Difference between PA and B12 deficiency

[Meblue]

I’m confused on something with this. Most of you here have PA which, correct me if I’m wrong, means that you lack intrinsic factor to absorb B12 even though you are getting B12 in your diet. What is the difference between that and someone like a vegan who develops B12 deficiency and can absorb it. Do both outcomes lead to PA or is PA the condition that you lack the intrinsic factor. Are both outcomes the same for these two different types of people?

[Gambit62 Administrator]

PA is one (and the most common) of several absorption problems that can affect the ability to absorb dietary B12. This results in a B12 deficiency.

Not having enough B12 in your diet will also result in a B12 deficiency.

The symptoms of PA (and other absorption problems) are the symptoms of the B12 deficiency that it causes.

As such symptoms of dietary deficiency and symptoms of absorption problems will be the same and, unless the B12 deficiency is corrected, the results will be the same.

However, because the cause of the deficiency is different the treatment is different - a dietary deficiency can be treated by oral supplementation. Because an absorption problem such as PA can't be treated through oral supplementation it needs to be treated in a way that by-passes reliance on the gut.

[Meblue in reply to Gambit62]

Thanks, I understand now. So the PA comes first and that leads to symptoms of a B12 deficiency. But a vegan who doesn’t have PA will experience the same problems as someone with PA but they can just take oral supplements.

[Gambit62 Administrator in reply to Meblue]

Yes, which is why the BCSH recommendations are treatment with 50mcg of cyanocobalamin as tablets in the case of dietary deficiency.

[fbirder in reply to Meblue]

As Gambit62 says, PA causes a B12 deficiency and, therefore, has the symptoms of a B12 deficiency.

But PA can have side effects that you don't get with a dietary deficiency of B12. PA's underlying cause is an autoimmune attack on Gastric Parietal Cells. As well as making IF, these cells also make hydrochloric acid. With PA there's not enough acid produced (achlorhydria) which can cause gastrointestinal symptoms that you won't get with a dietary deficiency.

[CAgirl in reply to fbirder]

Thank You for always be patient and explaining everything so clearly! I have been concerned about gastric parietal cells and the making of IF and hydrochloric acid. If this is happening, is there any good ways to supplement for this? If we are injecting B12, do we still need some B12 in our stomach? I am concerned about making my stomach work the best it can with these underlying issues. Any input would be greatly appreciated!

[fbirder in reply to CAgirl]

If you're injecting there's no need (and no point) in taking oral B12, although some people say that it helps between injections. It did nothing for me.

Some people find that drinking something acidic during a large meal helps with gut problems caused by no acid. I use lime juice (about 30 mL in a glass of water) others swear by apple cider vinegar.

[Sleepybunny in reply to Meblue]

Hi,

In UK, BCSH guidelines suggests anyone with B12 deficiency with neurological symptoms should have every other day loading injections and I think this applies whatever the cause of b12 deficiency even diet.

[Ssmart in reply to Sleepybunny]

This is what they did with me I had the IF blood test and it was negative. They are giving me b12 for life though, I had loading doses and then injections at doctors every 12 weeks. Been having them for around 5 years now. I’m vegetarian since age of 11 and am now 39.

[Nackapan in reply to Sleepybunny]

Yes I'm still on every 2 week b12 hydroxocobalamin injections and tested negative for the intriscic antibody. I aL so didn't have megoblastic aneamia. Have been told injections for life but eventually on 2 monthly.

[Alfabeta]

Hi Meblue

I became b12 deficient because as a vegetarian close to vegan I had insufficient b12 in my diet but this was made much worse by my doctor putting me on omaprezole on repeat prescription and I took the drug for around six years.

I’ve read what Gambit and fbirder have said and they know what they are talking about as far as PA but I have damage to my myelin sheath and this causes a whole range of symptoms which, as far as reading PA sufferers on this site, PA sufferers do not seem to have for the most part.

If you go on the b12 site, you will see a list of symptoms which verge on the infinite.

However, regardless of the differences, the treatment is the same - you need b12 supplementation once the damage is done either orally if you can absorb b12 or through injections if you can’t.

I get injections because my doctors think I cannot absorb b12 - frankly, I don’t know if I can or I can’t- so I continue with them and supplement orally.

Good luck.

[fbirder in reply to Alfabeta]

Anybody with a severe, prolonged, B12 deficiency will have demyelination and will have the symptoms of demyelination. No matter what the cause of the deficiency. Even people with PA.

[Alfabeta in reply to fbirder]

I’m sure you’re right but no medical professional that I have spoken to and no administrator on this site has recognised my symptoms as symptoms of PA but all of my symptoms are listed as b12 deficiency on the b12 site.

[fbirder in reply to Alfabeta]

What is 'the' B12 site? Some sites seem to list every single medical problem that ever existed as caused by B12 deficiency.

If you look on the PAS website, they list the symptoms of a B12 deficiency - pernicious-anaemia-society.... - and I've seen all of these mentioned here.

Or you could try WebMD's list of symptoms of a B12 deficiency - webmd.com/diet/vitamin-b12-...

Or the NHS - nhs.uk/conditions/vitamin-b...

Or Harvard -health.harvard.edu/blog/vit...

Or the NIH - ods.od.nih.gov/pdf/factshee...

Indeed, it's difficult to find a reputable website that doesn't have a list of symptoms similar to all of these.

[Alfabeta in reply to fbirder]

b12.org

It provides free B12d shots

[fbirder in reply to Alfabeta]

B12d.org also thinks that the heart is a nerve. b12d.org/b12d/submit/viewfa... and other stupid notions.

[Alfabeta in reply to fbirder]

kenhub.com/en/library/anato...

B12.org has helped hundreds of b12 sufferers and it is a shame on you to dismiss it out of hand based on a misreading of its website.

[fbirder in reply to Alfabeta]

That link says that the heart is supplied with nerves. Not that "the heart is a big bundle of a special sort of muscle which is also nerve"

I did email them to tell them that they were talking nonsense (that example and another four or five). But they didn't bother acting on it.

[Meblue in reply to Alfabeta]

What are your symptoms with the deficiency?

[Alfabeta in reply to Meblue]

Hi Meblue

Tinnitus

Fatigue

Auditory hallucinations

Confusion

Sudden bouts of semi consciousness

Itchiness about my face shoulders and arms

Blurred vision

After my injection, I would be all right for around six weeks then I would get a week of symptoms then nothing until the next injection.

I would get 6/8 attacks about 10 seconds duration then the number would reduce over the next 6/7 days.

Sometimes, days before, on the day and some days after I would get the odd attack.