Help with intrinsic factor results

[Confused1806]

hi all i was recently told i tested positive for gastro parietal cells. This is my intrinsic factor results. Im confused is this a positive or negative? And what would the parietal cells with this result mean?

[Nackapan]

I think around 80% of those that test positive for parietal cell antibody test can have PA. I also don't understand your IFAB test result.

There has been a few posts on this recently.

I thought it was positive or negative

A positive you've PA

A negative result does not rule out PA .

There is not a definitive test.

You shouid be treated on symptoms and a low b12 reading .

If b12 'in range ' functional b12 deficiency should be considered if other things are ruled out.

Sorry not more informative

[Technoid]

The IFAB result seems to be in range. This is not conclusive of anything though unfortunately. You could ask your GP for clarification.

[wedgewood in reply to Technoid]

The trouble with asking a GP for clarification is that so often they are not knowledgeable about B12 deficiency/ P.A.

We have heard so often on the forum that a negative IFAB result means that a patient is told that they don’t have P.A. , so they don’t get treatment . It’s really quite frightening.

[Technoid in reply to wedgewood]

Indeed. It's a terrible situation 😔

[Sleepybunny]

Hi Confused 1806,

Welcome to the forum,

Do you mind me asking which country you are in?

The reason I'm asking is that treatment and diagnosis process can vary between countries.

These links may be useful.

Testing for PA

pernicious-anaemia-society....

Thread about tests for PA/B12 deficiency

healthunlocked.com/pasoc/po...

What to do next if B12 deficiency suspected or recently diagnosed

b12info.com/

Have you considered joining PAS (Pernicious Anaemia Society) if you suspect you have PA?

PAS (Pernicious Anaemia Society)

Based in Wales, UK.

pernicious-anaemia-society....

There is a helpline number that PAS members can ring.

PAS membership is open to people worldwide. You do not need a PA diagnosis to join.

PAS membership is separate to membership of this forum.

pernicious-anaemia-society....

A negative or normal range result in IFA test does not rule out PA.

It's possible to have Antibody Negative PA.

Diagnostic flowchart which mentions Antibody Negative PA.

stichtingb12tekort.nl/engli...

Two useful B12 books

Published a few years ago so some bits may need updating.

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

Martyn Hooper is the former chair of PAS (Pernicious Anaemia Society).

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

Very comprehensive with lots of case studies.

If you're in UK...

I suggest you search online for this UK document "NICE CKS Anaemia B12 and Folate deficiency" and try to read all of it including Background Information section.

Try to find the local B12 deficiency guidelines used by your ICB (Integrated care Board) in England (Health Board in Wales/Scotland). If you can't find them online or by searching forum threads here then best bet is to submit a FOI (Freedom of Information) request to ICB or Health board asking which B12 deficiency guidelines they are using and for a link to or copy of them.

I've written many detailed replies on this forum which may be worth looking at.

There is a pinned post "Various PA/B12D resources" which has lots of links to info about B12 deficiency and PA.

I'm not medically trained.

[Rexz]

It's hard to assess what positive parietal cell antibodies PCaB may mean without additional information. PCaB are not specific to PA. I presume you had, or have, symptoms that had your GP suspecting PA. Did you have B12 deficiency and/or megaloblastic anemia? There is currently only one gold standard test to 100% diagnose PA and that's a pathologist looking at a biopsy of the parietal cells of your stomach and seeing the damage.

So GPs must put together a patchwork of diagnostic tools. The first being symptoms, then serum B12, MMA, Homocysteine levels, PCaB, and IFaB.

Any of these by themselves are not diagnostic of PA. But together they can be. 90% of those with PA will be positive for PCaB but PCaB are not specific to PA. ~50% if those with PA will "show" positive for IFaB. A positive IFaB is much more specific to PA. However, the sensitivity of the IFaB test is purposely adjusted downward to eliminate false positives. That adjustment is what makes this test more specific. So if you truly have PA and your test shows negative for IFaB it does not mean you do not have IFaB. It only means that you don't have high enough levels of IFaB in your system for the test to detect. These IFaB will eventually show up positive as PA progresses to an advanced state. Personally, I originally tested positive for PCaB and negative for IFaB but had PA verified by pathology back in 2020 then IFaB showed up positive in late 2023. Then once all your Parietal cells are destroyed and you've zero IF, the antibodies will lesson over time and again become undetectable. They will always be there much like a virus vaccine over time if you're not exposed to the virus the affect of those antibodies will lesson and thus a booster is needed.

In addition to IFaB test two tests that can be diagnostic of PA are positive PCaB coupled with high levels of serum Gastrin, another simple blood test.

Hope that helps. It can be a bit confusing.

Best wishes, Rexz