I was diagnosed with a B12 deficiency approx. 15 months ago, had loading doses and have been on 3 monthly injections since then, I find these only seem to improve the symptoms for about 6-8 weeks, I already have neurological symptoms in my toes and fingers, confirmed to me by a doctor I saw in a clinic for balance problems, as I was falling over a lot. Unfortunately his report to the GP was lost in a computer system change, and has never materialised. I am trying to get a GP to investigate whether injections on a monthly time span would be better. The GP I spoke to last week said only retest B12 levels every 2 years, and because the level was within normal range after loading doses, no need. I also have been taking levothyroxine for many years currently at 62.5 mgs daily, I was not aware there is a link between the 2 problems before reading other posts.
I have an appointment with another GP next week, who I know better and hopefully will be more helpful. What is concerning me now is reading various posts is the relationship between B12 and having anaesthetics. I have had 3 gynaecological ops over the last 3 years with a general anaesthetic. It is only since then I have had a B12 problem, The last op was in February this year, and it is since then I have had a big increase in the symptoms of B12 deficiency, I have no idea what type of anaesthesia I was given, at the pre-op I handed them a list of all my current prescriptions, and added B12 injections to the list, but no mention of it was ever made about it. Is the anaesthesia used in UK NHS hospitals the one that causes problems with B12 and is it a temporary or permanent change.
Thanks for any advice
Written by
scadman
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I really have no idea, as I was unaware there was a link until I read a reply you posted a while back that mentioned the link. It never occurred to me to query it at the time of the op, I would have presumed the anaesthetist would have read the prescription list to which I had hand written 3 monthly B12 injections to the printed list, and avoided the problem drug. But reading through old posts it seems the medical world in the NHS either doesn't know or consider the implications of a B12 deficiency. It's only since joining this site I have become aware that B12 deficiency is more than just a minor inconvenience.
nitrous oxide reacts with B12 turning into a form of cobalamin that can't actually be used by your cells. It is used as an anaesthetic but if you had alerted the anaesthetist to your B12 status they should have avoided using it as an anaesthetic.
I am not aware of any other anaesthetics which will cause problems with B12.
Current guidelines for the treatment of B12 absorption problems actually say not to retest B12 levels after treatment starts unless there is reason to believe that treatment is not being complied with. Levels after loading doses don't really have much significance unless they come back low indicating that you metabolise B12 quicker than the the period between maintenance shots. High levels after loading doses aren't significant because loading doses introduce new factors that mean the 'normal range' no longer applies. serum B12 only tells you what is going on with the amount in your blood - it doesn't tell you about the processes that allow it to be transferred from blood to cells or about the way it is actually being used in cells. It is quite possible - to be B12 deficient at the cell level when levels in blood are high - this is called functional deficiency. The best way of judging whether you have enough B12 after loading doses is actually monitoring symptoms - which you seem to have done and worked out that the levels start falling below the level you need at 6-8 weeks.
If you can work with the GP you are speaking to then it might be worth making them aware of the microsite for GPs on the PAS website
You really need to see a neurologist to find the cause of your neuropathy and ataxia.
Unquestionably GA damages the B12. I had two ops in 2015 and after the first op had extreme fatigued day or days and walked to my right along the pavement. Before the op my B12 was "normal" but low for me personally so I broke my vegan diet and ate liver twice a week. I also spoke with the anaesthetist prior to the second op who agreeably adjusted the GA so I suffered no consequent problems. It seems to deplete all the B12 including storage...my present B12 is fine but brain cognition and learning memory has not improved. MRI shows damage but 75mg aspirin prescribed treatment seems irrelevant...
In UK, people with B12 deficiency with neuro symptoms are supposed to get loading injections every other day for as long as symptoms continue to get better then it's an injection every 2 months.
"I already have neurological symptoms in my toes and fingers, confirmed to me by a doctor I saw in a clinic for balance problems"
Neuro symptoms include tingling, pins and needles, tinnitus, memory problems, balance issues plus many other possible neuro symptoms.
Do you have other neuro symptoms?
Have a look at lists of B12 deficiency symptoms below.
There is chapter in book "Could it Be B12; An Epidemic of Misdiagnoses" by Sally Pacholok and JJ. Stuart (USA authors) which discusses the effects of nitrous oxide and I think other forms of anaesthesia on B12 levels.
There are blog posts on Martyn Hooper's blog about PA and B12 issues that mention nitrous oxide.
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