Completed loading injections, now what?

[Magpie1234]

Hiya, I had my last loading injection 7days ago, had a total of 6.

Just had a blood test to check b12 levels,is that right as I thought after 6 loading injections my results wouldn't be accurate.

The nurse assumed I'd finished my loading injections 10 weeks ago

Have I had my blood test too early?

Please advise

Thank-you

[clivealive Forum Support]

Hi Magpie1234 far too early for testing serum B12 levels which will probably be high off the scale after only a week.

Fortunately you cannot overdose on B12 as any excess is excreted via your urine so if your nurse panics when she sees the results you can reassure her.

Was your Folate tested too?

I am not a medically trained person but I've had Pernicious Anaemia (a form of B12 deficiency) for more than 46 years.

I wish you well.

[Magpie1234 in reply to clivealive]

Hiya clivealive.

My b12 levels were 124,the doctor said that was low and gave me a course of 6 injections, one every other day.

What will happen when my blood tests come back as I too am expecting off the scale?

I'm not sure if my folate level has been checked but I will chase that up.

How is pa diagnosed as the doctor has already mentioned that I more than likely have this?

[clivealive Forum Support in reply to Magpie1234]

A B12 deficiency is "found" via the blood test you had with the result of 124.

The test for Pernicious Anaemia is called an "Intrinsic Factor Antibodies" (IFA) test.

Simply put Intrinsic Facor is "produced" in the stomach and is essential to process the B12 in our food - meat, fish, seafood, eggs, poultry and dairy produce. The Intrinsic Factor and B12 travel down through our digestive system together to the Ileum where the B12 can then pass through into the bloodstream.

If we do not produce Intrinsic Factor, e.g. because of low stomach acid levels, Gastric Parietal Cell Antibodies, no Intrinsic Factor or Intrinsic Factor Antibodies, the B12 in the food will just not be processed and we become deficient.

Sadly some people with "traditional P,A." either do not produce Intrinsic Factor or if they do, they also produce an antibody which destroys it and it is then called "Autoimmune Pernicious Anaemia". In addition it can happen that we produce "Parietal cell Antibodies" and "Intrinsic Factor Antibodies" which totally wipes out any chance of absorbing the B12.

Unfortunately the IFA test is unreliable in that it gives false negatives in people with PA half the time. So a negative result doesn't mean that you don't have PA. However, a positive result is a sure-fire, 95% certain indicator of PA.

A wiser person than I has commented previously:

"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.

"

If we cannot absorb B12 naturally via our digestion we have to have it replaced by other means - hence the injections or sublinguals

Hope this helps

[fbirder]

Testing B12 after injections is pointless.

This NHS describes various treatment regimens. They all say ‘no further testing’.

hey.nhs.uk/wp/wp-content/up...

[pvanderaa]

Start a logbook of symptoms to record when they return and offer the list to your GP every visit.

You may need frequent injections