Pernicious Anaemia Society
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Intrinsic Factor test result

Hello there. I have just had the result of my IFA test and was hoping someone could help with interpretation. It was 1.69 (>6). According to the text that came with it, this clearly shows that I do not have PA. I have though read on this site that a negative result does not necessarily rule out PA. Since I assume this depends on how low or high the actual figure is can anyone tell me if this result definitely rules out PA or not? If not, what is the next step? I have all the usual symptoms of B12 deficiciency but am now thinking in terms of low stomach acid as a cause. Many thanks!

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It's just not a very reliable test. My understanding is that a positive IFA definitely means you have PA, but a negative test means not very much at all!

In terms of treatment, it makes no difference at all; treatment for PA or B12 deficiency is just the same.

It's frustrating though, isn't it? I almost think I'd like the 'official label' - telling people 'I don't absorb B12' is about as well received as 'my chakras are misaligned'! :)

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Yes indeed.... I was almost hoping it would be PA as at least that is clear! Now I am not sure what to do or even if it is worth establishing for certain that it is not PA. I have been taking sublinguals for weeks and they certainly help, though I have occasional bouts of brain fog. So I really just wanted to know if I should have B12 injections or just persevere with the tablets/drops. A definite diagnosis of PA would have been a definite spur to try injections...

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After reading your previous posts my question is, How did the doctors determine your h pylori was inactive?

My understanding is that a breath or stool sample can test for an active infection while a blood test can show antibodies for h pyori for up to 2 years (usually only 1 year) after it has been killed off by antibiotics.

If you didnt know you had it before you havent been treated with the dual (2 antibiotics at the same time) treatment.

If they say h pylori is inactive just from looking in your stomach, they could have missed it.

Btw, as you know the IFA test is unreliable.

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Hello KimberinUS. Thanks for that. The Russian gastroenterologist used a so called 'gastric test' to check my stomach. This involved taking a blood sample, then drinking some kind of liquid (not sure what it was), then waiting for 40 minutes, then another blood test. This revealed the h pylori, though it was "in remission" according to the written analysis that i saw. He explained that this meant simply that the h pyloris was no longer active. Quite how this bacterium can still remain in my stomach without being active, I don't know. I also have no idea what killed it off, as I have never taken antibiotics for this. I have read that these h pylori can disappear in time, especially in people over 50. Possibly also the kefir I drink killed it off...

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Uhm. It looks like h pylori prevalence is super high in Russia with 88% of adults having it!!! It can be transmitted from person to person through kissing or even eating food prepared by a person that has it, that has not washed their hands.

ncbi.nlm.nih.gov/m/pubmed/9...

I have never read about testing the way you describe it!!! Blood test then drink something then 40 mins later another blood test.

This is a link to how breath testing works.

my.clevelandclinic.org/heal...

that is exactly how i was tested except i only waited 15 minutes between blowing into a bag, drank something, waited 15 min, then blowing into a bag again.

Breath, not blood. 15 min, not 40.

I would ask to be breath tested!!!

Get treatment, feel better in appox 3 months. Dont get treatment and possibly get worse.

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interesting... I had no idea it was so common in Russia. I can only assume that the laboratory people and the gastro doctor who confirmed my result knew what they were talking about. But who knows? I will think about having a breath test - not even sure if it is possible here! Meanwhile I am on daily kefir and apple cider vinegar and feel better for it...

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"1.69 (>6)"

Hi Frank77 Just a query - are those figures correct, or was it just hitting the wrong key.

I don't think 1.69 can be greater than 6. I don't suppose it makes any difference.

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so sorry...i hit the wrong key. It should of course have been a < not a > !

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surprised that the notes with the test completely ruled out PA as the cause given that the test has a low sensitivity so gives false negatives 40-60% of the time. It most definitely does not categorically rule out PA as the cause.

