low b12,folate,d3 and weight loss,

[Cooljay]

Hi Everyone, I am new to this site and i have been suffering from low energy,weight loss,indigetion,stomach burning,

weak all the time.I have done my bloods and my potassium,iron,Reb bloods are with in range except Serum b12(152 ng/l),serum folate(2.8 ug/l and vitamid d3 18.7.

I have started supplements for D3, Holland &Barret b12 cyanocobalamin(1000 MCG) and Folic accid(400), after 50 days supplements i have heart palpitaion, stright away i have stopped b12 and folate.

Now fromlast week i have started Solgar b12 methylcobalamin 1000 mcg and holland&barret folic 400 taking, not feeling ok ..not much energy.

My worry is on my weight loss i have almost lost 7 kg in 5 months, still feeling weak and my GP is not recomending for injection as my red bloods are okey

I would like to find out which kind of anemia i have with above test.. do we have any private clinics in UK to treat b12 and folate..please give suggetions and adivised how to handle this.

[Gambit62 Administrator]

Although the title of this form contains the word anaemia PA is actually a gastric problem that affects ability to absorb B12. Assuming that your diet contains meat/fish/egg/cheese in reasonable quantities it is unlikely that a low B12 is due to diet implying an absorption problem. Unless your diet is poor in fruit and veg - particularly green veg - the same is probably true for folate.

The stomach burning sounds like it is probably acid reflux - which is a symptom of both high and low stomach acidity ... and low stomach acidity is also a potential consequence of PA.

Macrocytosis isn't present in 25% of patients presenting with B12 deficiency - and can actually be masked by microcytic anaemia being present if absorption problems are also affecting iron.

There are no private clinics specialising in folate and B12 absorption problems that I am aware of - the consequences of deficiencies in both cause symptoms that cross over into a large number of the normal medical specialisms.

I suggest that you write to your GP drawing their attention to the BCSH guidelines on diagnosis and treatment of cobalamin and folate disorders which can be found here

onlinelibrary.wiley.com/doi...

your GP can also find them through the BNF

particularly draw your GPs attention to the fact that the absence of macrocytic anaemia doesn't rule out a B12 absorption problem.

If you have any neurological symptoms you should also mention these as the guidelines are quite clear that neurological symptoms need treatment promptly.

Ask to be treated in line with the guidelines - loading shots and maintenance doses.

Ask for a referral to a gastric specialist in relation to the gastric problems - specifically investigating the possibility of atrophic gastritis, ceoliacs or crohn's.

Copy to the practice administrator.

If this doesn't get a result then suggest you join the PAS who sponsor this forum and contact them for support

pernicious-anaemia-society....

pernicious-anaemia-society....

You can get private blood tests done - medichecks and blue horizon are two companies that are frequently used - but GPs can be rather sceptical of the results.

There are ways of getting hold of injectable B12 (eg using a site that provides it for non-medical reasons) or obtaining it from on-line european pharmacies in countries where injectable medications aren't prescription only, eg Germany).

[Cooljay in reply to Gambit62]

Hi Gambit62,

Thank you very much for the information and adivse given. I will contact my GP and see if he can order further test.

[ButterflyActive]

It took me three years to get a diagnosis of PA (Pernious Amemia) after I asked my GI doc to do a Methylmalonic acid as my serum b12 test came back 'with in range'. My MMA test came back elavated as my cells were not absorbing b12 from my foods. Then my doc tested intrinsic factor test and my parietal antibody test for the Autoimmune disease PA both came back positive. When your getting any of these tests done you must be off all b12 supplements for at least 4 months. If you can't absorb b12 supplements will be pointless as your intrinsic factor that takes up the b12 from the food you eat is no longer working and would need to get injections for life. Once I got the diagnosis treatment took a while to get going, eventually with the God's on my side I was given the go ahead to self inject at home. I self inject two weekly. I would not go not this route yet until you get properly tested and get your first b12 injection at your GP incase you might have a reaction, rare but just to be on the safe side. I would look at your folate too as you would need to take folate in order for the b12 to work, they both need each other. I would look at your iron too. Have you had your thyroid levels tested? As b12 issues can sometimes over lap with thyroid issues. I would test TSH,Free T4, FreeT3 Rt3 TPO antibodies. There is a huge connection with b12/PA issues. There is a great book that helped me along the way and also a very good fb group. Could it be b12 by Sally Pacholok. Check out her YouTube for her YouTube film etc. Hope you get sorted.

[Cooljay in reply to ButterflyActive]

Thank you so much ButterflyActive, Appreciate your inputs. yes i have done a full blood test 3 months back all are normal (iron,red blood count,thyriod....ect) only folate,b12 and D3 were very low. I will try to check with my GP on Methylmalonic acid test , if he is not convinced I will test privately below tests.Hope that is okey.

serum b12

serum folate

Methylmalonic acid

intrinsic factor

parietal antibody test for the Autoimmune disease.

My worry is b12 supplements, initially it was working with cyanocobalamin but after 2 months i got heart palpitation,diarrhea and stomach indigetion, now using B12 Methylcobalamin it seems working but dont know what reaction will get in the future and i do not know howlong should i take these b12 sublinguals.