GP surgery wanting to remove my B12 i... - Pernicious Anaemi...

Pernicious Anaemia Society

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GP surgery wanting to remove my B12 injections after 2-3 years ??

Harhun profile image
11 Replies

Hi guys,

I have been on B12 injections since 2017... Doctors surgery phoned today to say they are going to run a blood test for antibodies as it’s not been tested for a few years and are looking to drop the B12 injections... this was despite my last GP putting these injections from 12 weeks to 8 weeks. I challenged this am was told my B12 level was normal on last general blood test and if the antibodies come back normal they will be taking me off the injections ? I thought you were on these injections for life ?

Any advice ?

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Harhun profile image
Harhun
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11 Replies
wedgewood profile image
wedgewood

Yes , for life for Pernicious Anaemia patients . Trouble is that about 50% of P.A. patients test negative for the intrinsic Factor antibodies . Doctors should know this if they are up to date on their knowledge .Symptoms must be treated . Also they should know that once injections have been started , the B12 level will be high ,and must stay high Ask your doctor to Look up the very latest guide lines . I would write a letter to the G .P. , and the surgery manager . Look up all the advice that you can find on the right hand side “Information “ Do not let them get away with this disgraceful behaviour . Your health is at stake . I’ve had to resort to self -injecting . I have a positive IFAB test , but need more injections than the “ one size fits all “ treatment , and have to inject weekly . Best wishes .

Harhun profile image
Harhun in reply to wedgewood

Hi could you point me in the direction of the information I may require. I have been contacted again to say I’ve to have blood test on Friday and results will be in 2 weeks. I’ve not to bother with my injection that is due until then ... must be something going on as I’ve read a few Similar posts regarding the B12 being withdrawn lately...

plus my prescribing GP has just left the practice... so it’s basically someone working off a set of results with no prior history of issues and previous testing etc...

Nackapan profile image
Nackapan in reply to Harhun

Horrid. Tour b12 levels ate only okay as you have been having injections!!

Not rocket scienceHioe toy get on okay .

We shoukdnt have these upsets and threats of stopping treatment.

Hope you get in okay.

Sleepybunny profile image
Sleepybunny

Hi,

Have you thought about joining and talking to PAS who can offer support and info?

PAS (Pernicious Anaemia Society)

Based in Wales, UK.

pernicious-anaemia-society....

There is a helpline number that PAS members can ring.

PAS support groups in UK

pernicious-anaemia-society....

No meetings during pandemic.

Blog post about how PAS can support PAS members seeking PA diagnosis

martynhooper.com/2017/06/24...

PA tests

Intrinsic Factor Antibody (IFA) test

labtestsonline.org/tests/in...

Parietal Cell Antibody (PCA) test

labtestsonline.org/tests/pa...

PCA is not recommended as a diagnostic test for PA in UK.

It is still possible to have PA with a negative result in IFA or PCA test.

About 50% of people with PA test negative on IFA test.

About 10% of people with PA test negative on PCA test.

PAS members can access useful leaflets and documents from PAS website.

pernicious-anaemia-society....

I suggest reading and printing off the following if you join PAS.

"Treatment is for Life"

"Testing B12 during treatment"

Perhaps your GP would like copies?

BSH Cobalamin and Folate Guidelines

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

The above document mentions Antibody Negative PA where a person has PA but their body does not produce intrinsic factor antibodies.

"I challenged this"

Unhappy with Treatment (UK info)?

Letters to GPs about B12 deficiency

b12deficiency.info/b12-writ...

Link above has letter templates that people can base their own letters on.

I think it is more effective to put queries about treatment/diagnoses into a letter to GP and possibly copied to practice manager.

In UK, letters to GP are supposed to be filed with medical notes so hopefully are less likely to be ignored than info passed on verbally.

Useful to have a paper trail in case there is a need to make a formal complaint. I think it's wise to keep copies of any letters sent and any replies received.

May be worth drawing GPs attention in any letter or conversation to the risk of permanent damage to spinal cord if B12 deficiency is untreated or under treated.

CAB NHS Complaints

citizensadvice.org.uk/healt...

MPs and devolved representatives may be worth talking to if struggling to get treatment.

Symptoms Diary

Might be helpful to keep a daily symptoms diary which tracks changes in symptoms over time and if and when any treatment is received, Could be useful evidence to show GP if experiencing deterioration in symptoms.

Neurological Consequences of B12 Deficiency

PAS news item

pernicious-anaemia-society....

PAS article about SACD, sub acute combined degeneration of the spinal cord, access to PAS members only.

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

Have a look at my replies in the thread I linked to below which has links to B12 deficiency symptoms lists, causes of B12 deficiency, B12 books, more B12 websites, UK B12 documents and other B12 info including some hints on dealing with unhelpful GPs which might be useful.

healthunlocked.com/pasoc/po...

