If using B12 sublingual or injections does hypersegmentated neutrophils, or macroovalocytes blood cells normalize over time?
If so how long would the treatment take to improve cell health?
I assume that this dependent on how far the deficiency B12 was before treatment.
Red blood cells have a life span of about 120 days .
It took about 4 months from starting treatment of B12 for my FBC tests to normalise and become good. Haematocrit and haemoglobin levels for me were the problem.
B12 deficiency is associated with anaemia affecting red blood cells more than white blood cells.
The anaemia affecting red blood cells should correct in a few months - could take 4 months - this is because red blood cells are replaced as they 'die' and the average life of a red blood cell is 3-4 months.
I have no idea how B12 deficiency affects white blood cells.
If you have B12 deficiency then anaemia isn't the only thing that your body will be dealing with. B12 is sued by a lot of processes that go on in cells and its effects are widespread. It also supports the immune system and as most of the feelings we associate with illness are down to the immune system that can mean that you feel a lot worse before you start to feel better.
If you have neurological symptoms then there are at least 2 processes using B12 that affect nerve function. One is resetting neurotransmitters - and that doesn't take long to resolve but you can go through a period when the aches and pains get worse because the brain can take a while to adapt to the signals getting through better. The other mechanism is damage to the lining around nerve cells which is much much slower to heal and can take years.
Scientist, not medic.
We've got two cell lines here; the neutrophils, and the erythrocytes.
Hypersegmented neutrophils are quite a sensitive indicator of megaloblastic change because the cell lifespan is short. Providing your bone marrow with 'the stuff' to make normal cells, [B12 & folate] the hypersegmented neutrophils should vanish from circulation in no time at all; maybe a week.
Erythrocytes [red cells] have a lifespan of 110-120 days, and the macrocytes don't have a shortened lifespan, so once you start making new ones with adequate B12 & folate, the macrocytes should disappear at the rate of about 1% per day. If you're anaemic, then you'll see this happen a bit more quickly.
If you see your FBC results and you have an RDW [red cell distribution width] given then this will rise during treatment, and peak about half way through, then slowly fall back to normal as your macrocytes all disappear to be replaced by normal sized ones. I hope this helps.
Your information is fantastic! I truly appreciate it.
I have more questions, in regards to the scientific aspect of it.
So I started the sublingual B12 in July 2022, my MCV has been climbing for years, and I was getting sicker along side it.
In July my B12 levels were rising, they never did MMA (Ugh), and ended up at 452 in August, and then now it is 1149 pg/mL. Is there any concern with this? Or what could be the reason that it is that high now?
I also had significantly in July low Glutathione, and started Infusions in September of B-Complex, Glutathione, Magnesium, and Vitamin C in September. In October I started mHBOT, and that was a game changer! I have been feeling so much better. Since my cells were normalizing by this point, it would make sense as to why/how I was feeling much better, this helped my brain function and clarity.
How much time would it take to start for cell repairs to take affect for lowering Glucose, and helping with Kidney Function do you think?
Perhaps these are not all scientific questions, but your information is spot on and fits my timeline. If you do not feel comfortable answering these, I understand.
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MCV - 85-92 fL should be the functional range, and HealthPartners/Allina indicated 80.0 - 100.0 fL
09/24/2009 92.90
06/18/2012 93.60
8/28/2020 95.00
8/17/2021 96
9/20/2022 96
11/07/2022 92.7 - First time since starting B12 its anywhere near the 2009 amount, which corresponds with all my symptoms starting.
Interesting! Your MCV as you've reported it has never been raised; it's varied slightly. Some labs quote a higher reference range than others, but even so, they tend to be 95% ranges, so 1 in 20 results can be outside the range but the patient is still normal. Recording them over time is really sensible; that way, you can see changes quickly. The MCV is measured in most Haematology labs, but dependent on the analyser in use, it's more stable with some analysers than others, and tends to drift up as the sample is stored. The MCH is, in many respects, a more reliable measure because it relies on the Red Cell Count and the Haemoglobin, and they don't fluctuate on storage. If you get results from more than one lab, it's a good idea to find out what methods they use. They'll be happy to tell you, or they should be.
