Test result help

[Jaye75]

I've had intrinsic factor levels checked and the results were 1.0 U/MI what dies this mean....my b12 was 814 and haematocrit lower than usual, I've been getting reoccurring anemia for 2 years now and having a lot of symptoms of b12 deficiency despite having a higher level. But intrinsic factor has me a bit baffled as I've read a few things but unsure if my result means b12 deficiency or PA I won't see Dr until Monday as I've got my results online.

[wedgewood]

Officially — less than 1.2 -Negative 1.21–1.52 -equivocal

Greater than 1.53 -Positive

But it is known that about 50% of PA patients test Negative to intrinsic factor antibodies. Symptoms are what must be treated .

Also the b12 blood serum reading can be well within range for a patient with PA .

I hope that your doctor is aware of these facts about PA .

PS - Pernicious anaemia is the most common form of B12 deficiency.

[Gambit62 Administrator]

a) the test is a negative but a negative result doesn't rule out PA as a cause of B12 deficiency, because it is prone to false negativesb) PA is actually an auto-immune disorder of the gut that attacks the specialist mechanism by which the body absorbs most B12 from food. This results in a B12 deficiency, one potential symptom of which is macrocytic anaemia in which red blood cells are larger and rounder than normal

c) there are many other types of anaemia eg microcytic anaemia occurs when red blood cells are smaller than normal and is caused by iron deficiency - which could be diet, could be an absorption problem, could be excessive bleeding

d) if your B12 levels are high without any supplementation that would seem to rule out PA and B12 deficiency

e) the reason why the range for IFAB doesn't start as 0 is that the test method means it picks up other substances that are naturally found in your blood as well as IFAB, so 1 is the point at which it starts to be more certain than not that the test is picking up IFAB. This is also the reason why it gives false negatives so often and can't be used to rule out PA.

f) the symptoms of B12 overlap with a number of other conditions, including types of anaemia not caused by B12 deficiency.

Suggest that when you speak to your GP you clarify which types of anaemia you have had in the past.

[Jaye75 in reply to Gambit62]

Iron deficiency anemia and folate deficiency anemia also I have had low ferritin, low vitamin D ...I have a healthy diet so this is why I know something is going on I just hope the dr refers me to hematologist like he said he would as I can't keep going on like this it's every 3- 6 months and hits me hard I'm sick of being tired and my skin burning especially legs

[Gambit62 Administrator in reply to Jaye75]

sorry to hear about the rollercoaster. Symptoms of folate deficiency have a very strong correlation with B12 deficiency.Ferritin is a protein marker that generally gives a good indication of iron deficiency - but it doesn't tell the whole story so should be a prompt to do a full iron panel, which appears to have been the case from what you say. Vitamin D could be dietary but its actually not that uncommon for people in UK to be Vit D deficient in the winter months because of lack of suitable sunshine in winter months. There are some dietary sources.

Folate would either imply dietary deficiency or an absorption problem. As both B12 and folate are absorbed in the ileum its common for both to occur at the same time but again, the high serum B12 (unless you have had an injection or supplemented in the last few years) would imply that you don't have a B12 absorption problem.

Hope a haematologist can help but it may be worth asking for a gastrology referral as well to see if there is something in the gut that might account for absorption problems.

[Jaye75 in reply to Gambit62]

I have been using the B12 spray from Holland and Barrett 1200ug dosage for about 6 weeks taking it 3/4 times a week I don't know if this would make a difference also I tried B12 supplements low dose about 4 years ago for about a month. I'll see what the Dr does on Monday and let you know. Thank you.

[Gambit62 Administrator in reply to Jaye75]

6 weeks of that high a dose could have affected the serum B12 results but its a bit unlikely that it would have made the B12 levels that high if you had an absorption problem.

[wedgewood in reply to Jaye75]

If you have P.A. you lack stomach acid ,which is needed to break down food and absorb vitamins and minerals . Food starts to be broken down with chewing and the enzymes in saliva ,but that is not enough , So if you have P.A. or suspect you do , even if you have tested negative , always chew your food well , don’t have large meals , but smaller meals more often . Also I take a modest vitamin and mineral supplement .Also a probiotic capsule ,as a poorly acidified stomach is bad for stomach flora ( friendly bacteria) We are all out on our own to a certain extent due to ignorance of P.A. by the medical profession. Also we are all different , and need differing treatments , which we have to discover for ourselves by trial and error ..

This forum is invaluable , because we can read how others tackle their problems with the condition l

[FlipperTD]

Scientist, not medic.

It would be more helpful if you could post not only a result but any other information such as reference ranges or coded comments on the test. Interpreting numbers on their own is tricky.

Intrinsic Factor antibody results can be confusing, and I would prefer to see them reported as 'Positive', 'Negative', or 'Equivocal, plese repeat' because simply applying a numerical value to such a test is not particularly helpful, but there are technical reasons why it might be used.

It would be interesting for you to track other bits of your FBC; what's happening to your MCV, when you get your recurring anaemia, for instance.