Hi a little confused
I have been on b12 injections for years and on loading doses a few times. Due to low b12
I was told i had pernicious anaemia years ago as i had pareital cell antibodies along with the low b12. However a recent gastroscopy showed no anaemia and all was normal.
Is that possible? ?? Or maybe my b12 injections have kept everything under control.
Hi Sandra_Holmes_R 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.
"
Were you tested for Intrinsic Factor Antibodies (IFA)?
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
Can you see yourself among any of the above people?
I am not a medically trained person and wish you well
So there are 2 relevant antibody tests? - Parietal cell antibodies and Intrinsic Factor antibodies?
Here is an extract from Martyn Hooper's book "What you need to know about Pernicious Anaemia & Vitamin B12 Deficiency"
"In a normal healthy person the stomach lining has what are called "Gastric parietal cells" which produce "Intrinsic Factor" which travels with food through the small intestine which is made up of three parts - the Duodenum, the Jejunum and the Ileum.
Iron is absorbed in the Duodenum, most other nutrients in the Jejunum and our friend B12 in the Ileum.
Here the Intrinsic Factor binds to the B12 and the "B12/IF Complex" enters the cells on the wall of the Ileum after binding to receptors on the surface of the Ileal cells, allowing it to enter the blood stream.
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".
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 P.A. However, a positive result is a sure-fire, 95% certain indicator of P.A.
Please remember I am not medically trained.
Pernicious anaemia is a misleading name. The actual condition isn't anaemia it is an autoimmune gastritis that results in a B12 deficiency which means your cells don't have enough B12 to run a lot of processes, including the one that produces new red blood cells when your old ones 'die'. This results in larger rounder red blood cells - macrocytic anaemia.
20% of people with B12 deficiency don't present with anaemia but present with symptoms caused because other processes going on in your cell don't have enough B12 - eg neurological problems.
Gastroscopy won't show anaemia - it will show damage to the gastric tract, and it may be that the gastroscopy didn't pick up the sort of damage usually seen in PA. However, there are other absorption problems that can result in low B12.
My MCV came back at the top of the "acceptable" range - 98 - limit 99. Is it a range that you are better to be in the middle off or is high good? I am wondering if my blood cells were close to macrocytic? Thanks.
full blood count is a diagnostic test rather than a management test - ie looking for oddities or checking that oddities have been corrected by treatment - it's impossible to say where a given individual should be - the normal range is just where the range that covers where the vast majority of people are.
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