Help please

[Lunadoo]

Hi. I recently had B12 result of 189 (180-700 range). I have tingly feet and hands, Tiredness, visual disturbance and muscle aches. My father and brother both have pernicious anaemia . Intrinsic factor and parietal were negative and Hb and MCV ok. Saw GP yesterday ( young locum) who did full neuro exam - all ok except much reduced ankle jerk reflexes. I have been on Omeprazole for 10 years and GP was unaware this could cause problems with B12!! She agreed to give me a trial of injection and review in a month. GREAT I thought. Should add that after an hour of wrangling my normal BP and heart rate had shot up! On returning home she called - she had discussed with senior partner who won't start injections unless B12 under 150 and until I have had MMA, Magnesium and bone profile blood tests. Instead they have given me 50mcg B12 x 3 times a day ( 2week supply!) I have been taking sublingual Methylcobalamin 1000mcg for 10 days and worry this will skew the result of MMA test tomorrow? Feeling very fed up and worried. Any advice very welcome.

[Nackapan]

I woukd ask on what evidence to wait until yiu have deteriated further ? Also why wait until under 150. Dont know range .With your family history snd symptomsc I woukd dispute this in a letter.

Stare yiu do not want irreversible damage . .state the Intrinsic factor test ifen us negative In PA patients.

State bnf guidelines

Sleepybunny has put loads of links to help you if you go through the posts.

I had my Gp in the end went against peers

Any doctor csn prescribe in their own right.

Hope you get the 'trial'

If yiuve trued oral they are not working

[Gambit62 Administrator]

Try asking for treatment in line with BCSH guidelines which can be found here,onlinelibrary.wiley.com/doi...

in particular refer to importance of treating neurological problems promptly even if results in range.

also refer to comments on interpretation of tests - serum B12 is only accurate to 20% and your result is well within this.

Supplementation might have affected MMA but suggest you focus on being treated on symptoms