What causes my b12 deficiency?

[Milliemaria42]

Hi everyone,

long story short, since my last post I had an appointment with my Doctor scheduled anyway as it was for a review of the prescriptions I have in order for him to renew them. He was actually keen to discuss it all with me and so I got to ask his opinion on what is causing my deficiency. I told him about my family history of PA and he said they actually did do the test for intrinsic factor the first time when they discovered my B12 was low. The test came back negative so they ruled out pernicious anaemia. My previous Doctor said it must be caused by my diet, so I asked him if he thought the same (I obviously would change my diet if so. I am a vegetarian). He asked me about what I ate and I told him and he said he really didn't think it would be my diet causing it. I have actively been eating my dairy products and egg anyway just in case. He then said something along the line of thinking that I probably just have a higher susceptibility for having low B12. At the time I just wanted to get out of there as I've always disliked going to the Doctors so didn't really question it further. I've been thinking a lot more about it since though and I just don't really get it. Has anyone else been told something like this? From what he said it sounds a bit like PA but its not PA? He also asked if I was taking my vitamin D tablets as prescribed and I said yes (I may have forgotten now and again but have been taking them fairly regularly and take them basically religiously now). Guessing that might somehow make my B12 deficiency worse? Or maybe he just added it on at the end because that was another prescription I have so would have to be reviewed as well. (They renewed them both).

In summary, is it possible to just be more susceptible to B12 deficiency but not have PA?

Thanks in advance and hope you're all doing good.

Millie

Edit: Forgot to say that I have been tested for celiac disease because of problems with my stomach I had previously (still isn't great). I also thought if it wasn't PA that they would just give me supplements instead of injections because my stomach would be able to absorb it? (I'm going to buy some soon anyway and hope it helps me get through the last few weeks inbetween injections)

[expatkerry]

Hi There, You mention stomach problem I don't know if you've has it investigated but if You have bacterial overgrowth (SIBO) it's possible That the bacteria can deplete your B12. So it isn't necessarily PA. I don't know if a négative IF test is 100per cent sure, perhaps someone here can reply.

[fbirder]

The Intrinsic Factor test is worse than useless. It is negative in half of all those with PA. onlinelibrary.wiley.com/doi...

IFAB is positive in 40–60% of cases (Ungar et al, 1967), i.e., low sensitivity, and the finding of a negative IFAB assay does not therefore rule out pernicious anaemia (hereafter referred to as AbNegPA).

This wouldn’t be a problem if doctors knew how unreliable it is. But they don’t. They insist on ruling out PA based on that one, unreliable, test. Blimey, my idiot haematologist said I didn’t have PA based on the fact that I’d never had the test!

Print out the attached links (recommendations from the British Committee on Standards in Haematology - the biggest brains in British blood) and post them to your doctor with a covering letter xplain8ng how you expect to be treated correctly. Send a copy to the practice manager.

[clivealive Forum Support]

Hi Milliemaria42

Anyone at any age, can become B12 deficient. However, certain people are at an elevated risk. They include the following:

Vegetarians, vegans and people eating macrobiotic diets.

People aged sixty and over

People who’ve undergone any gastric and/or intestinal surgery, including bariatric surgery for weight loss purposes (Gastric bypass).

People who regularly use proton-pump- inhibitors. H2 blockers, antacids, Metformin, and related diabetes drugs, or other medications, or infections such as h-pylori that can interfere with B12 absorption.

People who undergo surgeries or dental procedures involving nitrous oxide, or who use the drug recreationally.

People with a history of eating disorders (anorexia or bulimia).

People with a history of alcoholism.

People with a family history of pernicious anaemia.

People diagnosed with anaemia (including iron deficiency anaemia, sickle cell anaemia and thalassaemia).

People with Crohn’s disease, irritable bowel syndrome, gluten enteropathy (celiac disease), Pancreatic insufficiency, or any other disease that cause malabsorption of nutrients.

People with autoimmune disorders (especially thyroid disorders such as Hashimoto’s thyroiditis and Grave’s disease) Type 1 diabetes, vitiligo, lupus, Addison’s disease, ulcerative colitis, infertility, acquired agammaglobulinemia, or a family history of these disorders.

Women with a history of infertility or multiple miscarriages.

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.

Can you see yourself among any (other) of the above people and do you suspect that you may have an absorption problem?

Were your Folate and Iron levels tested?

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

I wish you well.

[Nackapan]

I'm not a vegetarian but as I put on a previous post have no idea why I stopped absorbing b12. First ever test 106 serum after horrible neurological symptoms. I haven't any other health problems. I also was initially put on a loading dose and told injections for life. It's seems to be Diy with the help of this forum about getting treatment. I ask for blood tests I ask for injection regime I ask to be monitored. The last neurologist wanted to know why not absorbing but in a way of stopping injections then testing again. I unwilling of course to get ill .I don't know if there's a more accurate blood test. It's natural to want to know. I imagine as a vegetarian a supplement would be a good idea as although diet is good its very hard to get enough b12 at times. If you having injections that is good. Without a reason I'm continuing with injections as it's the only thing that is definite and has proved to help me. Other diagnoses are guess work. Some doctors simply can't believe all my symptoms down to b12 defiency. Well they haven't found anything else. Just keep trying to go down the anxiety route. How often are your injections?