Since you started sublingual B12, then you've clearly been able to absorb it. The fact that it's high is a reflection of the replacement therapy, and I wouldn't worry about that because B12 isn't toxic, it's water-soluble and any excess to take in you excrete.
In terms of repairing other bodily systems, that's way outside my experience and my guess would be no better than anyone else's.
In general, if you are feeling better then you're probably getting better! Good luck, and listen to your doctor.
I thought you would like to see these then.
Unfortunately, nobody thought testing would be of importance for those, and these are the only date ranges I have, but again they were never considered to be outside of range other than the Functional doctor's recommendations.
You have my permission to ignore the MCHC. Once upon a time it was almost all we'd got, but as stuff got smarter and smarter, the MCHC became less and less valuable. The MCH in the old days was worthless because we couldn't do a red cell count with sufficient precision, whereas now [and since about 1968...] the red cell cound has been OK. The Hb hasn't really improved since then; the MCV is best left out of this discussion. The ones to consider [in my lab mind] are MCH and RDW. The Hb is good too, obviously but if the Hb result is OK and the MCH and RDW are OK then there probably isn't much wrong with the red cells at the first glance.
Sorry, I probably should have given you more info from the get-go, but this is such valuable information to me, and not sure if it would have had this discussion if you had seen it all at once... I am waiting for more results to filter in, and once I have a full view I will be posting that for you to see it all.
Beginning of November 2021, I started Sublingual B12. In February 2022 I went to Mayo and the internal specialist told me all my supplements including this one was not necessary (No B-12 testing was done). She wanted me off of them all, and only intake by food.
By July 2022 I was feeling super sick again and ended up at a Functional doctor, and she told me to get back on all the ones I was on, she was astounded that the Mayo Internalist took me off things without testing, and now I wish we had the testing for the HGB in August/September.
I have been on the B12 sublingual since July/August, and my true improvements did not start until October. I have been told that I have a spring back in my step, I am no longer nauseous, or have liver pains, IBS, headaches, brain fog, heart palpitations, and chest pain all lifting.
I did stop the B12 prior to the diagnosis for just a week, to see what the results may be. The symptoms returned in fierce vengeance, in less than a week. I went right back on.
THANK YOU for your insight, this is so helpful.
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One last two questions for today.
After starting the B12, what happens to the Intrinsic factor antibodies, and parietal cell antibodies?
What may that response look like?
If you were tested for Intrinsic Factor Antibodies [IFAb] before you started the B12 replacement and your result was low, [that's the best way to test for it], and if it's positive, then that's an indicator of Pernicious Anaemia. If you'd had a previous negative IFab before B12 therapy and all of a sudden you're seeing positive results all over the place, then I might be suspicious of those. Some methods in use in the past were prone to false positive results when a lot of free B12 was present in the sample. If they report a number for the IFAb and it's a very low number, then it's probably meaningless. [Sorry, colleagues.]
Parietal Cell Antibodies are a bit too non-specific to be of much use diagnostically [sorry to all my colleagues out there who are testing for them!] in PA; they have other uses.
So there were no Antibodies testing done… So no idea about what it would have been before. I had low B12, now it’s as over 1000.
I went off of the B12 for 7 days to see how I could possibly handle being off for four months. That is not going to work… I have done so much and improved substantially I am not doing that again…. I might die, well I felt like it.
Please remember that positive IFAb results are only found in about 50% of PA patients, and it doesn't alter the treatment if it's negative. I'm not suggesting you try this, but if you could find the lab where the testing is done, then there's usually someone who simply can't shut up about the tests they do [that'd be me, then] and they might be able to advise where it's worth testing. Some labs over here in UK even have open days, and there's people who are only too happy to talk, as otherwise no-one knows we even exist.
If what you're doing makes you feel better, then keep on doing it. Don't lose sight of medics however, because they need to learn too. You might even help them.
Good luck, and 'keep the faith'!
Low 'normal' B12, high folate and enlarged red blood cells.... And high Haematocrit...
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