I would appreciate your advice. Unfortunately, I am using my phone and searching through previous Q&A is difficult so my apologies if this query has been raised previously.
My query is this - is it un/likely that a person will have PA if their total B12 is returning at 397 and indeed is usually in and around that range on previous tests.
I know that my B12 is low but I am trying to determine whether I can improve this by supplement (under tongue) or whether B12 injection is the only feasible way.
My symptoms are muscle and joint pain, depression, some nerve tingling in legs, low exercise threshhold, coldness, dry skin. My thyroid results are in range and i am classed as euthyroid. My D currently sits at 80nmol.
I have supplemented in the past and my active B12 was >300 which I understand is more likely to be a false high.
I must admit that the thought of self-injecting is a worrying one and I am conscious of causing myself damage. I have not as yet had an MMA or antibody test at Medichecks.
Many thanks
HV
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High_Valour
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No. An active B12 of more than 300 is not likely to be a 'false high' it is likely to be a true representation of your blood levels of B12 and shows that you have no problem absorbing the B12 from the supplements. In other words, you definitely do not have PA.
Start taking B12 supplements again. Low dose ones will almost certainly be fine, but high dose cyanocobalamin will be easier to find and less likely to cause unwanted side-effects than methylcobalamin.
Go and see your doctor about the tingling in your legs and ask to see a neurologist about it.
My diet does include meat, fish, eggs and some dairy so in theory I should bet getting b12 from my diet. However, my digestion is not great with low HCL and possibly leaky gut.
I was curious to understand whether it was possible to have a b12 reading of 397 at all with PA. From what I have read, people appear to have total b12 readings in and around 100.
It may be the case that improved digestion is key here which in itself is a challenge as we age (48).
One final Q please, is it possible to absorb sublingual b12 under the tongue and this bypass the gut? - I assumed that this is why these lozenges were a preferred option. I have tried the better you b12 spray but it contains chromium which irritates my kidneys.
I must admit that the aspect of having b12 readings but having symptoms as the b12 is not in the cells (and working) confuses me.
the differences between sublingual and high dose oral absorption are minimal.
High dose oral and sublingual can be useful if you have an absorption problem. They by-pass the normal mechanism designed to absorb B12 and rely upon a much less efficient process called passive absorption which occurs along the whole gut - but averages 1% - however it can be higher than this and for some people it is much lower, meaning high dose oral isn't effective for them.
The normal range fr serum B12 is a difficult number to interpret. The range his huge when looking at the population in general. Levels tend to be more constant when looking at an individual over time but will vary by 20% because the test is only accurate to that margin. 300 is in the grey area but that doesn't mean it isn't the right level for you - serum B12 is more useful as a test if you see falling levels over time, which does indicate an absorption problem
I wrote a 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.
From what I've read it is possible that you are absorbing b12 normally so that your levels are raised in the blood but for some reason your body isn't utilizing the b12 properly so you can still have deficiency symptoms. I believe treatment is the same, high dosage of b12 whether by injections or supplements.
You can have any level b12 and still have pa. The determination factor is the antibody.
So just increasing your b12 Isjust increasing your b12. If you have the antibody, you will still have pp a at 98 or 1298.
Now. I don't believe you are having absorption issues in the gut like you're thinking. Point being vitamin d is a fat soluable hormone. If you have troubles absorbing b12, you would also more than likely have low vitamin d. They go hand in hand.
An inadequate diet over a long period of time, can cause b12 deficiency regardless of antibody status.
Lastly, only way to find out is to have the antibody testing done. Then take it from there. But just because you're low b12 or near the threshold doesn't mean it's pa, and even minimal deficiency can cause neurological issues. Some people have naturally higher threshold for their body chemistry; in addition to how well they are maintaining their supporting vitamin cofactors.
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