B12 and Anaemia

[Maggie29]

I've been diagnosed with low B12 and anaemia. Dr, checking whether I've got pernicious anaemia. I had a whipples operation just over 2 years ago now so my duodenum has been removed along with other parts. I've read that post whipples patients do get problems with low B12 and anaemia as a result of this. Dr, sending me to Bowel Dept to check for Cancer? No treatment been given yet, I'm tired, pale skin, sometimes have palpitations. Anyone out there with similar problems please?

[clivealive Forum Support]

Hi Maggie29 sorry go read about your tummy problems.

Symptoms of B12 deficiency tend to develop slowly and may not be recognised immediately. As the condition worsens, common symptoms include:

Weakness and fatigue

Light-headedness and dizziness

Palpitations and rapid heartbeat

Shortness of breath

A sore tongue that has a red, beefy appearance

Nausea or poor appetite

Weight loss

Diarrhoea

Yellowish tinge to the skin and eyes

If low levels of B12 remain for a long time, the condition also can lead to irreversible damage to nerve cells, which can cause the following symptoms:

Numbness and tingling in the hands and feet

Difficulty walking

Muscle weakness

Irritability

Memory loss

Dementia

Depression

Psychosis

Treatment for PA and non-dietary vitamin B12 deficiency is virtually the same.

The symptoms of PA are the symptoms of the B12 deficiency that it causes. If the cause isn't dietary then it is an absorption problem so you need to find another way of replenishing B12 initially. Most absorption problems aren't treatable but a few are - notably h pylori infection - which would mean that once that has been dealt with you would be able to absorb B12 from your diet so wouldn't need maintenance shots for life.

Come back and let us know the results of you P.A. test.

I had two thirds of my stomach removed in 1959 which in turn led to a diagnosis of P.A. in 1972.

I am not a medically trained person but I'm still "clivealive" and over 75

I wish you well

[Maggie29 in reply to clivealive]

Thanks

[Galixie]

Having your duodenum removed definitely impacts your ability to absorb B12 through your diet.

This gives a description of how important the duodenum is for absorption: ebmconsult.com/articles/vit...

The thing to keep in mind is that oral supplements still require a functioning duodenum for normal absorption. This means that you should be treated with injections. Do not let your doctor put you off from getting B12 injections. The longer you go without this vitamin, the sicker you'll become.

Whether or not you also happen to have the autoimmune condition of Pernicious Anemia is irrelevant at this point. I am a little surprised that your doctor hasn't realized that. Remind your doctor that your stomach surgery causes this complication and press to be treated appropriately.

[fbirder in reply to Galixie]

The lack of proteolytic enzymes that impair B12 absorption will also affect folate absorption.

Folate in foods is found as the polyglutamate. This form cannot be absorbed, so the glutamate moieties must be removed - by pancreatic proteases.

So it's essential that you supplement with folic acid as well. 400 ug a day should be enough. Lack of folate is a cause of macrocytic anaemia, so it could explain your condition.

[Maggie29]

Thanks for that