Pregnancy

[Quigley2005]

Hi. Daughter 14 weeks pregnant. B12 is 152. Ferritin folate all good. Doctor says not low so just use pregnacare and wont give her b12 tablets either. She had b12 injection 6 months ago from beautician so woukd have thought level wouldnt be so low. Is it safe to give her an injection? Also she had iron infusion last week as hb was very low despite taking iron tablets.sorry for long post I'm just worried

[fbirder]

What were the units and range for the blood test? What are her symptoms that make you think she may need an injections?

[Quigley2005 in reply to fbirder]

B12 range 150 to 700. Hers is 152 6 months after having injection. Shes knackered but maybe due to low hb . Had iron infusion on monday. Looked into buying etc b12 tablets but 15 quid for 50. I think in a months time her level will go down further. I'm b12 deficient due to coeliac but I self inject. She has just been tested for coeliac but negative

[Nackapan in reply to Quigley2005]

You are right to keep an eye on it as b12 just as important as folate in pregnancy. At least she just in range at the moment. We all operate at different levels.

Can your daughter eat a little more lean meat and up her diary. Cereals are fortified too.

Pregnicare does have a small amount in.

I would get her to discuss her concerns with the midwife.

Her present symptoms of low iron may make it difficult to know whars what.

Also b12 can drop especially after delivery so good to be aware now.

Most women can feel rough up to at least 16 weeks so perhaps things will be clearer soon.

[Quigley2005 in reply to Nackapan]

Thank you

[fbirder in reply to Quigley2005]

If you want to try oral B12 then you can get tablets much cheaper than that -

amazon.co.uk/Vitamin-B12-10...

[Quigley2005 in reply to fbirder]

Thanks so much

[Sleepybunny]

Hi,

Pregnancy is mentioned in UK guidelines below.

BSH Cobalamin and Folate Guidelines

b-s-h.org.uk/guidelines/gui...

What's her diet like?

Coeliac disease is an auto immune condition. Having auto immune conditions in the family increases the chance of developing one.

PA (Pernicious Anaemia) is an auto immune condition. Has she been tested for PA?

PA tests are not always reliable

If there's a possibility of PA, worth joining PAS (Pernicious Anaemia Society).

PAS (Pernicious Anaemia Society)

Based in Wales, UK.

pernicious-anaemia-society....

There is a helpline number that PAS members can ring.

Doctors may put low B12 purely down to her pregnancy and / or diet so it's important that they are aware of any other risk factors for B12 deficiency in your daughter's life and any symptoms suggestive of B12 deficiency.

Link about Pregnancy and B12 Deficiency

Some of the details in this link below may be upsetting to read.

b12deficiency.info/b12-and-...

PAS (Pernicious Anaemia Society) have a leaflet "Vitamin B12 Deficiency in Pregnancy and Newborns Leaflet"

You would need to be a PAS member to access this.

pernicious-anaemia-society.... See Page 2 of articles.

"She has just been tested for coeliac but negative"

I'd suggest she gets access to her test results and checks which tests for Coeliac she has been given.

UK guidelines suggest two tests for Coeliac.

Did she have both tests?

1) tTG IgA which checks for antibodies to gluten

2) Total IgA which checks who has IgA deficiency

Patients with suspected Coeliac who are IgA deficient will need alternative tests for Coeliac as their bodies cannot make the antibodies to gluten that tTG IgA test looks for. See links below.

Was she told to eat plenty of gluten in more than one meal per day for several weeks prior to the blood being taken for testing?

UK guidelines suggest this to ensure there are plenty of antibodies to gluten in the blood which increases the chance of a positive result in tTG IgA test in people who have Coeliac disease.

The advice may be different for a pregnant woman.

If she hasn't had a Total IgA test and wasn't asked to eat plenty of gluten before blood taken then it's possible that the negative result may not be reliable.

If Coeliac type symptoms continue even with a negative result, the guidelines suggest referral to a gastro enterologist.

NICE guidelines Coeliac Disease (UK document)

nice.org.uk/guidance/ng20/c...

Coeliac Blood Tests

coeliac.org.uk/coeliac-dise...

Unhappy with Treatment ( UK info)?

Letters to GPs about B12 deficiency

b12deficiency.info/b12-writ...

CAB NHS Complaints

citizensadvice.org.uk/healt...

I wrote another very detailed reply on another forum thread with links to symptoms lists, causes of b12 deficiency, info about tests for PA, B12 books, B12 websites, UK B12 documents, letters to GP about B12 deficiency and other B12 info which you might find helpful.

healthunlocked.com/pasoc/po...

I am not medically trained.

[Quigley2005 in reply to Sleepybunny]

Thank you for your reply.i will look into it x

[Sleepybunny in reply to Quigley2005]

For future reference your daughter may be interested in info about nitrous oxide.

Nitrous oxide is in "gas and air" mix used as pain relief during labour and sometimes as part of anaesthesia during operations.

Nitrous oxide inactivates B12 in the body so someone with low levels of B12 given "gas and air" may have issues afterwards.

I had symptoms consistent with B12 deficiency after a long labour with prolonged exposure to nitrous oxide in "gas and air". If I had known about the issues I would have considered other methods of pain relief.

Some people have experienced issues after a relatively short exposure to nitrous oxide.

Nitrous Oxide

gov.uk/drug-safety-update/n...

Midwives may not be aware of the potential issues with inactivation of B12.

There have been midwives on this forum who feel their symptoms are due to regular exposure to nitrous oxide during their work.

The NHS page on Pain Relief in Labour says there are no harmful side effects with gas and air...

nhs.uk/conditions/pregnancy...

This in my mind is not accurate (I'm not medically trained).

I think there is a risk if patient has low B12 levels prior to exposure and also if exposure is prolonged.

Search online for "Nitrous Oxide B12 deficiency" for more info.