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Pernicious Anaemia Society
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It's been a miserable year!

Can I just start with "It's been a miserable year" and the sooner 2017 departs the calendar, the happier I might be.

I saw my Neurology Dr. this morning and found out my GP will be scheduling the B12 shots (he ordered on 10/6/17) Called the GP office and no reply as of yet. In the meantime... my B12 test result was 201 (239-931) but states he prefer's the number to be between 400-500. Some of my other questions did get answered such as:

No way of telling how long of period I have been deficient

It is possible the side effects of Otezla may have exacerbated the condition - resulting in lowering the numbers further.

Not recommending liver biopsy at this time

B12 test did not include folate levels.

My 2nd MRI threw a new ingredient into the mix. Apparently, a bulging/herniated disc at C5-C6 and will be hearing from surgeon, possibly by end of week, to schedule prelim consult & surgery to fuse C5-6 with C7.

Now, not only do I feel like a Weeble (who can't stop falling over) but we have attached it to a Bobblehead. Until surgery, I am to do my very best NOT to fall (again) or get in any type of accident.

So, how much of the symptoms are B12 or the disc will be a matter of time. Time for upload of B12, surgery and healing process. Either way, I am mildly optimistic that I'll see some improvement over the coming weeks as I go through the procedures.

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Saddened to read this Enjay222 and hope you get your B12 injections before your surgery.

I'm not a medically trained person but do know that if you have nitrous oxide as an anaesthetic it will play havoc with your B12 levels so it may pay you to ask whether it will be used during your surgery.

I wish you well and hope things improve for you for the rest of the year.



Link about nitrous oxide


There is a chapter in Sally pacholok's book "Could it Be B12" that discusses nitrous oxide.

Hope everything goes well.


Thanks for that Sleepybunny

Just in case Enjay222 cannot open the link in the USA here is a relevant paragraph

"Vitamin B12 deficiency

In patients with subclinical deficiency of vitamin B12, neurological toxic effects have occurred after a single exposure to nitrous oxide during general anaesthesia. Assessment of vitamin B12 levels should be considered before nitrous oxide anaesthesia in patients with risk factors for deficiency of this vitamin. Individuals at risk include elderly people, those who have a poor or vegetarian diet, and those with a history of anaemia."

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and we wish you well mydear soon

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sorry to hear that it has been such a bad year and hope that the surgery goes ahead quickly and successfully.

Are weebles still out there as a toy?

hope you don't mind if I point out that the think about weeble's was that they didn't fall over - 'weeble's wobble but they don't fall down' - because they had such a low centre of gravity ... so hope you manage to be a proper weeble and then even the wobbliness goes.


I hope for a better 2018 too, but I know from what I have been told that I will "never get better" so it'll just roll out of 2017 and straight into 2018 with no change. Only my other conditions getting worse. Hey Ho, once more into the fray! :D hehe

I am really sorry about your disc problems. Having both degenerative disc disease and spondylitis - I am fully aware that back pain is so very horrible and there's no relief because no matter what position, you cannot not be either using your back or lying on your back.

I hope that your surgery fixes and relieves things for you. Have they discussed nerve compression at all?


Other points in your post which were not yet responded to, I don't think even the most qualified Neuro or Haemy could tell you how long you have been deficient.

On reading the side effects of Otezla, none of them would have caused your B12 to be deficient, I cannot see why anyone is considering that possibility (unless I'm just reading the wrong sites)

Why do you want a liver biopsy? O.o

Need to ask for folate to be tested, if that is exceptionally deficient, no amount of B12 would help - as it's the folate that is needed to make the B12 work at a cellular level.


"Why do you want a liver biopsy?"

iirc, the OP has been on a medication regimen that is known to affect the liver (methotrexate).

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Thank you, I didn't know that, I am going through a super bad patch, so I am barely here, so I didn't read their entire history.


Thank you


In regard to the Otezla - I was taking for psoriasis for 90 days (June - Sept) While taking it, the side effects were very hard on my gastric system (constant diarrhea). Since reading about B12 deficiency, absorbing through ileum - and being diagnosed with deficiency so soon after .... wondered if there was a correlation.

Again, due to psoriasis, have been on methotrexate for number of years which may cause hepatotoxicity.


I had an operation recently and told the anaesthetist I had B12 deficiency, he thanked me for telling him and made a note not to use nitrous oxide and used another anaesthetic. I was lucky that he knew about the connection.

Good luck and hope you feel better soon.


Will bring up to surgeon & anesthetist.

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