Where do I find literature which says if no other cause of B12 Deficiency is found then assume that you have pernicious anaemia?

[Padders12]

I am due to see the occ health at work this morning and have printed off loads of info from the pa website. All the info talks about pa not B12 Deficiency. I have not been diagnosed with pa but remember reading that in the absence of any other causes of B12 Deficiency the pa should be assumed. I can’t find that literature anywhere and really wanted to print it to take with me. Can anyone remember where to find it?

[Padders12]

Thanks 😄

[spacey1]

sorry to hijack, but I'm following as I'd like to know that too!

[fbirder]

The following NHS document has a couple of flow charts. hey.nhs.uk/wp/wp-content/up...

To summarise the relevant bits:

If you have symptoms sufficient to give a strong suspicion of B12 deficiency...

1. Test blood levels of B12.

a. If below lower limit then start treatment for PA and test for IF

i) If IF positive then treat as PA for life. No further testing.

ii) If IF negative and a positive response to treatment then treat as PA for life, no further testing.

b. If levels are intermediate then start treatment for PA and test for IF.

i) if IF positive OR a positive response to treatment then treat as PA for life. No further testing.

ii) if IF negative and no clinical response try oral supplements.

As you can see, if the IF antibody test comes back negative then they base their decision to treat as PA on whether or not the treatment fixes the symptoms.

That, along with pushing the idea that further testing is useless, are two of the ideas that we’ve been pushing for a long time. Now we just need other NHS trusts to do something similar. I really would recommend anybody having problems with their treatment to print out this document and send it, via snail mail, to their doctor. Then you can ask why HEY can do what they say is impossible.

[Padders12 in reply to fbirder]

That’s great, thanks 👍

[Foggyme Administrator]

Hi Padders12

Here's the diagnostic flowchart from the British Committee for Standards in Haematology (BCSH) Guidlines for the Disgnosis and Treatment of Cobalamin and Folate Disorders (what all GP's should know and use - though most don't):

stichtingb12tekort.nl/weten... (BCSH B12 Deficiency / PA Diagnostic Flowchart)

One page - print and show your GP - use with fbirder's 'talk-through' 😉.

And here's the full document, in case you want a read:

onlinelibrary.wiley.com/doi... in Haematology (BCSH) Guidelines for the Disgnosis and Treatment of Cobalamin and Folate Disorders)

👍

[Padders12 in reply to Foggyme]

Fab, thanks 👍