12 and Folate Deficiency" ...think this is on page 3 of guidelines or put "cobalamin and folate guidelines" in search box.

[Advice1 in reply to Sleepybunny]

Thank you sleepybunny

for your kind help and all the links very generous of you to take the time.

Yes i did show flowchart to GP but goes by but really goes by update from a Rheumatolgy dept advice from a Hospital.

The GP did read some of

the pinned from here from PA forum ...at least took time to read it .

I will also show the other link to GP from print out

on stichtingb link which is helpful.

Thanks for reply.

[Foggyme Administrator]

Hi Advice1. No...hemanitic testing (for folate, iron and B12 deficiency) will not tell you if you have PA.

Unfortunately, the IF test for PA is very unreliable. If you test positive, you definately have PA but if you test negative, there is still a 50% chance that you could still have PA. unfortunately, not many GP's know this.

One of the problems with going back and asking for the Anti-IF antibody test is that if it proves negative, your GP may very well decide to stop your B12 treatment. Many do, despite that fact tha B12 deficiency has causes other than PA.

As the treatment for B12 deficiency and PA are the same, and you are already having treatment, it might be worth considering if your GP might fall into the 'stop-treatment' category, something you definately don't want to happen.

Many people with PA (especially antibody negative PA) fail to get a confirmed PA diagnosis - but the most important issue is continuation of treatment...which may be at risk if you get a negative IF result.

So...to test IF or not...difficult question! You'll be okay if it turns up a positive result, but,outcome might not be what you would like if you test negative. Entirely depends on how knowledgable or open to education your GP is. 😀😀

Good luck with whatever you decide to do.

[Advice1]

Hi foggyme,

from what you have mentioned

so far on IF testing .I think as i have low B12 anyway i should just carry on with the every 3 month injection as the GP is treating that and like you say me it could cause the GP to stop injections if Negative .So it will not harm me to have B12 every 3 months as it is water soluble and a small amount even if in the absence of PA. Thanks for taking the time to explain all the pitfalls

with the Intrinsic factor test.

What i was curious to know also was what bearing doing the Reative Cretinen Protein test on top of ferritin and folate as i had three individual results which can be seen in my other post"Test Values"

which would be helpful in understanding a bit more.

Thanks for the generous help and helping in mentioning that the B12 could be cancelled by GP

when actually could have PA even with a negative IF result.

Thanks for your kind very helpful advice.

[fbirder in reply to Advice1]

C-reactive protein, creatinine and urinary protein tests are all looking at kidney function.

[Advice1 in reply to fbirder]

Hi fbirder thank you for reply.. so Serum C reative protein level

is to do with testing the kidneys .did i need this test for B12 or PA?..thanks for the explaination .Does this normaly come with Serum folate and serum ferritin testing all at one time ?I originally had two GPs who both gave me two separate

blood test to go do elsewhere so it could be the lab may of lost one of the request form the IF test form as i did mention to my surgery wouldnt it be better to start a fresh and put on one form but they said no just give them both.

(I had to wait purposely for 3 months to do these tests due to loading B12 dose)

Another thing that may of happened was when i asked the GP for the

Intrinsic Factor test

The GP didn't understand and asked whats that was for and refered then to MMA test.

So maybe just gave me the CRP test instead!

all very strange but probaly good luck on my part as i may as already mentioned by in another post could of had a negative IF test with 50% chance of still having PA.

So as i do have lower than normal B12 it won't hurt to carry on with B12.. Injections every 3 months.

Thanks for your generous help much appreciated too.

'

[fbirder in reply to Advice1]

Docs like to test kidney and liver function, just in case. I think they reckon you've got the needle in already, so they may as well take a couple of extra tubes.

[Advice1 in reply to fbirder]

Hi fbirder thanks for your reply i see now that makes sense that GP would do these extra tests too. Thanks to everyone on the forum for educating me on all the issues on B12 and PA lots of very helpful people on the PA forum giving their time to answer all my concerns

Thanks fbirder foggyme sleepybunny Gambit62 and any others i may of forgotten from past help all great contibutions to answers and advice on the forum ....

Wishing you all a Happy New Year.

Advice1