Could it not be PA/B12 deficiency?

[palmtop]

Hi, after getting weekly injections for the past year, my ferritin level is no 7 (range 10-225), so it seems I'm in need of an iron perfussion urgently. My K, CA, VitD are all good. Obviously Hematocrits and Hemoglobin are also low. B12 is 1470 (range 189-883), but seems useless. Now I think my B12 deficiency is not an accurate diagnosis. I'm trying to get a HoloTC test, but with that many injections in 1 year I'm beggining to think my problem could be a different type of anemia.

I'm worried, I've been to different doctors and the last one told be just to avoid ibuprofen (and she presented herself as a B12 specialst!). What other anemia types can present themselves similar to PA?

Thanks!

[clivealive Forum Support]

I'm not medically trained so all I can say is that I have been on permanent iron tablets for most of the 47 years that I've had P,A. so perhaps there is a connection.

I wish you well

[palmtop in reply to clivealive]

Thanks clivealive. I thought tablets would do nothing because the absorbtion issue, but clearly I'm wrong, I'm missing something and so are my doctors. I have an appointment tomorrow.

[Nackapan]

I think there is a connection. I've never had low ferritin until low b12! Hand in hand. For me an absorbtion problem i guess. You will feel better with higher ferritin levels. I've been on iron supplements since January. Settled on Ferrous fumerate 21OMG. Lower than prescribed but is tolerated. My ferritin now 44. I don't shake now and get far less breathless. 8m starting to seperate symptoms now 14 months in. Long way to go still though.

[palmtop in reply to Nackapan]

Thanks Nackapan, I now have more useful information for my tomorrow's appointment.

[Nackapan in reply to palmtop]

Let us know how you get on

[Gambit62 Administrator]

PA is an auto-immune gastritis that specifically attacks the mechanisms that allow you absorb B12 - it also afffects stomach acidity which can lead to problems absorbing other vitamins and minerals. The two most commonly affected are iron and folate.

Macrocytic anaemia is a result of B12 deficiency because of the part B12 plays in regulating the process that produces healthy read blood cells, with the result that they become larger and rounder than they should be.

Microcytic anaemia is a result of iron deficiency because there isn't enough iron to go into new red blood cells so they are smaller than normal.

Your high B12 reading is going to be a consequence of the injections which put an enormous amount of B12 into your blood by passing the mechanisms in your stomach that aren't working any more. The levels then reduce over time, as excess is removed by the kidneys - how quickly varies over time ... and there are some studies showing that in some people it took 4 years from an injection. The serum B12 test only tells you what is going on in your blood - it doesn't tell you what is going on in your cells where B12 is needed for a large number of processes to run properly - including generation of new red blood cells, releasing energy in the cell, recycling neurotransmitters, maintaining the lining around healthy red blood cells. In that respect the title pernicious anaemia is misleading as it isn't the anaemia that is causing most of the effects but the B12 deficiency that results from an absorption problem.

PA has a very dramatic effect on absorption of B12. The effect on other minerals and vitamins isn't so dramatic so you still have enough absorption for the tablets to be a workable option with iron.

[palmtop in reply to Gambit62]

Thanks a lot, Gambit62! Your comment is very thorough, I will insist on the HoloTC test (active B12), and now they are saying copper might be also the problem, but I doubt it as I do eat the foods that provide it (ie. greens & nuts).

I don't quite understand why I would absorb iron from tablets but not from food, maybe it's just a concentration issue?

[Gambit62 Administrator in reply to palmtop]

lack of stomach acidity may just mean that your gut has become much less efficient at extracting micronutrients from your food - leading to multiple deficiencies

Personally I wouldn't bother with the holo-T test - same issues as for serum B12 - only telling you what is going on with your blood and it will be distorted by the injections.

[Showgem]

It sounds like iron anemia, iron tablets should work as you will absorb some. You probably have both anemia’s

[palmtop in reply to Showgem]

Yes, I spoke to a hematologist and advised Iron and Copper for now. I'm waiting for an appointment, but it does look like I do have iron anemia and B12 definciency (not PA).

[palmtop]

Hi, as lots of you answered, here I have some update: it's clear now that I do have B12 deficiency and also Iron anemia. I need B12 injections and also Iron perfussions periodically (unfortunately, oral iron did not work). We're now going to figure out the correct regime for me, I think it will take several months but I will finally stop feeling exhausted! All my other blood levels and vitamins are good. Thanks for your support