Pernicious Anaemia or Dietary?
Posted , 3 users are following.
Hi everyone,
basically I've had neurological issues, dizziness, stomach pain etc etc (nearly all the symptoms for b12 deficiency) for a couple years now. I had blood tests done and was told I had a b12 deficiency and Vitimin D deficiency in late 2016/early 2017 and had 5 booster shots in a week. I felt a lot better after a couple months but then started going downhill again a while later and went back for more blood tests. They said my b12 was fine and I ended up not going to the doctors until last week when my symptoms were getting so bad (extremely bad dizziness and nerve tingling in my neck, arms, legs, head etc). Had another blood test and they said my B12 was low again and I'm now having injections every 3 months, This made me think that it is probably due to pernicious anaemia since its only been about a year since I had my previous injections. However, the nurse who gave me my shot today went back in my notes all the way to 2014 when apparently I had a blood test done and my b12 levels were on the borderline of being low and said how they've just been declining as the years have gone on apart from when they were fine for those few months, She then proceeded to say (as the doctor I had a year ago did) that it is probably due to my diet since I am a vegetarian and don't have a lot of dairy in my diet. Which I could see why since its a high source of b12 but I wasn't even a veggie in 2014 and ate quite a lot of meat, but my levels were already nearing the low side. If it was my diet still surely my levels wouldn't have dropped so fast after having the initial booster shots as well? Since my Doctor now has said I need to have injections every 3 months (this was only relayed to me over the phone by the receptionist so I could book a day for my injection) which is typically done for people with pernicious anaemia (Which there is also a family history for), does that mean I have pernicious anaemia or it is my diet? I'm planning on making another appointment with my Doctor to discuss this more but in the time being I'm worrying that it is due to my diet and I've brought these horrible symptoms on myself. What do you guys think?
Thanks in advance,
Millie
1 like, 2 replies
patricia64333 Milliemaria42
Posted
Hiya Millie, I started symptoms last March 17, my feet felt like I'd trodden in stinging nettles,and were hot and itchy,that went on for 2 weeks,then left me with a tingling sensation, Dr just said r u a diabetic ? Said no ! B12 deff not mentioned till sept, when blood test result came back was told they were ok.
November I'd had en ough, went back, Dr said have u been checked for b12,said yes, she looked at test results and said 169,they r a bit low, so had 6 loading shots, followed by test for folic levals,which were 3, but!! Folic acid tabs make me feel sick.what to do ?? I take omeprazole tabs for reflux,so can't absorb normal tabs, I'm currently having follow up every 8 weeks, but they gradually wear off so I take sublingual tabs.now this is probably , not answering your question is it, sorry, !! you say is it because you bring it on yourself, NO !! Certainly not, looking back over the last 5 years I've have had all the symptoms off b12 deff, but put each one down to, age!! Ibs!!recovering from cancer!!, arthritis!! I worked for 17 years for a GP, and consider myself to have a little medical knowledge, but not once did I Think about b12, deff. My Dr didn't test for it, I think that today so little is known about it by medical professionals, that it's the last thing they look at, I'm so glad my own GP has taken on board all the info I get off these brilliant web sites, I read as much as I can about pa, and understanding it's not your fault goes a long way to recovery, this is not something you've brought on yourself,, I hope I have helped in someway to help you put your mind at rest, and understand more.keep reading answers via this website.
Tricia 2710.
clivealive Milliemaria42
Posted
Anyone at any age, can become B12 deficient. However, certain people are at an elevated risk. They include the following:
Vegetarians, vegans and people eating macrobiotic diets.
People aged sixty and over
People who’ve undergone any gastric and/or intestinal surgery, including bariatric surgery for weight loss purposes (Gastric bypass).
People who regularly use proton-pump- inhibitors. H2 blockers, antacids, Metformin, and related diabetes drugs, or other medications, or infections such as h-pylori that can interfere with B12 absorption.
People who undergo surgeries or dental procedures involving nitrous oxide, or who use the drug recreationally.
People with a history of eating disorders (anorexia or bulimia).
People with a history of alcoholism.
People with a family history of pernicious anaemia.
People diagnosed with anaemia (including iron deficiency anaemia, sickle cell anaemia and thalassaemia).
People with Crohn’s disease, irritable bowel syndrome, gluten enteropathy (celiac disease), or any other disease that cause malabsorption of nutrients.
People with autoimmune disorders (especially thyroid disorders such as Hashimoto’s thyroiditis and Grave’s disease) Type 1 diabetes, vitiligo, lupus, Addison’s disease, ulcerative colitis, infertility, acquired agammaglobulinemia, or a family history of these disorders.
Women with a history of infertility or multiple miscarriages.
Your vegetarian diet will be a contributory factor. Do you "see yourself" in any of the other "People"? B12 is stored in the liver and can hold several years worth but will need "topping up".
Symptoms of B12 deficiency tend to develop slowly and may not be recognised immediately. As the condition worsens, common symptoms include:
Weakness and fatigue
Light-headedness and dizziness
Palpitations and rapid heartbeat
Shortness of breath
A sore tongue that has a red, beefy appearance
Nausea or poor appetite
Weight loss
Diarrhoea
Yellowish tinge to the skin and eyes
If low levels of B12 remain for a long time, the condition also can lead to irreversible damage to nerve cells, which can cause the following symptoms:
Numbness and tingling in the hands and feet
Difficulty walking
Muscle weakness
Irritability
Memory loss
Dementia
Depression
Psychosis
The test for Pernicious Anaemia checks for Intrinsic Factor Antibodies.(IFA)
In a normal healthy person the stomach lining has what are called "Gastric parietal cells" which produce "Intrinsic Factor" which travels with food through the small intestine which is made up of three parts - the Duodenum, the Jejunum and the Ileum..
Iron is absorbed in the Duodenum, most other nutrients in the Jejunum and our friend B12 in the Ileum.
Here the Intrinsic Factor binds to the B12 and the "B12/IF Complex" enters the cells on the wall of the Ileum after binding to receptors on the surface of the Ileal cells, allowing it to enter the blood stream.
Sadly some people with "traditional P,A." either do not produce Intrinsic Factor or if they do, they also produce an antibody which destroys it and it is then called "Autoimmune Pernicious Anaemia".
In addition it can happen that we produce "Parietal cell Antibodies" and "Intrinsic Factor Antibodies" which totally wipes out any chance of absorbing the B12.
Sadly, the IFA test is unreliable in that it gives false negatives in people with PA half the time. So a negative result doesn't mean that you don't have PA. However, a positive result is a sure-fire, 95% certain indicator of PA.
Treatment for PA and non-dietary vitamin B12 deficiency is virtually the same.
The symptoms of PA are the symptoms of the B12 deficiency that it causes. If the cause isn't dietary then it is an absorption problem so you need to find another way of replenishing B12 initially. Most absorption problems aren't treatable but a few are - notably h pylori infection - which would mean that once that has been dealt with you would be able to absorb B12 from your diet so wouldn't need maintenance shots for life.
There is a complex interaction between folic acid, vitamin B12 and iron. A deficiency of one may be "masked" by excess of another so the three must always be in balance.
Symptoms of a folate deficiency can include:
symptoms related to anaemia
reduced sense of taste
diarrhoea
numbness and tingling in the feet and hands
muscle weakness
depression
Folic acid works closely with vitamin B12 in making red blood cells and helps iron function properly in the body.
I am not a medically trained person but I've had P.A. (a form of B12 deficiency) for more than 45 years.
I wish you well