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The most common cause of vitamin B12 deficiency in the western world is a condition called pernicious anaemia.
In a normal healthy body, a protein called intrinsic factor is secreted in the stomach. This protein attaches itself to B12 and enables this vitamin to be absorbed during the digestion process.
Those who suffer from pernicious anaemia lack this essential protein. This is a major problem because B12 is required for the production of new red blood cells. Without B12 the blood cells are unable to divide normally and release out of the bone marrow.
What causes a loss of intrinsic factor?
A common cause is stomach surgery. It can also be due to an immune system reaction where cells in the stomach are destroyed. In very rare cases, intrinsic factor can be missing at birth.
How does this disorder present itself?
There are usually no symptoms to begin with, and then gradually the symptoms develop. These symptoms include getting tired easily, general weakness, tongue soreness, tingling and numbness in the hands and feet, unsteady gait, confusion, blurred vision, gum bleeding, dizziness, mild depression.
What happens if the condition isn't treated?
There can be progression towards heart failure or significant permanent nerve damage. It used to be a chronic fatal disease, in the days before the correct treatment was discovered and understood.
How does a medical professional make a diagnosis?
There are numerous tests which can be done such as complete blood count, schillings test, biopsy specimen, reticulocyte count, bone marrow biopsy, serum LDH. A schilling test will show if the B12 deficiency is because of an absence of intrinsic factor. Essentially, this test is a measure of how much B12 is excreted in the urine after a dose of B12 having been taken in.
What is the appropriate treatment?
B12 injections are prescribed. Initially, there may be up to eight injections in the first month. After this, the total level of B12 in the body is measured, and usually the injections are carried on each month depending on overall B12 level. It is also advised that sufferers take folic acid and iron supplements, to help the B12 work more efficiently.
What is the prognosis?
The earlier the detection the better. Correct treatment and early detection should mean a normal life. If it is detected late, there may be some irreversible nerve damage. Someone with pernicious anemia is between two and three times more likely to develop stomach cancer. It might be sensible to have regular tests for this, although there is a debate among doctors about whether this is actually necessary.
I first wrote this article on helium.com, it is there under the title, "Pernicious anemia or vitamin B-12 deficiency", by Carl Marshall.
When most people think of anaemia they think of a lack of iron, cured by diet or maybe pills. However pernicious anaemia is different - your body kills off the B12 you eat so diet won't cure it and without treatment it is fatal.
I knew something was wrong with me and had been back and forward for about a year to my GP saying that I felt tired all the time and I thought I was anaemic. I was taking iron supplements and my iron levels were ok, within normal but at the low end. Various other tests were done but no one thought to test my B12 levels (in retrospect I know this is because of my age - normally Pernicious Anaemia only occurs in pensioners and I was in my 20s)
Looking back I had so many of the symptoms, tiredness (I was having to nap nearly every day and still felt tired) shortness of breath on any exertion, palpitations, nearly fainting, lack of taste, tinnitus (ringing in the ears), paleness, bloated (I looked pregnant at times), weight loss, my nails broke at everything, pins and needles frequently. Then I saw one GP who suggested testing for PA, however before I got the results I collapsed and ended up in hospital as my B12 had got so dangerous low that it caused my bone marrow to shut down. I ended up with several blood transfusions before starting the usual treatment for PA in the UK- hydroxycobalamin. For the first week I had injections every other day and am currently on 3 monthly injections for life.
Life is better now the treatment has started but they don't last long enough so I'm arguing for 2 monthly injections (despite the fact that they sting like crazy)
If you feel this may be describing how you feel then please get treated, I was lucky I collapsed when I did and that I survived, had it gone on for a few weeks more I would have got to the point of no return
Not sure really how to write this review so I'll just do my best, thanks for reading
For the past year I've not really felt 100% health wise, Last April I fainted then I got a Viral Cough which I had for around two months, along with this I got a very bad head and some on and off again dizziness.
Then I had a mole removed to which I got told it had melanoma cancer in it, luckily this hadn't spread, so I now have to go for regular check up's on my moles and skin.
