Need help comprehending research article.

[KimberinUS]

I am struggling with contentration today. Can somebody please condense what this article is saying for me.

Thank you so much

ncbi.nlm.nih.gov/pmc/articl...

[clivealive Forum Support]

Hi KimberinUS unless you are training to be a medical professional I would stick with is Martyn Hooper's "What you need to know about Pernicious Anaemia & Vitamin B12 Deficiency" which you already have or buy the book “Could it be B12? – an epidemic of misdiagnoses” by Sally M. Pacholok R.N., B.S.N. & Jeffrey J. Stuart, D.O.

I wish you well

[fbirder]

It's a long, complicated, paper. Can you pick out a particular part of the abstract that you need clarifying?

I covered some of the points raised in the summary in a reply in this thread - healthunlocked.com/pasoc/po...

[Gambit62 Administrator]

the conclusion of the article is that gastroenterologists need to be more aware of PA

The article ranges over the causes, the symptoms, diagnositic techniques. Its a bit confused about the relationship with macrocytic anaemia, seeming to imply in the abstract that this is a defining characteristic of PA but later on in the discussion talks about presentation with neurological symptoms only.

It talks about the causes and contains a discussion of evidence that autrophic body gastritis might be caused by long term h pylori infection as well as PA (in the sense of auto-immune gastritits - however it is awfully confused about the link between PA and macrocytosis.

It talks about the fact that symptoms come on slowly meaning that people may not present in an obvious way because the symptoms aren't clearly symptoms, mentions dyspesia as a symptom that often isn't obvious.

It also talks about other potential causes of B12 deficiency.

It talks about the relationship with iron deficiency.

Talks about diagnosis both of B12 deficiency and PA as a specific cause. Mentions schilling test and fact that IFA is prone to false negatives. Talks about treatment but seems at one point to have confused the frequency of maintenance doses with hydroxocobalamin and cyanocobalamin in Denmark.

It also discusses the need for follow up in relation to relation to development of other gastric consequences - including lesions and carcinoma, but makes no recommendation on frequency of follow up because the studies are so inconclusive.

Basically its trying to point out that people need to be a lot more aware of PA as a condition.

[KimberinUS in reply to Gambit62]

Thank you gambit62. That helps. Had to look up dyspnea, even in your much more easily understood explaination.

Who knew that was the fancy name for my now gone shortness of breath. Lol

[Polaris]

Thank you so much for posting this very interesting article KimberinUS and, although others have precised the research, I personally, found the following highly relevant to my family's experience:

Their findings highlighted an increased association of PA with other autoimmune diseases, such as type 1 diabetes, vitiligo and in particular, Autoimmune Thyroid Disease . Atrophic Body Gastritis and ATD are closely linked with ATD being present in about 40% of ABG patients[41]. "These data suggest that, in patients with autoimmune disorders, in particular ATD, a possible association with PA should be suspected and excluded."

"The diagnosis of concomitant autoimmune thyroiditis and PA may have an important clinical implication, in particular, in those patients who require replacement therapy with thyroxine. Recently, it has been reported that patients with impaired acid secretion may present with thyroxine malabsorption that requires an increased dose of the drug[42], and in patients with PA, associated hypochlorhydria is always present, due to the loss of oxyntic mucosa[4]." (damage to gastric lining).

Their data also showed that, by combining the assessment of intrinsic factor and parietal cell autoantibodies, the diagnostic performance of surrogate markers for PA may be notably improved and may be interpreted as damage to the gastric lining.

For those who haven't time to read to read the whole research, this was an important point:

"CONCLUSION

"PA is an often silent and under-diagnosed autoimmune disease, because its onset and progression are very slow and patients may become used to their complaints. Nevertheless, the clinical consequences of undiagnosed PA may be serious, including gastric neoplastic lesions. Thus, gastroenterologists should increase their awareness of this disorder, whose definite histological diagnosis may be preceded by reliable noninvasive serological screening."

[Marz in reply to Polaris]

Thank you Polaris It so often concerns me that people are often reluctant to rule out AITD even when symptoms overlap with Low B12.

[KimberinUS]

I asked because i feel like i am the only person really concerned about my health snd therefore have to understand before i can commuicate my concerns with my doctor.

I just got copies of recent blood working showing high platelet count, which i read can be due to b12/folate recovery

labtestsonline.org/understa...

But it also shows above normal high absolue lymphocytes which i am struggling to find a reasonable answer for.

Not super high (like in leukemia) in my opion.

It was 3.5 X10E3/uL. Range 0.7 -3.1

Maybe h phlori. I dont know... i am struggling with concentration today

My intrensic factor came back negative but i know that isnt reliable.

B12 came back at 814 pg/ml. Range 211 to 946. Seems low considering i have had 9 cyno injections (im in us) and taken over 130,000 mcgs of tablet methyl b12 during last 3 months.

My more recent injections were 6-30, 7-5 and 7-10 prior to test done on 7-27-2017.

[Polaris in reply to KimberinUS]

Your B12 does seem low considering you've had injections and supplements.

Did you notice that H/Pylori was mentioned in the research you posted above? I also found this interesting as I was diagnosed by endoscopy years ago after a particularly bad bout iof Gastritis :

"Long-standing Helicobacter pylori infection probably plays a role in many patients with PA, in whom the active infectious process has been gradually replaced by an autoimmune disease that terminates in a burned-out infection and the irreversible destruction of the gastric body mucosa."