I'm curious to know...

[Irene]

How many members also have another auto immune disease. I started with thyroid nodules, moved on to ovarian cancer and have ended with ibs/coeliac disease. Be interested to know which came first with you. (PS now confirmed with pernicious anaemia as well)

[vikkihope]

Yes I do I also have ibs, I've had enlarged heart, inflamed liver, rheumatoid arthritis, high blood pressure, the list goes on never been right since I diagnose 11 years again, how I have written it is how it all started, I'm sure many others are like this as well

[shaws Administrator]

I was diagnosed with pernicious anaemia 15 years ago. It was diagnosed before any symptoms showed and it has never given me a problem as I have quarterly injections. I have since read I should have been given a yearly thyroid test on the off-chance but never did.

<b>Updated on Aug 16 2010 5:30PM:</b> I had a Schilling's test to confirm the intrinsic factor. My mother also had pernicious anaemia..

I prefer the quarterly injections.

Rod has given very clear information on PA.

They say Rheumatoid isn't inherited, but my sister and daughter are both severely disabled with it. They were both 23 when when they had their first flare-up.

[Irene in reply to shaws]

Thats interesting. I've recently been told I have very low B12 and have received a couple of injections. I'm waiting for the results of a test to see if this is a result of intrinsic factor being missing (Pernicious anaemia) or due to non absorbtion for another reason e.g. Coeliac.

[Alli1 in reply to shaws]

Hi Irene

I have low B12 and I'm wondering what further tests are you having in order to find out if there is a problem with the intrinsic factor?

Alli

[helvella Administrator Thyroid UK in reply to shaws]

Alli,

This snippet is from the Brighton and Sussex University Hospital's Pathology department.

ImmunologyGastric parietal cell (GPC) antibody

These are present in individuals with autoimmune gastritis and pernicious anaemia. However they are not specific for these conditions, as they may be also found in healthy individuals, particularly with increased age, and in those with other autoimmune conditions (thyroiditis, Addison’s Disease, IDDM). If Vitamin B12 levels are low then intrinsic factor (IF) antibody should be requested in addition to gastric parietal cell antibodies. These will be sent to an external laboratory. GPC antibody is more sensitive but less specific for pernicious anaemia than IFantibody.

pathology.bsuh.nhs.uk/Patho...

And all injection-receivers may be interested in this snippet about the use of oral B12.

Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency

Vitamin B12 deficiency can cause anaemia and neurological complications. Vitamin B12 is rarely prescribed in the oral form in most countries. Two randomised controlled studies were included in this review. The trials recruited a total of 108 participants and followed up 93 of these from 90 days to four months. The evidence derived from these limited studies suggests that high oral doses of B12 (1000 mcg and 2000 mcg) could be as effective as intramuscular administration in achieving haematological and neurological responses.

www2.cochrane.org/reviews/e...

Oral B12 is available in a variety of forms including a metered spray which does not contain any sugars/sweeteners (and tastes nice) and various tablets.

I was reading a paper the other day which discussed parietal cell antibodies and intrinsic factor antibodies. At point of diagnosis of autoimmune thyroid disease, 24.5% had parietal cell antibodies and 4.8% had intrinsic factor antibodies.

After 5 years, 24% of those who originally had no parietal cell antibodies now had a positive test result.

ncbi.nlm.nih.gov/pubmed/206...

This appears to show a strong connection between autoimmune thyroid disease and autoimmune gastritis (which often develops in those who have parietal cell antibodies).

All the best

Rod

<b>Updated on Aug 16 2010 6:33AM:</b> And if you want even more, this whole paper is available online here:

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

Pernicious anemia: new insights from a gastroenterological point of view.

Abstract

Pernicious anemia (PA) is a macrocytic anemia that is caused by vitamin B(12) deficiency, as a result of intrinsic factor deficiency. PA is associated with atrophic body gastritis (ABG), whose diagnosis is based on histological confirmation of gastric body atrophy. Serological markers that suggest oxyntic mucosa damage are increased fasting gastrin and decreased pepsinogen I. Without performing Schilling's test, intrinsic factor deficiency may not be proven, and intrinsic factor and parietal cell antibodies are useful surrogate markers of PA, with 73% sensitivity and 100% specificity. PA is mainly considered a disease of the elderly, but younger patients represent about 15% of patients. PA patients may seek medical advice due to symptoms related to anemia, such as weakness and asthenia. Less commonly, the disease is suspected to be caused by dyspepsia. PA is frequently associated with autoimmune thyroid disease (40%) and other autoimmune disorders, such as diabetes mellitus (10%), as part of the autoimmune polyendocrine syndrome. PA is the end-stage of ABG. Long-standing Helicobacter pylori infection probably plays a role in many patients with PA, in whom the active infectious process has been gradually replaced by an autoimmune disease that terminates in a burned-out infection and the irreversible destruction of the gastric body mucosa. Human leucocyte antigen-DR genotypes suggest a role for genetic susceptibility in PA. PA patients should be managed by cobalamin replacement treatment and monitoring for onset of iron deficiency. Moreover, they should be advised about possible gastrointestinal long-term consequences, such as gastric cancer and carcinoids. 2009 The WJG Press and Baishideng. All rights reserved.

ncbi.nlm.nih.gov/pubmed/198...

[Alli1 in reply to shaws]

Thank you so much Rod for all this info, interesting reading.

Alli

[Annamaria in reply to shaws]

i have had half knee replacements due to trauma induced osteo arthritis and the extra weight that i have put on due to being hypo is playing havoce with my knees so am desperately trying to lose weight but am finding it very dificult.

[Irene in reply to shaws]

Hi Alli - the doc ordered a parietal(?) test. This takes longer than basic blood test, that said I need to chase now for the results. I think they've forgotten to mail out to my gp.

<b>Updated on Oct 26 2010 5:03PM:</b> Confirmed pernicious anaemia after the intrinsic factor antibody test came back positive. Now on b12 injections for life as oral b12 can't be absorbed via the stomach as the intrinsic factor needs to be present in order to process it.