Head scratching time

[Cb1963]

So had my blood results back and it was only through this forum that I requested that I have my B12, and folates tested when being checked for diabetes, now I would assume that your blood is tested for any unusual or incorrect readings as normal procedure, so now I've been informed I have to get B12 injections and take a foliate tablets,so does this mean I've got PA or is the word PA just symptoms that I'm not really aware of? On top of having peripheral neuropathy it's really difficult to know what "normal" feels like, and having a reoccurring skin condition that never seems to settle down, are these symptoms all related to PA, I've often wondered if the likes of having my tonsils removed and adenoids as a child and my appendix removed in adulthood have caused these problems to be accelerated, I believe taking omprazole can be a starting point as this interferes with the acid in the stomach, and this is always going to be an issue for me as I had an internal bleed last year, and have been informed that I'll be on this medication for my natural days, I know there's a fair bit of reading here but it'd be good to see if anyone else is suffering with the same complaints that I've ended up with, thank you all

[clivealive Forum Support]

Hi Cb1963 Anyone at any age, can become B12 deficient. However, certain people are at an elevated risk. They include the following:

"Vegetarians, vegans and people eating macrobiotic diets.

People aged sixty and over

People who’ve undergone any gastric and/or intestinal surgery, including bariatric surgery for weight loss purposes (Gastric bypass).

People who regularly use proton-pump- inhibitors. H2 blockers, antacids, Metformin, and related diabetes drugs, or other medications that can interfere with B12 absorption.

People who undergo surgeries or dental procedures involving nitrous oxide, or who use the drug recreationally.

People with a history of eating disorders (anorexia or bulimia).

People with a history of alcoholism.

People with a family history of pernicious anaemia.

People diagnosed with anaemia (including iron deficiency anaemia, sickle cell anaemia and thalassaemia).

People with Crohn’s disease, irritable bowel syndrome, gluten enteropathy (celiac disease), or any other disease that cause malabsorption of nutrients.

People with autoimmune disorders (especially thyroid disorders such as Hashimoto’s thyroiditis and Grave’s disease) Type 1 diabetes, vitiligo, lupus, Addison’s disease, ulcerative colitis, infertility, acquired agammaglobulinemia, or a family history of these disorders."

Can you see yourself in any other of the above people beside the one highlighted?

The test for Pernicious Anaemia is more specific although the treatment is very much the same as for Vitamin B12 Deficiency. Your doctor may test you for Intrinsic Factor Antibodies at some time in the future but at the moment he/she appears to be treating you for "Vitamin B12/Folate Deficiency" in accordance with the N.I.C.E Guidelines which you can read below by clicking on the link, then on "Scenario: Management" and scrolling down.

google.co.uk/url?sa=t&rct=j...

I'm not a medically trained person but one who has had P.A. for over 45 years.

I wish you well

[Gambit62 Administrator]

strictly speaking PA is a particular cause (auto-immune) of B12 deficiency. Others include coeliacs, crohn's, low stomach acidity, and drug interactions (which includes omeprazole as it will lower your stomach acidity), h pylori infection, gastric surgery affecting the ileum.

The symptoms you describe are symptoms associated with B12 deficiency but there are also a lot of other things that can cause peripheral neuropathy.

Unlikely that the ops you mentioned are the cause but more recent operations could have accelerated things if nitrous oxide was used as an anaesthetic as it will inactivate B12 and if you have an absorption problem you won't have been able to replace the lost B12.

The treatment for non-reversible absorption problems is B12 injections for life. This means that you are by-passing the gut as a way of getting B12 in to you system so taking omeprazole won't be a risk factor any more