Getting a diagnosis : Hi I've had... - Pernicious Anaemi...

Pernicious Anaemia Society

32,672 members24,065 posts

Getting a diagnosis

Uluru72 profile image
9 Replies

Hi

I've had symptoms potentially related to a b12 problem just about all my life (I'm 50 now). I became very ill about 3 years ago with a typical list of symptoms along with extreme weight loss and loss of muscle mass. I was anaemic then and also had very low serum ferritin. I saw a neurologist who told me that he thought I had motor neurone disease, then MS, then I was given an ME/CFS diagnosis and left to my own devices. I think my b12 was tested around this time and I presume that it must have been within the normal range.

About 6 weeks ago I was too weak to swallow and started to have sensory disturbances, along with burning skin, constant palpitations etc. housebound.

Looking at my situation myself decided that my problem looked a lot more like a b12 problem than ME/CFS. I would have been prepared to chase the diagnosis privately, but I honestly don't think that I had the time to wait: my father was undiagnosed, had many of the same symptoms and just faded away and died.

I started self injecting the cyanide stabilised form about 5 weeks ago, every other day. I'm a long way from being well, but my improvement is immense, some problems I've had all my life have gone and I can walk for an hour with no problems whereas before, I was scarcely able to move around my house.

I would like to get a diagnosis. My injections will mess up any b12 testing but I presume that the intrinsic factor antibody test would still potentially deliver a result, is this so?

I have seen so many doctors over the last 30 years, including many privately at great expense. I don't understand how this hasn't been hit on before, my life has been a massive struggle and extremely limited.

My ME/CFS diagnosis (if you can call it that) will certainly have to be removed as already I don't meet the criteria.

I've written to my GP describing what I'm doing and my situation but I've had no response. Can anyone suggest a pathway towards a re diagnosis?

Best regards

Simon

Written by
Uluru72 profile image
Uluru72
To view profiles and participate in discussions please or .
Read more about...
9 Replies
Bluebell7575 profile image
Bluebell7575

Hello Simon,

I’m sorry to hear you have been suffering for so long. I am happy to hear that you are self injecting so that you can start to heal.

You can get a parietal cell antibody test and intrinsic factor testing. Both are blood tests. You will need to come off B12 for 2 weeks for intrinsic factor testing. Keep in mind, only 40-60% of people test positive to intrinsic factor antibodies even if they have pernicious anemia. You don’t have to come off B12 for parietal cell testing.

Now that you’re injecting, your B12 will be high so no need to test that anymore. There are some other tests you can do like MMA and homocysteine but the 2 tests above are the ones that give a definitive diagnosis (at least in Canada where I am).

Good luck!

newlandvale profile image
newlandvale

You could ask to see your medical notes (and pay for the honour!) or sign up to Patient Access which has some past records of blood tests.

tomdickharry profile image
tomdickharry in reply tonewlandvale

I'm just doing that but no approval yet from NHS. Does anyone know about NHS notes storage?

I was diagnosed with PA around 1985 and received regular injections until 2020. My then GP Told me I didn't need them then ignored me totally. So now I changed my GP again, but he tells me there's no mention of my diagnosis in my notes.

Am I being bad-minded in thinking this could be deliberate, or could it be clerical error? I always thought that the old-fashioned hand-written cards still had to be maintained.

Additionally. I have malabsorption, pancreatic insufficiency, and now reflux with hiatus hernia requiring PPIs. Every one of these needs B12 injections.

Oh why won't they listen?

Ghound profile image
Ghound

Hi Uluru, I'm so sorry you've had to go through all this 😔 For a start, your GP really should reply to your letter and hopefully suggest a consultation.

Chase them up and at the same time, as Newlandvale suggests, request to see your medical records.

The good news is that it is now free to access your records, - see the NHS website .

If you're having positive results from injections it sounds like you're correct in your assumption of B12 deficiency.

Your doctor should pay attention to the red flag of your father's illness.

It's difficult when you're ill, but starting with your GP, keep pushing for an NHS referral and some answers !

I'm glad your health is beginning to improve with the injections, there is light at the end of the tunnel !

Wishing you all the very best x

Ghound profile image
Ghound

Apologies , I've just spotted your name Simon x

Uluru72 profile image
Uluru72

Thanks for the helpful responses. Any mention of what happened to my father has been ignored as he was never diagnosed but his suite of symptoms was perfect for B12 and his wasting away and death was enough of a mystery for an autopsy to be done. He was presumed to have bowel cancer, but no sign of that was found.

Sleepybunny profile image
Sleepybunny

Hi,

Great to have some positive news on the forum that you're seeing improvements.

I'm assuming you're in UK so let me know if you're not.

I'm posting a lot of information so worth taking at least a week to look through it all.

Misdiagnosis of B12 deficiency as other conditions

b12deficiency.info/misdiagn...

martynhooper.com/2018/02/10...

Link about "What to do next" if B12 deficiency suspected or recently diagnosed

b12deficiency.info/what-to-...

Unhappy with Treatment (UK info)?

How to write letters to GPs about B12 deficiency

b12deficiency.info/b12-writ...

If you suspect PA, worth joining and talking to PAS.

PAS (Pernicious Anaemia Society)

Based in Wales, UK. Has some overseas members.

pernicious-anaemia-society....

There is a helpline number that PAS members can ring.

PAS membership is separate to membership of this forum.

Testing for PA

pernicious-anaemia-society....

Have also read that a pepsinogen test may be useful.

Some laboratories say to leave at least 48 hours after a b12 injection before testing Intrinsic Factor Antibodies (IFA or IFAb) and some say up to two weeks.

B12 Deficiency Info website

b12deficiency.info/

Stichting B12 Tekort (Dutch website with English articles)

stichtingb12tekort.nl/weten...

