is b12 deficiency always PA?

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Hi all. 

I am 4 shots into my loading jabs and have just read my prescription for cobalin and it says that the oral contraceptive pill affects the way the b12 works. I'm now very concerned as my doctor knows I am on birth control but didn't mention this when she prescribed it. I was hoping to try for a baby very soon, but am putting off trying until my b12 levels are up. Level was 181 before b12 injections started. Should I be questioning the prescription? Also, my blood tests for folates and intrinsic factor came back as low but I was advised just the b12 injections were needed, no mention of pernicious anemia. But after reading other comments it would appear if you have no intrinsic factor this is pernicious anaemia. I don't want to question the doctor as I'm sure they know best but I don't want to start trying for a baby until I know my body is fully ready!

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  • Posted

    Hi Kate,  B12 deficiency can be caused by many factors.  But the thing that leaps off the page at me, is that you are low on folates and considering starting a pregnancy.  My recollection is that folic acid is now given routinely to women in pregnancy to try to prevent birth defects (spina bifida, I think). Perhaps somebody else can provide more info.   For goodness sake, DO ask questions, and don't let yourself conceive until everything is in good order with your bloods.

    Best of luck.

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  • Posted

    I will ask the doctor I'm just worried I won't get an appointment until after my final loading jab on Friday and the prescription says the birth control pill affects the way b12 works, like it's all been for nothing and I will need to start again! Saying that I don't want to come off the pill until my b12 levels are normal. I wouldn't try for a baby until I know I'm good to go, I'm just worried I'm relying on my own research rather than that of a professional. I've read that those with low b12 levels shouldn't take too much folic acid as it can have a detrimental affect. Thanks for your reply smile
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  • Posted

    There's nothing to lose by having the jabs while on the pill (they can't do you any harm), but perhaps you will need more of it before you get right.  Folates are involved in the recycling of B12 in your system, so if they are low, you will struggle to hold onto the B12.  I wonder if you need to get a decent loading of B12 before it is wise to start on folic acid?  This is all stuff your GP should be able to explain but, from experience, they won't be well up on the subject - it's too complicated.  I think it's very important to be armed with all your own research so you can ask challenging questions.  It makes your GP sit up and do his own research!  Take notes and questions to the next appointment with you, and record the replies.  Make sure your GP knows that you are hoping to start a family soon, and press them about folate levels.  Ask for copies of blood test results and, if things don't come right fairly rapidly, ask for referral to a haemotologist.   If you feel anaemic and whacked out now, imagine how you would be with a new baby!  Not good.
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  • Posted

    hi Kate. i'm not an expert on b12 but am currently researching it as i'm deficient myself. however, i speak as an ex midwife with some experience in your area of inquiry.

    firstly i'm sorry to hear you're b12 deficient and to hear you've not had good information from your Dr in respect of b12, folate, the contraceptive pill & conception advice. unfortunately GP's don't tend to get much training in this subject and the many ramifications of b12 deficiency. subsequently they tend to be rather under informed on the subject. so it's up to us as patients to take responsibility to get the right treatment & to nudge them in the right direction.

    b12 & folate levels have been found to be lower in ppl on the contraceptive pill. the contraceptive pill interferes with folate metabolism and also affects absorbtion of b12 from the diet. however, as you have limited Intrinsic Factor, absorbtion of b12 will be much reduced, hence the need for the injection treatment route.

    as bluemaran has pointed out, there's many problems associated with low folate in pregnancy, not least the risk of whats called 'neural tube defects' in babies born to b12 & folate deficient mums. there's also other associated problems such as a higher incidence of post natal depression in mums and 'developmental delay' in babies of b12 deficient mums.

    so the good news is that you have been diagnosed & are about to be treated. it's advisable to keep tabs on your levels and not to try for a baby untill both levels are high. do ensure that both are monitored throughout your pregnancy when that happy occasion happens. about a month after your final loading dose, you should have your levels assessed. make sure they check your folate levels too as they sometimes omit to do this. b12 cannot be optimally absorbed & utilized unless there are healthy levels of folate in situe. they work hand in hand.

    hope this is helpful and all good luck with your journey back to healthy levels of folate & b12 and eventual conception.

    Caitlin.

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    • Posted

      Thanks Caitlin

      That's really helpful. I will just have to take the bull by the horns and be brave with the doctor!

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    • Posted

      all good luck Kate. we're all rooting for you on here as we know how challenging this condition can be.

      Caitlin

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