Re Previous Question on b12 deficiency

[graham]

I posted on 2/7/03 detailing symptoms which have worsened over the past five years. I explained that I suffered fatigue and worsening neurological symptoms ie tingling/burning/tightness in legs similar but less in arms/hands. Tremor in my fingers (when moving them) blurring of eyesight and slight movement between lines of text. I developed tinnitus during this period and tests in 2003 showed distinct hearing loss on left.
The doctors who carried out the hearing tests directed me back to my GP asking for a further neurological opinion (even though they knew I had previously seen two neurologists)

I asked you if you thought my b12 could be a problem. It had dropped from 289pg/ml in 98 to 189pg/ml in 2000. After being injected with b12 for a Schilling test (repeated)in Dec 2000 my b12 was 287 in March 2001 and 235pg/ml in Nov 2001 it was 235pg/ml

You advised that my levels were low and others borderline and  further testing was advised. My GP and other doctors had already disagreed with this and at my new neurological examination on 2/9/03 the neurologist decided that no further investigation was neccessary, even though my previous neuro tests in 98-2000 showed abnormalities. I was told not MS, my b12 was normal and no further tests were neccessary.

I was so concerned that I found a lab through the web that arranged blood tests. Results were b12 165ng/L (range 179-1162) folate (RBC) 535 nmol/l (range 435-1307). Other tests state within normal range although one test, ESR was 11 with normal being 0-11.
Do these tests confirm a problem & can you give any advice.

[CCF-Neuro-M.D.-CS]

These tests do not confirm a specific problem, however your B12 level contiues to be borderline low. There are several ways to asses B12 function. I am assuming that your Schilling test normal in the past. Have anti-bodies directed against the cells which make intrisic factor (this is needed for the body to absorb B12 from the intestines) every been checked? To asses the bodies ability to properly utilize B12, one can check methylmalonic acid and homocysteine levels. The high normal ESR is only a marker of inflammation, and is non-specific. A more senstive test is a C reactive protein to monitor inflammation. If you are continuing to experience symptoms, then perhaps a second opinion at a large academic center would be reasonable. Good luck

[graham]

I'm affraid I ran out of space on my question. I simply wanted to add that the tests you previously mentioned, methylmalonic acid, homocysteine, anti-intrinsic factor and anti parietal cell antibodies, were not on the list for testing with the lab I sent my sample to. I had an anaemia profile which included my b12 and folate.

Many thanks again
Graham