Diagnosis of B12d or PA ?

[Damseltree]

How is a diagnosis achieved does it have to include Intrinsic factor antibodies test to be positive?

[EllieMayNot]

For myself it was an easy diagnosis (once doctors actually checked, which they didn't for years). For the most part, a "normal" serum B12 does not rule out PA or B12d. What I mean is you can still test in the "normal" level and be deficient on a cellular level. For PA it helps to properly diagnose if you test positive for antibodies to IF or Parietal Cells but, from what I understand, many have PA without testing positive for these antibodies. For any cause of B12d (PA included), elevated MMA (Methylmalonic Acid) seems to be the most accurate indicator of not having enough B12 on a functional level. At least that is what the experts seem to favor.

I have found these resources helpful:

stichtingb12tekort.nl/weten...

kevinmd.com/blog/2014/08/mk...

[EllieMayNot in reply to EllieMayNot]

Another helpful link:

stichtingb12tekort.nl/weten...

[fbirder]

I was diagnosed with PA never having has an IF antibody test. My idiot haematologist told me that I couldn't have PA because I hadn't had the IFAB test?! I asked him what else could explain a B12 level of 65 pmol/L (that's serum B12, not Active B12), metaplastic gastric atrophy, high gastrin, positive antibodies against Gastric Parietal Cells, and a positive response to B12 injections. IH agreed it probably is PA.

If I were in charge then i would diagnose PA if somebody had the symptoms of a B12 deficiency and responded positively to a course of B12 treatment and had no other plausible reason for the deficiency. Low B12 levels, gastric atrophy, IF and GPC antibody tests, MMA and hCys tests could all be used as supporting evidence.