UK forum members have reported problems getting their B12 jabs during pandemic eg injections have been stopped/delayed/ frequency reduced or swapped for oral tablets.

I left a detailed reply about impact of pandemic on B12 treatment in UK in next link which might be of interest if you're UK based.

healthunlocked.com/pasoc/po.....

I am very cynical after having some bad experiences trying to get treatment and suspect that stopping B12 injections may be an attempt to cut costs.

I am not medically trained.

Cherylclaire profile image
CherylclaireForum Support

If you had intrinsic factor antibody test at any time that came back as a positive result , it is 95% correct and so you are IFab positive. Why are they retesting after a few years?

Your B12 was normal ? How normal ? Isn't attaining a normal reading the entire point of injections ? My last serum B12 reading was over 2000ng/L in 2016- and was never tested again as GP said it was pointless. She checks folate, ferritin, vitamin D and thyroid as these were all quite unstable. Not unusual with B12 deficiency.

Helping you to get symptoms brought under control -or having failed that, at very least reduced to manageable - that surely is the long-term goal. Who will be responsible for this, now that you have lost your usual GP ? That might be a question worth asking. Who is to take over continuity and monitoring your condition. After all, if pernicious anaemia, this is incurable.

I think you need to first ask for a copy of these results so that you can see what they are looking at and why they are making these decisions.

Take someone with you to meetings or appointments if possible. Helps you keep track, allows for a confirmation re symptoms, a witness, and for morale. If you have cognitive or memory problems, this can be essential.

Have you got a list of your symptoms ? Have they got this on record ?

I would start keeping a daily record of your symptoms: frequency, severity and show where B12 injections given. I notice Sleepybunny also thinks this might be effective- she probably advised me to start one 5 years ago! A pattern could emerge that would help support your case for more injections. If they do stop your injections, keep the record going to prove how you are managing (or not)without them. At the first sign of any recurrence of neurological problems, go back.

Wellington1 profile image
Wellington1

I too have been told to go for an antibody test on 14th September. I have been having B12 injections every 10 to 12 weeks for over 20 years. Its never been questioned before! I am not happy and am becoming increasingly anxious about it. I started to self inject when my injection was late during lockdown (every week) but am now worried that this will have an impact on the test so have now stopped. I will be asking for a copy of the results before I discuss with the GP. Please let us know how you deal with this and how you get on.

Harhun profile image
Harhun in reply to Wellington1

I will do, I am the same I managed to do B12 injections during lockdown. Stuck to one a month. Surely your level should be elevated anyway if you are receiving the supplement of injections? To make matters worse apparently it was a Pharmacist who has recommended that it my results are “normal range” I should stop receiving the B12 🤷‍♂️

Wellington1 profile image
Wellington1

Yes my B12 levels will be high but I am having the Intrinsic Factor test and I think Parietal Cells - am not sure if additional injections will affect these tests. I would write to your GP - a pharmacist should not be making such recommendations surely!

Sleepybunny profile image
Sleepybunny

Hi,

If you've ever had a positive result in an Intrinsic Factor Antibody (IFAb) test it is likely you have PA.

Might be worth getting hold of proof of any positive IFAb test result/previous diagnosis of PA.

If you were told in the past you had PA, don't be shocked if there is no record of this diagnosis in your records. Some forum members whose B12 injections were stopped were told there was no record of original PA diagnosis when they challenged the decision.

Access to health records (England).

nhs.uk/using-the-nhs/about-...

Intrinsic Factor Antibody (IFA) test

labtestsonline.org/tests/in...

Dee011960 profile image
Dee011960

Hi

I have had PA since 2003 (when diagnosed but think l have had it since l was 18), I was told it was for life, my problem is my gp in 2003 has mislaid blood test (due to going from papers records and changing electronic systems), my present gp was okay giving me my injections every 11th week, although really l needed them every 9, but due to Covid-19 they are using this as an excuse to retest me, l won't agree to the retest, so have brought B12 patches (1000 mcg), at first l tried 500 mcg, but my symptoms got worse, the 1000 is okay but is not as good as the injections, l am trying to find them on-line with everything included, so l can self inject , although l don't like needles but I would inject to get a better quality of life and be symptom free!

Harhun profile image
Harhun

Just out of Gp Surgery... practitioner nurse took the bloods, ask to speak to the Pharmacist regarding the retesting... she wasn’t available. The practitioner nurse booked me back in for 8 weeks and said she didn’t think they could stop this after 3 years ... and the results will be high due to being on regular B12 injections...

I’ve to make an appointment to discuss with a new Gp that’s been appointed to me since my regular one has left the practice...

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