Stress and B12

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I think I read somewhere that periods of high stress can reduce our B12 levels, is that right? I am on B12 shots every 3 weeks (have been doing this for about 6-9 months). I have had a very stressful couple of months and I just went through my lab results and noticed that the most recent test (a few weeks ago) was a lower result than the previous couple of months. Also, I am due for my next shot this Thursday but I have been noticing the deficiency symptoms coming on since Sunday. Do doctors prescribe extra B12 during stressful periods? I know that I am already getting shots fairly frequently. I am also on iron supplements daily. Or anything else you recommend (besides trying to reduce stress in the first place - it simply wasn't possible the last couple of months but is starting to get better now)? I imagine exercise, prayer/meditation etc but anything else?

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  • Posted

    Before your next injection, you may want to ask for a PA and Intrinsic Factor Antibody test. Sounds like you are not absorbing it. There are co-factors that you should be aware of to help your body use the B12. There is a Pernicious Anemia/B12 deficiency support group on Facebook.  You must request membership but it has invaluable information and protocols. 

    B12 deficiency left improperly managed, can be fatal. 

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  • Posted

    In addition to the good advice Dena58 has given you I suggest you ask your doctor to check your Folate level.

    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 and folic acid works closely with vitamin B12 in making red blood cells and helps iron function properly in the body. 

    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 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.

     Can you "see yourself" among any of the above "people"? 

    I am not a medically trained person but have had P.A. for more than 45 years.

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    • Posted

      Thank you Mr Clive. I will join the FB group mentioned by Dena as well. I do not have any of the "people" that are in your list above. My doctor checked my folate and iron levels at my request about 2-3 months ago and folate was normal but iron was quite low, hence the iron supplements daily. It was another doctor who had suggested getting those two labs checked because I was getting B12 injections but hadn't been diagnosed with any disease/disorder to justify the injections, just a low B12 lab. Even with the low iron level my doctor still doesn't list PA as a diagnosis for me. She refused to test for IF because as she says, we are treating the symptoms (B12 shots and iron pills) so whether you have the antibodies or not it won't make any difference.

      I have since moved and do not yet have a regular family doctor. Should I ask for a referral to a hematologist? I think I saw somewhere that those are the specialists for PA?

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    • Posted

      Are you in the U.K?

      Your "new" doctor may not be so amenable to prescribe you B12 injections without a cause (other than stress - you have "ruled out" most other risk factors) or a diagnosis which may mean testing for Intrinsic Factor Antibodies in accordance with the N.I.C.E. guidelines part of which says:

      "Seek urgent advice from a haematologist if the person has neurological symptoms, or is pregnant.

      Refer to a haematologist if the cause of vitamin B12 or folate deficiency is uncertain following investigations, or the suspected cause is haematological malignancy (urgently refer) or other blood disorder.

      Refer to a gastroenterologist if: Malabsorption of vitamin B12 (other than due to pernicious anaemia) or folate is suspected.

      The person has pernicious anaemia and gastrointestinal symptoms, especially if there is a suspicion of gastric cancer (for example co-existing iron deficiency). The urgency of referral will depend on the nature of the symptoms.

      The person is folate deficient, and antibody testing suggests coeliac disease (positive for anti-endomysial or anti-transglutaminase antibodies).

      Consider referral to a dietician if vitamin B12 or folate deficiency is thought to be due to a poor diet."

      Treatment for PA and non-dietary vitamin B12 deficiency is virtually the same."

      The sympotms 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.

      I wish you well 

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    • Posted

      Hello, no, I am not in the UK - I am in Canada currently. I probably won't have a real family doctor until next summer, but the doctor that I went to last week agreed to give me the 3-weekly B12 shots based on the lab results that I showed him. Thankful for that. I do want to one day find out the cause however. Currently I'm in an odd insurance situation until next summer where I can go to any specialist I want, in US or Canada, without worrying too much about cost, I just have to consider wait times, distance etc. I have been tested for celiac in several ways and it is not that. I am still not sure what to do, if anything - Based on your notes above,

      "Refer to a haematologist if the cause of vitamin B12 or folate deficiency is uncertain following investigations, or the suspected cause is haematological malignancy (urgently refer) or other blood disorder."... "Refer to a gastroenterologist if: Malabsorption of vitamin B12 (other than due to pernicious anaemia) or folate is suspected."

      So I should see both a haematologist and a gastroenterologist? The cause of B12 deficiency is uncertain; but there does seem to be a malabsorption issue because I do eat enough meat, dairy eggs etc that I shouldn't be deficient.

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    • Posted

      I'm afraid that once it gets to the "ologists" stage it's way above my "pay grade" or level of knowledge.

      At the end of the day you could always ask to have your Intrinsic Factor tested for antibodies.

      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.

      I hope you get some answers and the right remedial treatment soon.  Goodnight from the U.K. 

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  • Posted

    Testing blood when you a receiving B12 and iron will give inaccurate numbers. The active and inactive B12 is important. once you join the group, go under group documents and read the protocols.  I have printed them so I can highlight and reference. It is a large amount of information. 

    Doctors do not always follow the protocols as they do not seem to have much information on PA. My doctor is very open about all of it. I selfinject 3 Ml B12 weekly, supplement iron, folic acid, b complex 3 months then swap out b complex without B6 for the next 3 months, K2, D3, and consume magnesium and potassium heavy foods daily.

    each person is different so there is no set protocol. You must get in tune with what your body is telling you.  If my tongue is sore and palet raw, I am low on iron.  Spatone iron is easy on the system. 

    If if I start having cold or sinus infections, my immunity needs extra boosting. 


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