Stupid question time

Hi guys can I just ask this as for some reason I can’t get it clear in my head.

Is Functional b12 Deficiency the same as Pernicious Anemia. Thanks so much x

[fbirder]

No.

Pernicious Anaemia is when you suffer the symptoms of a B12 deficiency because you do not absorb enough from food.

A functional deficiency is when you do absorb B12 OK, but you still suffer the symptoms of a deficiency despite having loads of the stuff in your blood. There is a problem somewhere along the process of getting B12 from the blood into the right places in the cell, in the right formats.

B12 is involved in two main processes. One is the conversion of homocysteine (hCys) into methionine. This requires B12 to be converted to cob(I)alamin which attaches to an enzyme. If any of those processes do not work properly, then the conversion of hCys does not happen properly and a blood test will reveal high levels of hCys. Note that folate is also involved in that conversion, so low levels of folate will also result in raised hCys.

The other process is the conversion of methylmalonyl CoA (MMA CoA) into succinyl CoA. This requires B12 to be converted to cob(II)alamin and then adenosylcobalamin in the mitochondria. If any of the steps from blood to mitochondria doesn't work properly them you get raised MMA.

So a functional deficiency will show high levels of B12 in the blood plus high levels of hCys and/or MMA.

[Nackapan in reply to fbirder]

Must've been typing at the same time ad wouldnt have answered if I saw your reply!! 🙄

[Hidden in reply to Nackapan]

Ty Nackapan

[Hidden in reply to fbirder]

Thank you for that reply I just couldn’t get it right in my head I started off taking oral sprays and supplements but wasn’t getting things quite right because I was fighting on too many fronts I think,having biopsys done and brain scans and god knows how many other things that I just said stop and opted for the injections because my new endo looked at b12 results and MMA results and said functional b12 deficiency so before anything else get the b12 injections done.we can work on the other stuff after lockdown.

At least it’s a bit clearer now so thanks for breaking it down much appreciated.

[Nackapan]

Got me thinking.

I think it's the same as b12 deficiency but the serum blood test is normal but the b12 not getting to the cells.

I think with PA its different because its an auto immune condition producing the intrinsic antybody. Which does show up as low b12 on bloods.

Of course so many of us could have PA as the tests are so unreliable

.

Interesting question

I'm sure one of the better informed or scientists will come along and correct me where necessary.

[Nackapan]

Well I got the no it's not the same right lol

[Retteacher]

My husband tells me that as we get older serum levels of B12 reduce. Some researchers especially those in the USA, believe that over the age of 55 there may be an increasing inability for B12 to pass from the blood into the Central Nervous System. This hypothesis is unproven but might explain why large doses of B12 need to be supplied by injection to overcome this proposed barrier. It would also explain why the MMA and homocysteine tests, not to mention the serum B12 tests do not correlate well with patients symptoms in functional B12 deficiency. There was a mention last year of some specialised MRI studies showing evidence of changes in the brain with functional B12 deficiency but he has yet to find these.

[Bellabab in reply to Retteacher]

I have noticed that all the many ageing processes seem to have reversed since I have been injecting every other day. Liver spots on my hands have almost faded away. My body hair is growing again including on head and face and greying hair has considerably reduced. My skin is much less wrinkled.

It looks to me that B12 decline with age may be the cause of ageing or highly involved in it.

[Hidden in reply to Bellabab]

Funny you saying that because I’ve just said to my husband my roots are actually coming in quite dark,after I had my head injury my hair just went really silver but I got away with it because it blended nicely with the blonde highlights,I’m an ex hairdresser so I tend to notice even small changes.im so pleased I thought I was going a bit doo wally lol.

My skin is great too I describe it as having my glow back because I’m vain 😂

I had a dopey moment between Injections last week and got a really bad burn up my arm from the iron,I misjudged it’s position I used to do things like that a lot before supplements ,now a week later I only have a small mark where the burn was,it’s healed so quickly that’s just not usual for me.

Very encouraging isn’t it.x

[Retteacher in reply to Bellabab]

Interesting. My husband is certainly a fan of Prof A. David Smith of Oxford who believed that high B12 levels are required to reduce brain atrophy with age. Apparently as levels fall towards the traditional cut-off of 200pg/mL the more rapidly atrophy occurs. I think his data suggested that levels of the order of 760pg/mL were beneficial.

[Twaddletop in reply to Retteacher]

I have an MA from St Andrews University, ( it wasn’t yesterday). My main subject was English. I have trouble finding words now and sometimes I forget what the subject was halfway through a sentence. My GP says it’s age related ( I’m 64), but I am totally convinced it’d auto immune related. My old Irish Gran used to say “let one of the Royal family “get it”, and a cure will be found”. Do you think it would help if Charlie or Camilla developed this type of illness? There would be no GP telling them that their B12 was suspended indefinitely due to Covid19. Just saying x

[Hidden in reply to Twaddletop]

I agree!

[Nackapan in reply to Twaddletop]

I agree. They have probably been on supplements for years and regular blood checks for everything My first ever b12 check was when I wad 57! Bit late!!

[Showgem in reply to Nackapan]

My first test for b12 was when I was 67. I had every symptom on the list and had been symptomatic for years but by then I was so very ill.

[Nackapan in reply to Showgem]

So ridiculous not to be on the standard blood form. I was very ill and still am on most days!

[Showgem in reply to Nackapan]

I still have numbness in my feet, imbalance, tiredness and muscle loss. I fell again a few weeks ago and injured my foot, breaking a toe so have been using a frame as my upper body strength and loss of balance wasn't good enough for crutches.

If b12 was checked when they do the blood tests I would never have gotten to this state.

I hope you're doing well on your new b12 regime x

[JanD236 in reply to Twaddletop]

Without the MA in English but a lifetime of talking fluently (including a career which saw me giving lectures to accountants about tax matters) I had exactly the same experience of forgetting what I was talking about halfway through a sentence and being unable to find a word.

Luckily I’d changed careers by the time this hit me in my early to mid 50s. Before the PA diagnosis I did privately wonder if I had the start of early onset dementia.

At 60 it still affects me a little. I si twice weekly and sometimes the day before, or the hours leading up to my injection, the feeling of losing the thread and/or individual words creeps up on me.

However, this is alleviated immediately I have the injection. I wonder what process is happening that brings about such instant clarity?

[Nackapan in reply to JanD236]

So glad it has such a quick effect.

Perhaps its getting g blood to your brain or speeding up circulation by slightly raising your bp?

[Bellabab in reply to Twaddletop]

Look at this.

ox.ac.uk/news/science-blog/...

[Twaddletop in reply to Bellabab]

My poor Mum was diagnosed with small vessel disease before it was discovered she was also B12 deficient. I found that study fascinating and pray that they do go on with a large scale trial. Thank you Bellabab x