PA diagnosis or b12 d

[Damseltree]

If IF antibodies are not present, regardless of symptoms, how can anyone ever be diagnosed with P A specifically, rather than just b12 deficiency?

[wedgewood]

You could supplement with B12 tablets . If you have Pernicious Anaemia, your symptoms would not be helped . If you have a course of B12 injections , your symptoms will be helped . Always making sure that you either eat a diet with plenty of folate , or supplement with a modest 400mcg B12 tablet .

[fbirder]

PA is caused by an autoimmune attack on some stomach cells. This causes something called Autoimmune Metaplastic Gastric Atrophy. Autoimmune can be tested for by looking for gastric parietal call antibodies (it's not a definitive test because 10 - 20% of people without PA have the antibodies). Gastric atrophy can be observed during a gastroscopy (where they put a camera into the stomach). AMGA causes atrophy in specific parts of the stomach. Metaplasia (wrong type of cells) can be observed by microscopic examination of tissue samples taken during a gastroscopy.

AMGA causes the B12 deficiency. It also causes high levels of the hormone gastrin.

I was diagnosed with PA because I had very low B12, I was positive for GPC antibodies, I had gastric atrophy in the right bits of the stomach, I had metaplasia in the stomach and I had very high levels of gastrin.

My idiot haematologist said I didn't have PA because I hadn't had a test for IF antibodies. I reeled off my list of findings and asked him for an alternative explanation. He grudgingly admitted that I probably did have PA.

Otherwise - If you have a B12 deficiency, with symptoms that improve with B12 injections, and you don't have any of the other possible causes (you're not vegetarian or vegan, you don't abuse nitrous oxide, you don't take PPIs or metformin, you haven't had stomach or intestinal surgery, you don't have a fish tapeworm) then you have PA by default. Try asking the doctor what causes your low B12 if they don't agree.