Assessing damage caused by B12 deficiency

[character28]

Hi, I would like to know what is the best way to assess the damage caused by B12 deficiency. I have suffered of it for a long time and the stupid doctors I've seen wouldn't find out... Now I'm probably f***ed up... Which test should I get to evaluate this? Thanks in advance

[character28]

Hi again, well, this is what I did so far. I got the 10000mcg B12 injections for six days, then the folate therapy for three days (15mg folate, 1mg B12, also other B's) and then bought five 10000mcg b12 shots again and applied two yesterday, one this morning, tonight I'm gonna get one more and will end tomorrow. Since B12 is harmless as far as I'm concerned, I just got more.

I wrote to labtestsonline and they said that my B12 shots won't affect my test results as long as I fast 10 hours prior to the blood draw. So I'm gonna finish with this package and will wait to get my blood drawn for B12 on 31/10.

In the meantime, I had my doctor prescribe me further testing, and he requested ferritin, iron and calcium. The results are the following:

Calcium: 9.6 mg/dl
Iron: 92 ug/dl
Ferritin: 397 ng/ml

What do you think of these results? I also wanted to test Vitamin A, C, D, E and K, Zinc and Anti intrinsic factor, but found out that my stupid insurance won't cover the testing. Unbelieveble, right?. Whatever. I'll see if I can afford at least Vitamin D and intrinsic factor.

Furthermore, my GI doctor prescribed an endoscopy and biopsies of stomach and duodenum. I'll receive those results on Wednesday. So far the only thing I know so far is that the endoscopy suggested congestive gastritis... Congestive gastritis? What's that? I already researched but just found out that my stomach is full of mucus???

However, there's something that still has me concerned. My chronic purple discoloration. I found a couple sources on the web which state that it is caused by B12 deficiency, but so far it hasn't corrected, despite all the shots I've gotten. Are you aware of any link between this discoloration and B12 deficiency? Do you think it might take a while to resolve? Since no doctor so far has been able to tell me why the h*** I got that discoloration, do you think I should insist on it? Maybe trying another specialist?

Oh, and by the way, I must say that so far with the therapy the ONLY symptom which has improved is the fatigue. The rest, the same than before. I'll try to be patient and hopeful, though it's quite hard sometimes. My mind is playing me a very hard game these days. The most distressing is the brain fog. I hate it. If I was just able to fully recover my mind back again, I don't care of the rest if that was the price.

Whatever, I'll be waiting for your response. All comments are welcome. Thanks in advance.

[Londres70]

Please keep us posted.  

[character28]

Thank you very much Londres! I hope doctors are soon able to rule in or out malabsorption.

Red_Star that was a very complete answer and so useful information! Thanks!
By the way, did you have psychiatric symptoms because of pernicious anemia? Did you have peripheral neuropaties? What were your symptoms exactly? Did them all reverse with therapy?

Thanks in advance!

[Londres70]

I can't say this is a "malabsorption" issue as diet and other factors can cause B12 deficiencies.  Perhaps your level was even lower than it was BEFORE taking this medication with the 500 mcg of B12.  If a level drops to the level you have usually B12 IM therapy is warranted. There is no way to treat a level that low with ANY pill ALONE regardless if this was a malabsorption issue or not.  

I would leave this to your physicians to sort out if this a "malabsorption" issue or not.  I can't comment on if it is or not as I am not privy to medical records or your medical history.  Again, can't comment on this.  

[Red_Star]

I have autoimmune pernicious anaemia (rare juvenile form so i have had symptoms for decades). I use sublingual B12 spray daily (currently 2000mcg). Excellent!  B12 deficiency symptoms return in days if i stop taking my B12 sublingual.

***

Delivery System/Rate of Absorption*

Pill or tablet - 10%
Capsule - 20%
Gel Cap - 30%
Transdermal Patch - 45%
Sublingual Liquid - 50%
Intramuscular Injection - 90%
Intraoral or Sublingual Spray - 95%
Intravenous Injection - 100%

* Physicians' Desk Reference, NPPDR No. 18:676, 1997

***

Causes of B12 deficiency include:

Decreased stomach acid
Atrophic gastritis
Autoimmune pernicious anaemia
Helicobacter pylori
Gastrectomy, intestinal resection
Gastric bypass surgery
Malabsorption syndromes
Crohn's disease
Celiac disease (gluten enteropathy)
Chronic pancreatitis
Bacterial overgrowth (small bowel)
Fish tapeworm
Alcoholism
Malnutrition - eating disorders
Vegetarianism
Advanced liver disease
Transcobalamin II deficiency
Inborn errors of B12 metabolism
Certain drugs (eg: acid blockers)
Nitrous oxide

[character28]

I took that medication almost daily the month before testing. I must have skipped it twice or three times only.

But now that I'm getting injections, if there was any malabsorption problem, IM B12 would bypass the malabsorption, wouldn't it?