Help again please.

[Cn13]

Hi,

I have posted here before and got some great advice. I am hoping for more advice this time. I am very worried and stressed that my new GP is not treating me correctly. In March this year I was diagnosed as having severe iron deficiency which I've had in the past also. In 2012 I was told by a hospital that I had anaemia caused by B12 deficiency. My medical notes seem to have pages missing so I wasn't able to come up with "proof" for this new GP. He had agreed to loading doses of B12 while waiting for my notes but has now stopped the B12 treatment. I had not being on injections since 2012 and was just taking supplements on and off.

At my last appointment I'm not sure it went too well. I had a serum B12 test in March which was in the normal range which the GP quoted to me and says he doesn't think I have PA. He then went on to say he would refer me to a gastroentologist for an IF test. I'm just reluctant to have the IF test because he probably doesn't realise you can be negative and still have PA.

I have been doing a lot of reading trying to educate myself but am feeling quite alone with it all. I mentioned my neurological symptoms at the last appointment and I have been referred to a neurologist for my memory problems. I am worried about this too as I have other neurological symptoms not just memory problems. Dementia does run in my family. This GP did not ask about any family history.

I am having a blood test next week I noticed on the last blood test the GP did there was no RDW done. I am just wondering that now the iron deficiency is being treated maybe something might show up that indicates a B12 deficiency.

I had my last loading does a month ago so now realise I will have to wait months before doing any more tests to reveal a B12 deficiency.

I'm just sure what to do next. Can anyone advise please. Thanks in advance.

[Gambit62 Administrator]

Suggest that you talk to Haematologist when you have the IFA test done and specifically request that if the result is negative he mentions specifically in the covering letter that a negative result doesn't rule out PA as cause of a B12 absorption problem.

Have you also been tested for other possible absorption problems such as coeliacs?

[Cn13 in reply to Gambit62]

Hi,

Thanks for your reply Gambit. At the moment the GP has referred me to a neurologist which will probably take a couple of months. The GP has said he will then refer me to a gastroentologist to do the IFA test. I will do what you suggest and make sure they put what you said in the covering letter.

I had originally asked for a referral to a haematologist but the GP said no and I wasn't able to come up with anything to convince him on the spot.

No I haven't been tested for any absorption problems yet maybe the gastroentologist would do a test for that.

I just think there is more wrong that the iron deficiency. I really want to ask for an Active B12 test and MMA but I would probably have to wait until October now to have them done.

I'm very grateful for any help.

[Cn13 in reply to Cn13]

Hi again,

Would you be able to help please with how I might convince the GP to test active B12 and MMA. I was thinking I might write to him presenting my arguments but would need some help with this. I have already given him a copy of the BCSH guidelines which Foggyme suggested. When I mentioned the active B12 test at my last appointment he just ignored what I said. Would a neurologist run any of these tests? Would anyone know where I could find a neurologist that knows about PA/B12 deficiency. At the moment I'm being referred to Sheffield but the GP said I could choose anywhere. Should I request a referral to St Thomas's as I know they test the active B12. Please can you advice as if I have some kind of plan I might start to be less stressed and anxious.

Thanks.