I generally have normal b12 levels in the 500-600 range but have symptoms that mimic b12 deficiency. Sometimes my folate levels are low and I supplement there but was wondering if b12 injections are the next step.
My doctor did a parietal cell antibody test and that was high at 30 but mma was below normal(70) and intrinsic factor was negative.
Had anyone had normal b12 levels but had pernicious anemia despite that?
Yes, you certainly can have normal b12 blood levels and have P.A./ B12 deficiency . That’s called Functional deficiency The Intrinsic Factor Antibody test is only accurate if it gives a positive result . A negative result does NOT mean that you do not have P.A. The Antibodies come and go in the blood . About 50 % of P.A. patients test negative . Both of the above facts should be know to all GPs, but most do not know them . So many P.A. patients are suffering without treatment , which is shocking . If you fail to get B12 injections because of ignorance , I suggest self-injecting Ask if you want the information . It is a cheap and effective solution
Had you taken supplements or injections before the test?The symptoms of B12 deficiency overlap with a lot of other conditions
This forum is actually about B12 absorption problems - and in particular PA - if your B12 levels have remained constant around 500-600 then it is unlikely that you have a B12 absorption problem
The level quoted is well in the normal range which also makes it unlikely that you are B12 deficient but not impossible.
MMA is a metabolite that will build up if your cells don't have enough B12 to recycle it - the fact that it is normal implies that your cells do have enough B12 so, again, makes it unlikely that you have a B12 deficiency.
There are a few genetic variants that are known to affect the processing of B12 in the body and can lead to people needing much higher levels of B12 than normal but that is off topic for this forum.
Just wondered if there was a reason for the genetic variants to be off topic for the forum? B12 absorption seems to be heavily gene-influenced and some of the associated genes/SNPs are common so potentially will be affecting many of us. There is a wealth of knowledge here so it seems like a good place to discuss all types of B12 issues. Many of us won't know that we have a genetic/epigenetic issue, just that we have B12D symptoms, so it would perhaps be helpful to know that there are other factors involved which can be considered. Thanks.
The forum is about B12 absorption problems and the genes referred to don't relate to absorption problems - besides genetic counselling is a very specialised area
I agree about counselling, of course, but that is not generally what we are talking about here, with adult-identified deficiencies. At what point does absorption become metabolism become intercellular....this talks of all three and I found it extremely helpful ncbi.nlm.nih.gov/labs/pmc/a.... Best wishes
Bookish, this forum is about PA, a B12 absorption problem.
I may be misunderstanding here so hopefully someone will correct me as needed. Raised parietal cell antibodies are not diagnostic of PA, but are associated with a large % (90% + I think) of people with autoimmune gastritis which may lead to PA. They are also associated with autoimmune thyroiditis, relatives of PA sufferers, and otherwise healthy people, all of whom ideally would be monitored as at increased risk of developing PA in the future. The parietal cells release stomach acid and intrinsic factor, so with antibodies you are more likely not to be able to absorb nutrients from food, especially the tricky ones like B12 and iron, and digestion will be an issue. You can have the antibodies for years before you get PA, if you are going to, and iron usually shows as deficient before B12. If you are low in iron, that may be causing similar symptoms. Have you had a full iron panel done - if not, might be worth asking for one. And I personally would be asking for a Coeliac test, so that if you want to try an elimination autoimmune diet you can - but not until it has been checked. I wonder why you started B12 supplements and how low you tested initially. 500-600 pg doesn't seem high if you are supplementing and we know that people can be symptomatic at that level. Are you taking a folic or folate supplement? Best wishes
With normal levels of b12 can you still be deficient 
Normal levels for intrinsic factor antibody? 
What level is normal after B12 injections
what is a normal level
Bloods are normal 