I had another mole removed in February as they thought it looked funny so while waiting for the results for this I got my self very stressed thinking the worst and one morning I got this strange numb feeling in my lower arm and lower leg so when I had this all day long I rang the doctor and went in to see him the next day, he told me to have a blood test to test for various things, Diabetes, Thyroid problems, Iron, Folic and B6 and B12 deficiency etc.
By the end of the week I was asked to come back in for a second blood test as they said I had the B12 Deficiency not sure why the second blood test was needed really cos you would think that I either had it or didn't, my second blood test came back the same so I was told I would need the B12 Shots.
What are the symptoms of this type of anaemia?
Anaemia is a condition where you have too few red blood cells or not enough haemoglobin in your blood. It can make you feel tired, breathless and faint.
Vitamin B12 is a ingredient in DNA, the chemical that carries genetic information for new cells. It's found in meat and animal products but not in vegetables. You need vitamin B12 to make red blood cells and for maintaining healthy nerves.
Vitamin B12 deficiency may cause neurological symptoms due to inflammation of the nerves . This is called vitamin B12 neuropathy. It affects movement and sensation, especially in the legs and causes numbness or pins and needles. It can also cause confusion, depression, poor concentration and forgetfulness.
-If a person is otherwise healthy, it can take some time for the signs of anaemia to appear.
The first symptoms will be tiredness and palpitations (awareness of heartbeat).
Shortness of breath and dizziness (fainting) are also common.
If the anaemia is severe, it can result in angina (chest pain), headache and leg pains
Red, sore tongue and mouth.
-Some people with vitamin B12 deficiency will experience symptoms in their nervous system first, such as:
Altered or reduced sense of touch.
Less sensitivity to vibration.
Tingling in the hands and feet.
Difficulties with walking and coordination.
Psychological symptoms such as memory loss, confusion and depression.
In the days between seeing the doctor the first time and having my first shot (19 days).
I was now having a lot of different symptoms my head was feeling very light headed and my eyes just seemed to feel a bit drunk and some days I would feel like I was going to pass out, this was coming and going but it was lasting for hours at a time.
I had a furry tongue and my gums were feeling sore and bleeding every now and then.
I just seemed to have absolutely no energy, my legs felt like they were going to collapse under me and I felt like I had no strength in my arms.
I would feel tired all of a sudden, It would just hit me and this would last until I would wake up the next morning some days.
I would have days where I wouldn't feel too dizzy or my head and eyes felt fine or the numbness would just come and go but more often than not I would never feel quit right, I was also stressing so I think this may have been causing me a few symptoms as when I felt stressed certain things would feel worse.
I was told to have the B12 shots every week for 5 weeks then after that I think they said they would check my blood again after a month to see how my body had absorbed it.
Week One after 1st shot.(had symptoms for over 4 weeks now if not longer)
During the first week I was still feeling very tired and getting most of the symptoms I was getting above, these were coming and going, some days I would think I don't feel to bad today then the next day it would just hit me again a dizzy spell or all day numbness in my hand or legs and just feeling like I had no energy.
Week two after second shot
This week I have definitly seen an improvement in the tiredness I have been getting, The dizziness has improved slightly, I am still getting it but it doesn't seem to be lasting as long as it was. The numbess is still there, it just seems to move around my body.
I am hoping having the regular shots will start helping my symptoms soon and generally make me feel a bit better, I'm not sure when they'll start to kick in so I will have to try and add to this review at a later date to add things like how long I felt the shots took to work, What symptoms went first etc.
Good News and Bad news, after my 3rd injection i came out in really bad spots I thought this was just going to be a reaction that might last a few days of a week or two at the most. Well after two months I still have the spots and they are classed as grade 1/2 acne according to my doctor. Great feel better but depressed i look a mess.
After the initial 5 shots I definitly started to feel better then 6 weeks after my last shot i was due to have my blood levels checked again and i was experiencing the pins and neddles/numbness again.
My levels were still low and I am now taking 2 folic acid 5mg tablets everyday for up to 6 months I think , since taking these i have been feeling ok again really.