Two Questions

Hi Jennifer, I understand that, after an initial general blood test, an antibody test for the auto-immune condition that often causes PA is pretty standard procedure.  Mine was negative, which means there must be another cause of the B12 deficiency, it's just a question of finding out what. 

The initial blood test that reveales B12 deficiency usually covers a number of factors, which are shown against a range of readings considered "normal".  Try asking your doctor for a copy of the initial test.  If you've had several successive tests over a period of months or years, ask for all of them.  Compare the readings (even plot them on a graph), and see if you can relate any ups and downs in them to lifestyle changes, medical treatments or life events.  I discovered all my readings are currently low, and will probably remain so until my B12 levels are corrected - that's a feature of the condition.

I can't answer the gallbadder question, but I'd expect it would.  It has crossed my mind that my own mother had gallbladder trouble at my age, and the relationship is known.  Hope you recover well.

Hi Jennifer, you mentioned Hashimoto's disease. This may actually be the underlying cause of your vitamin B12 deficiency. Thus, your thyroid makes T3/T4, which are required to turn dietary vitamin B2 into FMN and FAD. FAD is used in many, many reactions in the body, but particularly in the energy cycles and in the recycling of folate. A deficiency in FAD can in itself cause vitamin B12 deficiency. I can link you through to the chemistry if you want. (for some reason the web-site describing this is down at the moment). You need to get your thyroid supplementation right (which I presume you will have started). You will still either need lots of B12 jabs - but you won't be able to use cyanocobalamin as a source as the enzyme (decyanase) that kicks the cyanide out of cyanocobalamin also needs NADH and FAD. Your doctor probably won't know this. You may have classical PA on top of this, which can only really be established via the antibody tests. You mention your gallbladder problems, these may contribute to B12 deficiency as well as you need bile salts to help in digestion. Will have to check whether gall bladder insufficiency also leads to dietary B12 deficiency..

Hi Jennifer, had a cruise around and many people who have had their gall bladder removed also end up B12 deficient. It appears that due to the lack of bile salts they change their diet and this leads to deficiency. It also leads to a deficiency of DEAK vitamins (the fat soluble ones) as these are now no longer "dissolved out of the foot" and therefore not taken up. Looks like you need to be fully aware of so much. Good luck!