To remind you of his background, two stents in 2018. He has heart disease due to genetics not lifestyle. He doesn’t drink excessively or smoke, has a bit more tum than in his youth but still does a physical job as a builder. He’s been on a low dose Avristatin, Asprin, Ramipril and Lansoprazole for 5 years without any checkup or review since discharge from consultation care
His B12 was 201 ng/l (145-800) and folate low, but iron high (over upper limit by 33%), MCV elevated too.
He’s had 12 B12 jabs and 5mg folate and is feeling better and acting better too! Now onto once weekly then monthly .
Seen cardio and had ultrasound - perfect - stents clear, no iron build up in the heart, all pumping well as it should.
Resting cardio, “odd” and treadmill cardio showed “odd” responses according to Cardio consultant but hubby had no chest pain or discomfort firing 9 minute exercise and recovered well. His starting BP was high at 160/96 but Cardio consultant put this down to the test conditions. Hubby is usually around 140/90 but we are working to reduce it to 130/80 if we can.
Cardio is comparing “odd” results to discharge results in 2018 as “odd” might be normal for hubby.
Cardio is taking hubby off Lansoprazole (yay!) and putting him on something “less effective” but not damaging to stomach (ironic as the Lansoprazole is described as “to protect tummy” on the dispensing label!).
No other change to meds.
Cardio not concerned about the diagnosis of autoimmune thyroid disease. Is this because of the medical “silo” mentality as I expected it to be of more interest?
Next step it to get GP to test T3 and T4 - another battle probably but I do hope not! Just to make you laugh after all the fuss by the GP over hubby NOT needing B12 they called him in fir a blood test - you guessed it - they tested his B12 and are concerned it’s too high now 🤦♀️🤦♀️
Hope I have given a reasonable take on what’s in my head!
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Good that the b12 reading is high . No need for concern about that . Doctors should know that ! The B12 needs to be high . No need to test it once treatment has started. This is stated in the guide-lines .
I often wonder if he truly realises what a wonderful service he made for so many people . He has saved many lives There is no doubt about it . Now that I know so much about P.A. and B12 deficiency symptoms through this forum and Martyn’s books , I am 100% sure that my mother died of P.A. Her B12 was never tested , and she did develop so many of the symptoms , that we know are associated with b12 deficiency .Yes, towards the end , there was the dementia , which is different to Alzheimer’s . If only I had known about this condition way back then . … It is a very slow and insidious death . ( Pernicious indeed!)
I think my Dad died of PA and the stomach cancer. He had all the symptoms and no one could work out why he was declining over a period of 15 years - he died at 68.
MARTYN has no doubt saved many lives including me and hubby. I would have been clueless and completely accepting our decline was old age and to be expected if not for this forum.
If he is hypothyroid, then low stomach acid is possible with that too. Make sure you post any thyroid results on the TUK forum. Docs are often as 'good' with thyroid as they are with B12
Has he had or will he have an endoscopy at some point?
He had one about 8 years ago and Cardio Consultant is talking about one.
What I am concerned about as a lay wiffy is that the symptoms of low stomach acid can mimic those of high stomach acid. The medic bods keep treating him for high stomach acid and hubby is convinced he has that too. But as I keep trying to explain high stomach acid may have been the problem pre Lansoprazole but given low B12 now and 5 years on Lansoprazole it could be that symptoms are now low stomach acid.
Is there a test to show what level the stomach acid is?
Yes there is a test! They don't seem to want to do it often though. It is done during an endoscopy. I don't have a reference / link to it sorry. If i find one i will send it.
They can also measure gastrin & pepsinogen in the blood (morning test after a fast of 12-14 hours).
The blood test sounds better. I need that too. I am trying to avoid invasive investigations as the number of people I know with post hospital, post operative and post investigative infections is very worrying. I don’t think they sing the full verse of “Happy Birthday” when wading their hands!
Just to add, periodic screening with endoscopy is not a bad thing. My father took PPIs for years and never once had an endoscopy nor saw a specialist. After he had swallowing problems, they found he had late stage esophageal cancer. My GI now thinks it may have been stomach cancer - I often wonder if he had B12 problems, but we didn't know any of this back then. He died 20 years ago in his mid-50s.
And you may know Rex's story now too - never had an endoscopy and after low B12 they found stomach cancer.
I get an endoscopy every 2 to 3 years because of my family history but also because they always find something 'interesting'.
Thank you that’s interesting. I am sorry to hear about your Dad and Rex’s story. I am not against and endoscopy I just want them to rule out other things first.
And now my donkey is really sick. Vet coming again today at least my animals get looked after …
I wish she could talk as she knows she’s unwell and keeps cuddling me ie standing very close with her head down. I think this is going to be an expensive month!!
Donkey is on B vitamin mix and probiotic! They don’t think it’s cancer or an abscess or a hernia - they are stumped so they are going to ring the vet at the donkey sanctuary who will give free advice vet to vet. Taken bloods and given her a pain killer. Heart and lungs ok. No temperature. Got to feed her fresh grass as she’s not eating (she gobbled it down which is good) and electrolyte every 4 hours. I am going to be busy!
Makes total sense to do that if having an endoscopy anyway. Why on earth are they so reluctant? I had a phone appointment with a gastro and I asked about a gastrin test - he didn't know what I was on about! Had the endoscopy and various biopsies but that opportunity was missed 🤯
So good he's coming off the PPI. He may be put on an H2 Blocker which is a vast improvement, gentler, much less damaging and in my experience much more effective.
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