Acid reflux: I’ve been b12 deficient... - Pernicious Anaemi...

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Acid reflux

Alfabeta profile image
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I’ve been b12 deficient for around 6 years now and on the 12 week injection cycle.

I was on 10mg omaprezole daily for acid reflux for over 6 years which, coupled with being a vegetarian verging on vegan, was the most like reason for the deficiency.

I stopped taking the drug about a year before I was diagnosed and, until the last couple of weeeks, never took it again.

I have bought some from over the counter as I have been suffering from severe acid reflux possibly because I have over dosed on emmental cheese (30 % b12 per oz) to ensure I get enoughb12 in my food.

Two questions.

1 As I have acid reflux and no obvious symptoms of pa can I assume that I do not have and will not develop pa?

2. How can I get my doctor to understandvthat b12 deficiency is an illness in its own right and, as such, I need injections as and when the deficiency reveals itself which, in my case, is about 6/8 weeks after the injection.

3. Omaprezole et al are now non-prescription drugs and I do not think that the scree inside warns users of b12 deficiency hence we can expect a rise in numbers.

Merry C and a Happy New Y and thank you for all your advice and ensuring that we do not suffer alone.

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Alfabeta
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Gambit62 profile image
Gambit62Administrator

sorry but acid reflux is a symptom of PA (and a lot of other things)

acid reflux can be caused by low stomach acidity as well as high stomach acidity

PA is an autoimmune condition in which your body attacks the mechanisms in the ileum that allow B12 to be absorbed. This also destroys the cells that produce stomach acidity. Without stomach acidity your body doesn't stop producing gastrin which stimulates the production of gastric juices so you continue producing gastric juices when they aren't needed and this can cause acid reflux.

Not sure how you as an individual can persuade your GP that they should give you injections 6 weekly - current UK standards are for loading doses 8-12 weekly as the vagaries of the licencing system are that it is not licensed for more frequently than 8 weekly though this isn't dangerous. The BNF was recently updated to include 8-12 weekly for PA/B12 absorption problems without neurological involvement. If you have neurological involvement then you should be on 8 weekly shots.

GPs are under a professional obligation to use their judgement which means that don't have to follow the standards but they would need to be able to justify their action if they aren't following the standards.

B12 deficiency is a result of PA. B12 deficiency is treatable/curable by increasing B12 levels. PA is not curable but it is manageable.

Unfortunately treatment with injections significantly changes the conditions that determined the normal range used for serum B12 deficiency and significant numbers of people find that they need to maintain levels well above the 'normal range' after starting injections which means that symptoms are the only real way of managing B12 deficiency post loading shots (though the fact that they overlap with a number of other conditions) doesn't make them a 100% fool proof way of managing PA either.

Have you pointed your GP at the area of the PAS website specifically aimed at helping medics improve the way PA is daignosed and managed? They can sign up for a newsletter and it would contribute to their CPD (continuing professional development - a requirement of their professional status).

pernicious-anaemia-society....

Alfabeta profile image
Alfabeta in reply to Gambit62

Thank you ,Gambit. That explains the issue. My doctors made the immediate assumption that I had pa but I do not have the symptoms continually recorded on this site. I have told my doctor about my symptoms and he dismissed them as not symptoms of pa and left it at that. I took specialist advice and was taken down the depression, mental illness route which is not where my symptoms could rationally lead any neurologist hence I am very wary of talking to doctors.

My lingering symptoms after starting treatment was a sequence of events:

A semi consciousness with tingling in head and upper body followed by tinnitus followed by auditory hallucinations the whole event lasting around 10 seconds.

I would have 5/7 events in day one then the symptoms would reduce in number over a 5/6 day period

The tinnitus stopped after about two years and the auditory hallucinations ceased after about 4 years.

Now, I simply have the first symptom of the condition and this is beginning to become less in intensity.

I generally get the symptoms 6/8 weeks after injection hence it would appear that I need the injections around this period although, on two occasions the symptoms occurred soon after the injection and after the last three injections the symptoms reappeared in weeks 10/11.

I have no faith whatsoever in my doctors but I have spoken with the doctor on the b12 site who after a long discussion stated that I was responding to treatment.

I take b12 tablets, a multivitamin daily and just hope all will come right or at least not get worse.

Have a nice Christmas and thank you for caring enough to respond.

Sublingual B complex is an option. No need for Doctors

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