Family doctor - tested b12 with a result of <50 (undetectable?) and referred to neurologist due to neuropathy symptoms
Neurologist - 2 more b12 related testing. All 3 of which normalized after 6 weekly shots. But found i had antibodies to parietal cells and intrinsic factor. Stopped injections and sent me to GI doc. B12 was 780.
Gi - oh hey your bloodwork means pernicious anemia. Shows surprise at neurologist stopping injections. He wants to do an endoscopy, requested I have my iron tested, and told me to restart injections at monthly intervals. However he didn’t want to order the bloodwork or do the maintenance shots, so he sent me back to the family doc.
Family doc- surprised i am back to him but complies with gi instructions. Bloodwork is back. With a 7 week break from injections my b12 is only down to 480. Looking good. The cbc shows most of the numbers that had been off previously have normalized. My iron and transferrin are normal but ferritin serum was only 7.0 [23.9-336.2 (ng/mL)].
Any thoughts on the ferritin or the endoscopy? He says the endoscopy is neither urgent nor imperative but that he always recommends ut to his PA patients.
Written by
BethCam
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the endoscopy will, I believe, be about monitoring the damage caused by PA as it increases the risk of a particular form of cancer so will be monitoring for pre-cancerous growth ... though even when that starts it doesn't mean progressing to cancer - ie it is a precaution given greater statistical risk.
neuro was indeed an idiot to stop the B12 injections.
if your iron and transferrin are okay I'd not worry about the ferritin - its quite a good indicator of iron status but it isn't definitive and there have been some reported instances of iron poisoning because treatment was started on the basis of ferritin alone.
serum B12 levels at this point are meaningless and can't be used to manage a B12 absorption problem that is being treated with injections - you need to go by symptoms
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