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Repeating intrinsic factor antibody blood test

Aumshantii profile image
9 Replies

Hello

Does anybody have any references to show a consultant that wants to repeat an ifab blood test? I have gastric parietal cells and am ifab positive with reading of 8 (range 0-5). He says I'm only weekly positive for ifab so wants to repeat the test.

I had one down in June that was negative, then in August it was positive. I am on loading doses of 3x weekly. Does the B12 make the ifab go down or go away?

I have thyroid autoimmunity and neuro symptoms, he says that this could cause the positive ifab too And that the symptoms could be the thyroid condition.

Any advice gratefully accepted, thank you.

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Aumshantii
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9 Replies
Nackapan profile image
Nackapan

I don't understand them doing it if they don't believe the results.You tested positive

You have PA

If anything having high levels of b12 in your bloodstresm could give a false positive ifab

Tgars why usually done before injections started

Perhaps they should be asking if you benefit or responded to tgd b12 injections.

If yih don't need them mist fkng react % respond?

Pas coukd maybe help with info. Fir professionals

FlipperTD profile image
FlipperTD

Scientist, not medic.

My personal experience of running the IFAb test showed that repeating over time, the reactions only got stronger. Logically, it has to start somewhere, and 'weak positive' sounds like 'early days'. Personally, I wouldn't argue; if they want to repeat the test, just go with it. You're already being treated.

Positive IFAb confirms the existence of PA. If by any slight chance the 'weak positive' was an error, then a repeat is sensible, given you'd had a negative in the past. B12 injections should not affect the result.

Nackapan profile image
Nackapan in reply toFlipperTD

A weak positive us surly a positive?As I understand it 50% of thuses with PA csn have negative tests.

I'm I really fo jot see the point in repeating tge test when antibodies have show up.

Unfortunately Gps do take a negative as you csnt have PA and fo stop treatment.

Disregarding ongoing symptoms.

A patient with b12 deficiency/ ifab neg PA

Who struggled to get the correct treatment.

Not a scientist or medic

FlipperTD profile image
FlipperTD in reply toNackapan

You're absolutely right; positive is positive is positive. However, when someone's seen 'weak positive' then that can confuse and if a GP can't actually grasp that 'positive is positive' then in my experience of doing the test, leaving it a while longer and repeating means that the tide's come further up the beach, and it's a stronger reaction. If however it 'went negative' and you'd had two negatives and one weak positive, well, I'd take the 'two out of three' coin toss approach. Some folks never develop detectable antibodies but it doesn't stop them needing treatment. If a GP won't treat them then I'd suggest it's time to change GPs. Treat the symptoms, not the numbers!

Springblossom13 profile image
Springblossom13 in reply toFlipperTD

Excellent advice Flipper - thank you

Aumshantii profile image
Aumshantii

Thank you all for your replies, I have a strong feeling they are wanting it to be negative so they can tell me'I told you so!' I have been very persistant with my requests for treatment. I fear that if -ve they will stop treatment. I am weirdly bolstered that if B12 injections are ongoing it likely will give a higher ifab result. I will keep that little tidbit quiete and go for the repeat test when requested. So the B12 never makes ifab go away?

I know thyroid antibodies wax and wane depending on what's happening in your life/body that's why I feared they may wane if I repeat the ifab and the door to treatment slammed shut. It was hard enough getting this far even with both apc and ifab positive. Injections have helped so much. Thank you all again

Springblossom13 profile image
Springblossom13 in reply toAumshantii

I think flippers advice is excellent. And you should be glad they are testing you for IfAB. It seems often this test is not done. Doing it multiple times makes sense to me, then you can feel really confident in your treatment

Sleepybunny profile image
Sleepybunny

Hi,

PAS link about testing for PA.

pernicious-anaemia-society....

PAS website has lots of useful leaflets/articles that might be worth passing to your doctors.

pernicious-anaemia-society....

You may want to mention to your GPs/specialists that PAS has a page for health professionals. It is free for them to join PAS as associate members.

See link below.

pernicious-anaemia-society....

"I fear that if -ve they will stop treatment. "

Hopefully if you get a negative result they won't stop treatment but it has happened to some forum members.

Diagnostic flowchart from BSH Cobalamin and Folate Guidelines which mentions Antibody Negative PA.

stichtingb12tekort.nl/engli...

More about Antibody Negative PA in

BSH Cobalamin and Folate Guidelines

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

A quote from above document is "and the finding of a negative intrinsic factor antibody assay does not therefore rule out pernicious anaemia”.

Antibody Negative PA is mentioned in Martyn Hooper's book

"What You Need to Know About Pernicious Anaemia and B12 Deficiency"

I believe Martyn Hooper, chair of PAS, was tested several times for PA before he got a positive test result.

Intrinsic Factor Antibody (IFA) test

testing.com/tests/intrinsic...

This link says "A negative test result does not necessarily mean that a person does not have pernicious anemia. As many as half of those affected will not have IF antibodies."

I also wondered if you had been tested for coeliac disease.

NICE guidelines Coeliac Disease

nice.org.uk/guidance/ng20/c...

Coeliac Blood Tests

coeliac.org.uk/coeliac-dise...

I left a lot of info on one of your other threads.

Aumshantii profile image
Aumshantii

Thanks Sleepybunny, it was incredibly difficult to get prescribed B12 even with the long term symptoms, positive apc and ifab. I dread the thought of it being negative. I have read the references regarding a negative ifab not necessarily meaning no PA, but can just imagine the glee and hand rubbing by the medics if it does turn up negative. I am strangely bolstered by the replies on the forum that said its likely the ifab will only increase with time. Its not something to be celebrating but I'm so tired of fighting doctors and if it means they will just quietly acknowledge PA and continue the treatment, well that's all I want. I know it works for me.

Its not just about getting the injections, I want it noted on my records in case of future needs/ treatments. With the increased gastric cancer risk PA should be flagged up so that any symptoms are treated accordingly. When you have had cancer before, it constantly worries you.

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