I've been suffering with lightheadedness, weakness, fatigue, balance problems for about 6 months. No room-spinning vertigo, but a general sense of weakness and not being able to stand up for long before feeling wobbly. And generally feeling crap. I haven't actually collapsed or fallen. I've seen ENT and Cardiology and both are clear. I've been referred to Neuro but haven't been yet. Can't help but try and self-diagnose. I'm here because I recently became aware of a possible connection between long-term use of PPIs and B12 deficiency. I've been taking omeprazole for about 25years. I insisted on having my B12 tested recently and according to my GP it was "normal" - it was around 330. Any advice on where I go from here? Am I likely to be deficient despite my "normal" test?
Written by
drlabman
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Omeprazole will certainly have caused you to become B12 deficient . It will have neutralised your stomach acid which is one of the components needed to facilitate absorbtion of vitaminB12 . 330 is a LOW reading for B12 . Remember 80% can be inactive B12 , inaccessible to your body . In Germany you would get injections at a reading of 500 and below , and never less than one every month. You are most definitely deficient and those symptoms prove it. You need to download some of the pinned posts that you will find top right on this page . Print them out and take to your doctor . Your symptoms need treating , not a number. Come back here if you have no joy . Best wishes
I'd suggest reading the "BSH Cobalamin and Folate guidelines".
This UK B12 document gives guidance to UK doctors on diagnosis and treatment of B12 deficiency.
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.
This link is to a flowchart in BSH Cobalamin and Folate Guidelines
Flowchart makes it clear that people who are symptomatic for b12 deficiency but have a within range B12 result should have an IFA (Intrinsic Factor Antibody) test and start initial B12 treatment. Also makes it clear that it is possible to have PA even if IFA test is negative. Sadly there are some UK Gps who are not aware of this document.
It's been a while but I thought I should provide an update on my situation. I've seen a neurologist without any great breakthrough. I was suspicious of my B12 despite an earlier reading that my GP said was normal (mid 300). Still feeling very fatigued and unsteady on my feet. Have started having tingling in lower legs the last couple of weeks so I decided to have my B12 tested privately (Blue Horizon). Here's my results:
Full Blood Count
Haemoglobin L 120 130 - 170 g/L
Mean Cell Volume 95.0 81 - 98 fl
Vitamins
Vitamin B12 616 pmol/L
Deficient <140
Insufficient 140 - 250
Consider reducing dose >725
B12-Active H 243.0 25.1 - 165 pmol/L
Serum Folate 13.77 8.83 - 60.8 nmol/L
So, strangely, the only abnormalities are Haemoglobin which is low, and active B12 which is high. I have to confess to taking sublingual B12 recently so I may have skewed my B12, but I don't feel any better for it anyway.
I guess the first thing to address is the haemoglobin. I haven't told my GP of my private blood test and the results yet, so that'll be awkward.
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