Gastrin levels are probably a more useful measure for PA but not sure this is currently recognised as a test - generally in someone with PA gastrin levels are astronomic. Not sure how expensive the test is though - which may be one reason why it hasn't come into vogue as a test for PA ... along with the medical community being slow and cautious when it comes to change

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yes, I think that this is a standard Russian way of interpreting a negative IFA test. But I can see now that there is a roughly 50% chance that it is wrong. I wonder in that case why people have these tests done at all... Have never heard of this Gastrin test - will try to check it out. Would you now recommend that I do other tests - thyroid etc - to try to find the cause of my B12 deficiency?

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personally I didn't bother with trying to find out the exact cause as it doesn't affect the treatment - however, exact cause does give you a heads up on other potential consequences, and if it is h pylori that is treatable - so worth checking it isn't h pylori.

Always worth double checking other things - hashimotos (autoimmune thyroidosis) and PA are a common cross over - 40% of PA patients go on to develop hashimotos - but B12 deficiency is a secondary link to hypothyroidism and exact mechanism isn't understood. Generally hypothyroidism affects iron levels first.

Whether you carry on trying to get to the bottom of the cause is up to you - there are pluses to knowing but my personal opinion was that you could drive yourself mad trying to get to the bottom of it in the face of limitations of the current test.

I don't think gastrin is formally recognised as a test for PA - there was a talk on it a few years ago at the PAS conference (2016) but that is probably as far as it has got. Think the talk is still available on-line if you are a PAS member

pernicious-anaemia-society....

pernicious-anaemia-society....

this is the link to the presentation itself

pernicious-anaemia-society....

I'm pretty sure I have PA as I have very low levels of stomach acidity (do a lot of heave ho when I have migraines and it doesn't burn the throat the way it used to when I was younger)

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hello Gambit62. Thanks for your help. I think I wanted to know the cause of my B12 problem simply because, if it is PA i can resign myself to lifelong regime of supplements since it is not curable; but if it is low stomach acid I assume that one can resolve this and eventually get back to a life without B12 supplements? On h pylori: the doctors have already told me that the bacterium is "in remission" and therefore no problem . Not sure what arguments I could now use with them to carry out further tests into this. What they did want to do is a full stomach scan to see if the h pylori has caused any ulcers. Since I have no ulcer symptoms or indeed any obvious problems with my stomach (apart I think from low acid!) I am not sure I am ready for this rather expensive test... However, I may well have the hashimotos and thyroid tests. Many thanks!

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quite possible that low stomach acidity could be result of PA anyway. The stomach scan could show up something else that could be connected to PA.

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Get your b12 ACTIVE level checked first at https: //nutris.viapath.co.uk an NHS LABORATORY 0costs £40?. ?best £40 quid you will ever spend

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Thanks for that. Since I am now on quite high oral B12 supplements I am not sure if there is any point in having this B12 active test. I suppose I would need to stop taking these supplements for a few weeks before the test? Not quite ready for that I am afraid...

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If you have a B12 absorption problem then only 10 to 30% of that B12 labelled on the container or ever get into your cells so just stop taking it for 3 or 4 days take it easy order the test and then get it done that is what I am doing I'm having my bloods taken on Monday and I will put a post on here to tell you how it went when I get the results back I was injecting for 5 months and I still feel as though I am massively B12 deficient the test will pick that up

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At its height before I started injecting I was taking upwards of 6 oral capsules of B12 a day with a strength of 5000 iu

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well I have found a place here in Moscow where I can have this 'active B12 test' carried out. As I understand their web site I do not have to stop taking B12 supplements at all before the test. Do you concur? By the way, I have read on this site that oral supplements of B1 have about a 1% absorption rate, nasal sprays about 3%. Do you know what the percentage for injections is? Jut wondering why you are so deficient if you are on injections?

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By the way, the cost of this B12 active test in Moscow is about 13 pounds! Will have it done tomorrow with results on Monday...

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What about parietal cell antibodies? I was positive for those and negative for IF. I've heard this may considered as PA.

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Hello Julz5. Don't know anything about this one.... will try to find out if such a test is possible here in Moscow. Thanks for the idea!

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