Hi been a frequent visitor reading many posts, finally decided to ask for some advice.
I have been having B12 injections for apx 3 years, initially every 3 months after loading doses then 4 weekly. This was after complaining that I wasn't improving and first loading doses being given over 6 weeks not 2. So after 3 years the nurse decided I needed to have instrinsic factor test which came back normal. I was feeling really rubbish at this time so went to the dr had parietal cell test also normal, I had H pylori bacteria a couple of years ago and was treated for it, redid this test and also clear. Was thinking it could be atrophic Gastritis but seems not. However the thing that came up was low vit D & low folate been supplementing over the past 5 weeks and feel a little better. However I'm now even more confused about what is going on and why I'm low on now 3 different vitamins. Anyone got any ideas what's going on ? Could it be that I have an absorption problem in my stomach rather than PA and where do I go from here ? Should I ask to see a specialist and who would this be ?
Anyone else have multiple deficiencies ?
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123adshead
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If you've been reading here, you're probably already aware that the intrinsic factor antibody test has a high rate of false negatives. So even though you tested negative for intrinsic factor antibodies, you may still have PA. Of course your history of having h. pylori could certainly have led to your absorption problems and, even though you've successfully been treated for that, some damage may still remain making absorption difficult.
Vitamin D deficiencies are very common, unfortunately.
I have had a similar experience where I've been tested for all sorts of things but never got to a solid conclusion for why I need B12 injections. I tested negative for h. pylori though, so I'm even more lost than you are, I'm afraid. I eventually reached a point where I realized it just doesn't matter what the underlying cause is, because whatever it is, there is no way for me to change it. I just need to take B12 to stay well.
very much agree with Galixie on the testing - you can just end up going round in ever decreasing circles because the tests aren't really conclusive - either IFA or PCA (which is no longer recommended as a test in the UK as it is so unreliable both ways). Whatever the absorption problem with B12 the treatment will be the same.
Flowchart in link below shows UK recommended process for diagnosing and treating B12 deficiency. It mentions Antibody Negative PA (PA where IFA test is negative)
If you are UK based it may be helpful for you to read whole "BSH Cobalamin and Folate Guidelines"
b-s-h.org.uk/guidelines/ click on box that says "Diagnosis of B12 and Folate Deficiency" should be on page 3 of listed guidelines or put "cobalamin and Folate guidelines" in search box.
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