My grandmother was paralysed from the waist down before being diagnosed with Pernicious Anaemia. She was disabled for many years before eventually dying of stomach cancer. My mother and two of her siblings had autoimmune thyroid disease.
My symptoms are very suggestive of B12 deficiency but my red blood cells are normal and B12 level is 300. My GP suggested cobalamin 150mcg daily by mouth.
As a doctor myself I had a tough time persuading him that;
Symptoms may occcur long before the red cell changes.
The lower limit of the normal range of B12 is probably much too low.
Symptoms can occur before that lower level is reached.
Only total serum B12 is measured, not active B12, which is a more accurate indicator.
Since my problem was almost certainly poor absorption, not inadequate dietary intake injections would be most effective.
There are no studies to show low dose oral supplements are as effective as injections. The studies only compared 1000 and 2000mcgs with injections.
There is no evidence that high dose B 12 is harmful, nor is it expensive.
I finally accepted a compromise of 1000mcg daily.
He had discussed my case with other doctors who agreed with his flawed analysis before suggesting the low dose treatment for me. As a doctor myself I am well aware of the perjorative way in which many GPs treat patients, particularly women, presenting with TATT - tired all the time - and other vague symptoms. My grandmother carried the burden of such cavalier disregard! Fortunately I was probably better informed than his colleagues and was able to argue the toss and insist on proper consideration and treatment.
I am generally pretty assertive and if it happened to me I dread to think how much of a runaround most patients get.
Arm yourselves with the fact and DON'T BE FOBBED OFF!