Vitb12 deficiency ?

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Hi, new to this forum. I've recently been diagnosed with a vitb12 deficiency, my level was 141 ng/l and the gp said it was slightly low?? I'm a final year student nurse and requested results and seems my b12 has been low since 2014. I was never aware of this. I have crohns disease, also have stomach ulcers and hiatus hernia and been on omperazole for 10+ years. It all started with a spell of dizziness which was diagnosed as vertigo, extreme tirdness, ringing in ears, mouth ulcers, sore tongue no matter what I ate, brain off, pins and needles. Then when I was on placement I took a spell out of nowhere which led to palpitations, this freaked me out and as a result have been suffering anxiety the past 7 weeks. Does b12 cause all these symptoms? There's more but I just can't remember at present. Thanks in advance.

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  • Posted

    Forgot to add I've just finished the 6 loading dose over 2 weeks and folic acid was 2 and have been commenced on 5mg folic acid.

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  • Posted

    I had all of your symptoms plus more. 

    You need to learn about other vitamins and minerals you are not absorbing. Low iron causes my tongue and mouth to hurt. 

    There is a Pernicious Anemia/B12 deficiency support group on Facebook that has great information and protocols you will not find anywhere else. You must request to join the group. 

    I wish you luck and a good doctor. 

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  • Posted

    The short answer is that all the "problems" you mentioned put you at risk of a B12 deficiency and your "forgot to add" comment shows that you are being treated correctly and in accordance with the N.I.C.E guidelines.

    The only proviso I would make is whether or not your neurological symptoms have improved sufficiently for you not to have the loading doses continued until there is no further improvement.  Only you can know this and your doctor is "allowed" to continue the loading doses if you "feel the need".

    That you have "struggled on" for three years is iniquitous.

    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 including certain contraceptive pills.

    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.

    Can you "see yourself" in any other of the above people - apart from those I highlighted?

    Are you able to eat animal products as this is the only natural source of vitamin B12.Another cause of B12 deficiency can be Pernicious Anaemia.

    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.

    A lot will depend on your response to your current treatment as to whether your doctor will test you for P.A. as at the moment you may have an absorption problem due to your Crohn’s and PPI plus any other cause you can identify.

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

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  • Posted

    Thanks for your replies, they are greatly appreciated. I feel the symptoms have alievated slightly but not to where I'm functioning as I once was. I take two steps forward and 5 back. I don't have any other of the risk factors, however my crohns is in my ileum so unsure if this can contribute? My normal gp wanted the intrinsic factor tested. However, locum gp thought this was unnecessary due yo have diagnosis of crohns? I have suffered anaemia over the years and a range of vitamin deficiencies due to the crohns. Thank you again for taking the time to reply.

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  • Posted

    The medicine omperazole depleats B12 in your body. All PPI drugs have been found to cause this. Recently, reports show they are more harmful than originally believed. 

    I was on it for 6 years. I have Pernicious Anemia with Intrinsic Factor. 

    A low B12 diagnosis should lead immediately to IF testing and other factors prior to the first injection uptakes. The current recommended uptake is not usually enough B12 to keep a person with PA going. I have been on B12 injections for 10 years. The first 5 years, I was given 1ML ever 12 weeks after the uptake series.  I would feel better after the injection but in a week felt exhausted and sleeping all day. 

    My doctor researched  and I researched information. I found the protocol on the Facebook group. This changed my treatment completely.  I now self-inject 1ML three times a week.  It got me moving again. The extended amount of time I stayed too low on B12, cause short term memory loss, Nero damage including losing the use of my left leg for 3 months, and SVT.  

    Learning about the required co-factors really helped manage this. Supplementing so the B12 is active and not inactive is key to healing. 

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