Is the test for PA pointless if you have been receiving injections?

[MCkit]

Hello everyone,

I was diagnosed as B12 deficient in August 2016 but the test for PA was negative. I have been experiencing symptoms so trying to get to the bottom of it all. I currently receive injections every 12 weeks but pushing the doctor to increase the frequency. She has said that she will agree to doing the tests again to see if I have PA but I am not sure if this would be pointless since I receive the injections but would appreciate your thoughts. I feel annoyed at myself that I just took the doctors words 4 years ago and didn't investigate further as to why I am B12 deficient but it seems likely given my symptoms and low folate and iron levels in the past (and present) despite a good diet. I also believe my loading dose was incorrect and if I recall correctly was given folic acid at the same time as my loading dose which from what I am now reading was wrong. Any advice would be gratefully received.

Best wishes,

Cathy

[Nackapan]

You can only move forward.

I wasnt even given the Intrinsic antybody test! But an outdated one they shoukdnt uses for a PA diagnosis.

As you injections ate 12 weekly if you have the test have it just before the 12 weeks.

High levels of b12 in the blood can give a false positive. That wont be a problem as your doctor would hopefully In crease I jections.

Some Gps wrongly stop treating if you have a negative test .

Which 50% of us with PA woukd be a huge mistake and for others that cant absorb from food. Or indeed their body used to injections now!

I think with such a long gap it's okay to do. Your choice.

Its such a dilemma because of the actual test and the Gps response to it!!

I like tou need iron for the first time in my life. Also vitamin d was 21. My folate was 9 so okay. I just have 200mcg when I take a multi vit.

[fbirder]

The test for PA is useless.

The test for antibodies to Intrinsic Factor is negative in about half of those with PA.

Print out this paper - onlinelibrary.wiley.com/doi... - Highlight the bits on Page 500 that talk about IFAB testing and AbNegPA.

Ask your doctor to check the entry for hydroxocobalamin in the BNF (British National Formulary). It changed almost two years ago. In the new version, the entries that read 'Every 3 months' now read 'Every 2 - 3 months'.

So your doc has no excuse for not treating you properly.

[MCkit in reply to fbirder]

Thanks Fbirder, I had mentioned this to her on the telephone and her answer was that she only treats one thing at a time (low folate) and would therefore not increase injections at this time but would agree to test again for PA - I guess she didn't see my point but I am going to do the test and see what the result says and then write a letter with this info and other guidelines attached. I would really like a diagnosis , looking back it was a different doctor who said I was B12 deficient and once the test was negative didn't do anything further however she did let me continue with injections which is good from what I read from others here it is not always the case.