Pernicious Anaemia testing

[GreenTealSeal_]

Hello,

Do you have to stop supplementing B12 in order to test for PA?

What specific tests should I be requesting to rule this out please?

Thanks

GTS

[Nackapan]

No.None of the tests are conclusive

The whole clinical picture should be looked at .

Symptons .

The Intrinsic factor antibody used.

Picks up around 40-50% of those witb PA .

The NICE Guidelines March 2024 worth reading .

[GreenTealSeal_ in reply to Nackapan]

Thank you! Sorry I think you said that in my other post but I’m struggling to absorb all the info!

Interesting that there is no definitive test.

Can the numbness and tingling associated with PA come and go? Or is it permanent?

I’ve had issue with it in my toes, legs, arms and fingers for the last 3 years but it comes and goes!

Will mention all this to my dr and hope they listen!

[Nackapan in reply to GreenTealSeal_]

Hopefully with enough time and B12 it will go.Or at least improve.

[WiscGuy]

The question regards B12 deficiency. The absorption process for B12 is much, much more complicated than for any other vitamin or mineral, and can break down anywhere along the absorption pathway. Pernicious Anemia refers only to the part of the pathway that is in the stomach. When a person has insufficient B12 available in the cells, for any reason, including PA, it is called B12 deficiency (though it is commonly referred to generically as pernicious anemia). There is no gold standard test that can determine whether there is sufficient B12 available in the cells. As has been mentioned, the diagnosis is therefore a clinical diagnosis, not a diagnosis based on lab tests results. Primary information for a clinical diagnosis comes from symptoms. If no other cause can be determined for the symptoms, the recommended procedure is to inject B12 every other day or twice a week for 3 months, and check to see whether symptoms are improved. The problem is that most physicians know very little about B12 deficiency: they think B12 is toxic (it's not), or they think lab tests are definitive (they are not), or they think injections have achieved healthy levels based on blood test results (that's bunk), and on and on. Another problem is that most physicians have no idea what the symptoms of B12 deficiency are. For a listing of the biggest mistaken beliefs of physicians, google the article, "The Many Faces of Cobalamin (Vitamin B12) Deficiency", with first author Bruce Wolffenbuttel, and look at the box on the second page.

You want to stop all B12 supplements (daily vitamins, Super B vitamins, etc) before testing, because B12 supplements can produce false results of the serum B12 tests, which many physicians think are definitive. The supplements can boost the serum B12 level into the normal range (a low bar) while not sufficiently boosting the amount of B12 available to the cells.