Some UK B12 documents

NHS article about B12 deficiency (simply written)

nhs.uk/conditions/vitamin-b...

BSH Cobalamin and Folate Guidelines (aimed at health professionals)

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

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

stichtingb12tekort.nl/engli...

BNF Hydroxocobalamin

bnf.nice.org.uk/drug/hydrox...

NICE CKS B12 deficiency and Folate deficiency

cks.nice.org.uk/topics/anae...

There are currently new NICE guidelines in development for Pernicious Anaemia and B12 deficiency. These should be published November 2023.

nice.org.uk/guidance/indeve...

If you click on "project documents" then on "consultation comments and responses" it gives a good insight into current issues around diagnosis and treatment (lots of pages).

I urge UK forum members to find out what's in the local B12 deficiency guidelines for their ICB (Integrated Care Board) or Health Board. If you can't find local guidelines online or by searching forum posts here then best bet is to submit a FOI request to ICB or Health Board asking which B12 deficiency guidelines are used locally and for a link to or copy of them.

Read this UK blog post if you want to know why I suggest this.

b12deficiency.info/gloucest...

Coeliac disease

Have you been tested?

NICE guidelines coeliac disease suggest anyone with unexplained b12, folate or iron deficiency should be tested for coeliac.

nice.org.uk/guidance/ng20

If you were tested in past and had a negative result then check the GPs followed the recommended diagnostic process...some don't.

A person with coeliac disease can get a negative result in the tTG IgA test for coeliac disease if

1) they have IgA deficiency

2) they were not eating enough gluten before blood was tested

More info on Coeliac UK website

coeliac.org.uk/home/

Risk Factors for PA and B12 Deficiency

pernicious-anaemia-society....

b12deficiency.info/what-are...

b12deficiency.info/who-is-a...

Next link about causes of B12 deficiency is from a Dutch B12 website

b12-institute.nl/en/causes-...

Two useful B12 books

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

Martyn Hooper is the chair of PAS (Pernicious Anaemia Society). Some of the UK treatment info is out of date. See NICE CKS and BNF link.

"Could it Be B12?: An Epidemic of Misdiagnoses" by Sally Pacholok and JJ. Stuart (US authors)

Very comprehensive with lots of case studies.

"I have seen so many doctors over the last 30 years, including many privately at great expense"

I can so relate to your comment above and I bet many other forum members will too.

Wrong ideas about B12 deficiency

Many of us have met doctors and other health professionals who lack understanding of B12 deficiency.

Misconceptions about a B12 deficiency

(From Dutch B12 website - units, ref ranges, treatment patterns may vary from UK)

stichtingb12tekort.nl/engli...

Diagnosis and Treatment Pitfalls

(From B12 Institute in Netherlands - units, ref ranges, treatment patterns may vary from UK)

b12-institute.nl/en/diagnos...

B12 article from Mayo Clinic in US

Aimed at researchers and health professionals.

Best article I've read on B12 deficiency.

The Many Faces of Cobalamin (Vitamin B12) Deficiency

ncbi.nlm.nih.gov/pmc/articl...

Table 1 in above article is about frequent misconceptions about B12 deficiency that health professionals may have.

Links to forum threads where I left other detailed replies with lots of B12 deficiency info eg causes and symptoms, more UK B12 documents, B12 books, B12 films, more B12 websites and B12 articles and a few hints on dealing with unhelpful GPs.

Some links may have details that could be upsetting.

Some of the info will be specific to UK.

healthunlocked.com/pasoc/po...

healthunlocked.com/pasoc/po...

healthunlocked.com/pasoc/po...

I am not medically trained.

Link to thread about Patient Safety, has useful links for those who have difficult health experiences in UK

healthunlocked.com/pasoc/po...

Hockey_player profile image
Hockey_player

With your immense improvement, do you really feel like you need an official diagnosis? One problem is that the tests are not very accurate. I never got an official diagnosis, but I went from sleeping 16 hours per day with a whole host of other symptoms in just a few days by taking B12. Eventually, I had nerve issues in my feet and switched from supplements to injections. Why not just assume you have pernicious anemia and continue life long supplements? I don't think it would help very much if you did not have a problem.

Uluru72 profile image
Uluru72 in reply toHockey_player

I agree with you that the specifics of my diagnosis are secondary to my improved health. However my current ME/CFS diagnosis has practical implications; I can't take out certain types of insurance, my mortgage is more expensive. From a clinical point of view PA would predispose me to an increased probability of some other conditions, things which I'm sure my wonderful GP would be monitoring. Essentially, I would rather be correctly diagnosed, officially, than not. I'm also on amitriptyline for peripheral neuropathy, I don't need that anymore, my overall situation needs to be reconsidered.

Not what you're looking for?

You may also like...

Help please - PA diagnosis

Can anyone please help? So I've just come back from my GP appointment regarding b12 deficiency, and...
helsbells80 profile image

Advice on diagnosis please

Hi, I'm having monthly b12 jabs with Hydroxocobalamin but as yet don't have a PA diagnosis. I'm...
poppym09 profile image

B12 made symptoms go away

Hi. I had ME/CFS and it seemed to clear up 16 years later. About 3 years ago, I had fatigue,...
MEguy profile image

I've been thinking a lot about people's misdiagnoses........

We talk a lot about the vast number of people who have been misdiagnosed, who went on to self...
BeachArt profile image

Help with getting a diagnosis for myself and daughter!

Me and my daughter are currently having problems getting a diagnosis, my daughter is 16 and has...
nichola79 profile image

Moderation team

See all
Gambit62 profile image
Gambit62Administrator
Foggyme profile image
FoggymeAdministrator
taka profile image
takaAdministrator

Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.

Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.