Re-reading Martyn Hooper

[Wwwdot]

Hi Guys

I have had such an extraordinary week chatting with you on this forum that my head is buzzing with PA questions!

I am having a PA review and research day today.

I am revisiting "What you need to know about PERNICIOUS ANAEMIA AND B12 DEFICIENCY" by our wonderful Martyn Hooper. The following paragraph on page 143 struck a cord in relation to this week's exchanges about frequency of self-treatment:

"In other words, the patients who were given large doses initially needed large doses for maintenance, while those who were started off on small doses only needed small doses in the future. Now why could that be? Often when modern-day patients ask for more frequent injections they are told that 'the more you receive the more you want' which, as far as I've [Martyn Hooper] been able to discover is based on no scientific evidence, but is a way of telling the patient that he or she is imagining that they need more injections. But the 1958 paper was not based on patient's feeling of wellbeing but instead on close inspection of the patient's blood. And patients who were given large doses initially needed large doses for maintenance, not to feel well, but to prevent their blood deteriorating. Why this was the case is not explained by the researchers and I [Martyn Hooper] haven't been able to find any papers that re-examine this phenomenon." Note my (wwwdot) emphasis in bold type and addition in [].

(The 1958 paper is Darby WJ, Bridgeforth EB, Le Brocquy J, Clark SL Jr, De Oliveira JD, Kevany J, McGanity WJ, Perez C. Vitamin B12 requirements of adult man. American Journal of Medicine 1958; 25(5):726-732)

This certainly puts our recent discussions and experimentation with frequency of injections into context.

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[WIZARD6787]

Sweet! Thank you for that. I have often felt that on a certain amount of B12 after a while my body heals and that becomes the new normal. And the new normal results in my knowing I need more B12.

[Narwhal10]

Great work Wwwdot.

If anyone is healthy enough and can go on a running or walking machine it asks you to put in your height and weight. It attempts to work out your Basal Metabolic Rate.

The number is a fib. Then the computer will work out how many calories you have burnt by walking 1 kilometre in 10 minutes with a Heart Rate of 101 beats per minute. Well they started with a fib, so the amount of calories is wrong.

Our Basal Metabolic Rate constantly changes when we are active, when we sleep, when we eat, after we eat. It is a bit like Body Mass Index. One woman was told she was Grossly Obese. So, she told the Doctor to look at her Occupation. Then asked Shall I undress ? A Professional Bodybuilder has very low Body Fat and she was ripped. She most probably could have picked him up and bench pressed him 10 times.

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[Wwwdot in reply to Narwhal10]

Hi Narwhal

An interesting point and I think all these metrics are being misused to potentially damaging effect

My BMI says I am obsese but I am a size 12 and 5’4” - and I go by the ratio of my waist to my height to defend my weight! I don’t see how I can lose weight without getting smaller than I was in my 40’s! I only eat two small meals a day, very rarely eat sweets or sugary food so “cutting back” is not an option - unless I omit my wine in the evenings which I have calculated cannot account for my “obesity”!

I think the smallholding and constant activity doing things helps my fat to muscle ratio.

It’s one thing being ahead of the curve in terms of vision and awareness and quite another to be completely off the curve when it comes to ones health!

C’est la vie!

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[Narwhal10 in reply to Wwwdot]

You sound perfect so there is no need to defend yourself. So, our metabolic rate at which we breakdown drugs i.e. Hydroxycobalamin, methylcobalamin have been nicely summed up by Onoji Faith Oghenevovwero, Renal medicine. Take this is your PA Review :-

portal.abuad.edu.ng/Assignm...

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[Wwwdot in reply to Narwhal10]

Hi Narwhal

Clever no doubt and useful to many, but I don’t understand it. This is a Sunday head down exercise! 🤣🤣🤣

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[WIZARD6787 in reply to Wwwdot]

The BMI as far as I know has been discredited. A case of good science being poorly applied.

[Bellabab in reply to WIZARD6787]

The original BMI used THREE measurements - height - weight and skin fold thickness at the waist. Without the last its fairly meaningless

[Wwwdot in reply to Bellabab]

Oh that’s interesting so yet another example of useful info being dumbed down!

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[Mixteca in reply to Wwwdot]

I wish I was a size 12 again! A healthy size at your height I reckon. I was getting closer to a 14 in some areas (some excess fat but a fair amount of muscle) but I'd rather have kept that all that weight than be how I am now.

[Narwhal10 in reply to Mixteca]

I have to lie down a lot to manage severe pain and can only eat once a day but I am PHAT - it means cool or excellent. I wear a badge that says Silently judging you.

The amount of people I ask, Are you ok ? Because their walk is doddery. Everyone thanks me. Yesterday, in a charity shop, I had a chat with the woman. Her husband was a Mathematician and had been involved in research. He was undertaking the calculations for the Answers to Happiness. I just hope that Wwwdot’s review goes well.

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[Wwwdot in reply to Narwhal10]

Hi Narwhal

So sorry to hear your pain is so severe.

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[Narwhal10 in reply to Wwwdot]

Thanks Wwwdot,

I just get on with it and breathe through it. The amount of sports injuries I have had means I am a wonky donkey anyway. We are still knock outs though meaning beautiful people.

😘

[Wwwdot in reply to Mixteca]

Hi Mixteca

My weight has always been an issue since I was a child - no-one looked at me and said you look healthy and not over weight. They always went by the numbers on the scale - I lost my youthful years to feeling ugly and fat and only now in my 60s I realise I wasn’t! Society has a lot of influence- good and not so good.

I am sure you will fill your clothes again!

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[Narwhal10 in reply to Wwwdot]

Oh Wwwdot,

No fair, sad about that. Caribbean women’s curves are held in high esteem. It means they are wealthy and can afford. I do not buy into Western society idealism. Twiggy and Kate Moss - heroin chic no way Hose.

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[Mixteca in reply to Wwwdot]

Definitely. Society, and some families, have a lot to answer for. Women wouldn't feel like you sadly did if we weren't judged so heavily about our bodies. Who gets to decide what looks are desirable or beautiful? Eating disorders become a part of so many women's' lives. It's hard to feel confident when there's so much pressure to conform to some unobtainable and unrealistic ideal.

I gave away some lovely pairs of trousers I could no longer fit into - no more size 10s for me, which was fine once I'd bought bigger sizes. Those clothes practically fall off me now, but I'm now living in sweatpants, so it's okay.

[Wwwdot in reply to Mixteca]

Hi Mixteca

You are right. It’s not easy to feel comfortable in who you are as so many overt and covert judgements and generalisations.

Sweatpants have their place - and I am sure your wardrobe will expand in due course. Hang in there ♥️♥️

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[Mixteca]

I have plenty of clothes packed away, some lovely garments, in smaller sizes most likely - kept hold of many things, just in case 😘