Questions for Hematologist?

[BgpjbA]

Good afternoon,

I’m scheduled to meet a new oncology hematologist on Wednesday, September 7th. I would appreciate suggestions for questions.

Background: I have Hashimoto’s and two thyroid cancers. Fortunately I have no evidence of disease (remission) at this time.

I learned on August 4 that 55% of Hashimoto’s patients also have Pernicious Anemia (PA). I immediately stopped my B12 /folate supplemen, waited two weeks and took the labs in the attached image that showed negative for PA. Quest and LabCorp are two labs in the US.

As you can see, Homocysteine is high. I was supplementing B12/folate for months prior to Dec 2021. You can see B12 was 942 and folate is 8.6, yet red blood cell labs were low. MCV is low, but so is iron.

A friend suggested the Homocysteine in July. I was surprised it was so high. Unfortunately I started the B12 & folate immediately for 3 weeks before I learned of PA and stopped for the labs. I know it wasn’t enough time to wait for the MMA.

I have read all three of Martyn Hooper’s books. The symptoms feel familiar.

I’m discouraged by the negative intrinsic, normal gastric, and negative parietal, even though I have read they are often wrong.

Homocysteine did drop, so maybe I was absorbing the B12 & folate even though I felt no benefit?

I have been referred to do a colonoscopy and endoscopy to look for sources of bleeding to cause the low iron. But I don’t feel strong enough for those procedures.

Hoping the hematologist will shed new light? Perhaps look at a fresh slide of blood?

Thoughts?

Thanks in advance.

[Nackapan]

IFAB test does not pick up around 5o% with PA.

Often iron and folate and vit d accompany low b12.

An Absorbtuin problem if good sources in food are eaten.

I was told to stop painkillers as some cause bleeds to cause low iron.

It 2as not the case with me as still need s low maintenence iron supplement abd vit d daily.

It takes time yto feel a benefit from supplementing. If not reaching cell level . With low b12 and symptoms most need injections. You know its going straight into your bloodstream.

No ifs

And see if a good response.

I can't add anything else.

Hope your appointment goes well

[BgpjbA in reply to Nackapan]

Thank you!