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Old 06-30-2010, 05:20 PM   #1
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Could I have Pernicious anemia?

First off, I am being treated for Severe Vitamin D Deficiency. But I am still feeling sick... tons of joint pain, muscle aches, fatigue.

My endo just did some lab testing and here are the findings:

Iron 29 (35 - 180 ug/dL)
Iron Binding Cap 386 (240 - 430 ug/dL)
Iron Saturation Index 8 (15 - 46 %)

Ferritin 12 (10 - 120 ng/mL)

WBC 7.3 (4.0 - 11.0 10e9/L)
RBC 3.98 (3.8 - 5.2 10e12/L)
Hemoglobin 11.1 (11.7 - 15.7 g/dL)
Hematocrit 33.9 (35.0 - 47.0 %)
MCV 85 (78 - 100 fl)
MCH 27.9 (26.5 - 33.0 pg)
MCHC 32.7 (31.5 - 36.5 g/dL)
RDW 12.8 (10.0 - 15.0 %)
Platelet Count 331 (150 - 450 10e9/L)

Vitamin B12 242 >210 - pg/mL
Interp: 211-246 = Indeterminate

=================================

So it seems my iron studies are abnormal, I am slightly iron deficient (I did just get over my monthly period), and my B12 is low or in the range of determining if it's significant.

Can anyone help me with these numbers? Thanks.

 
Old 07-01-2010, 12:31 PM   #2
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Re: Could I have Pernicious anemia?

B12 is low, and hemoglobin is slightly low. When my B12 was 363, I was having severe neurological symptoms. If I were you I'd try supplementing with a good B-12 sublingual and get retested. If it doesn't work, you may need injections.

 
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Old 07-01-2010, 07:56 PM   #3
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Re: Could I have Pernicious anemia?

Quote:
Originally Posted by japlopper View Post
B12 is low, and hemoglobin is slightly low. When my B12 was 363, I was having severe neurological symptoms. If I were you I'd try supplementing with a good B-12 sublingual and get retested. If it doesn't work, you may need injections.
Thank you so much for your response.

Here are my questions:

Well, my endocrinologist told me since I went from 10000 IU D3 to 2000 IU D3 I am now Vitamin D Deficient again (I was diagnosed six months ago with < 5 Vitamin D!) and he wants me to up it to 5000 IU D3.

So I guess this is my bottom line?

1. Vitamin D Deficiency AGAIN with dropping the D3. Have to up it to 5,000 IU D3
2. I now have Vitamin B12 Deficiency!
3. I am iron deficient, iron Deficiency Anemia

Is that correct to all you experts?

Also, where do I go from here?

1) I now have a B12 Deficiency... what would cause this? Just six months ago they ran a B12 back in December and my numbers were in the 350s so they dropped this much? What could cause this?
2) Why is my iron low? What could be causing low iron and is it connected to the B12?
3) Could I have that Pernicious anemia?
4) How could my B12 be low yet my Folate be okay?
5) Am I not absorbing nutrients for some reason and that's why both my Vitamin D and B12 are low? Could I have Celiac Disease. I read that bacteria in the stomach could cause B12 issues?
6) Is follow up testing necessary to find out why I have vitamin deficiencies and why my iron is low? What specialist/s should I see for all of this?

As you can tell, I am concerned over what is going on with my body. I just want a direct plan and of course to start feeling better.

Thanks.

Last edited by Mitch5; 07-01-2010 at 07:58 PM.

 
Old 07-01-2010, 08:16 PM   #4
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Re: Could I have Pernicious anemia?

1) I now have a B12 Deficiency... what would cause this? Just six months ago they ran a B12 back in December and my numbers were in the 350s so they dropped this much? What could cause this?

You could have PA or something else that bites the B12 levels. I have autoimmune hemolytic anemia and when it's active, my red blood cells explode, and no B12 is stored or processed.

2) Why is my iron low? What could be causing low iron and is it connected to the B12?

Your iron could be low if you have a bleed somewhere. Stomach, intestines, etc. Could be a slow bleed over time can drain your iron. Or maybe you don't absorb iron or B12 as in Celiac's disease.

3) Could I have that Pernicious anemia? Yes, you could. Or just a problem absorbing it in your gut for some reason.

4) How could my B12 be low yet my Folate be okay?

I didn't see your folate levels listed. But Folate should be the high end of the level to be able to process the B12.

5) Am I not absorbing nutrients for some reason and that's why both my Vitamin D and B12 are low? Could I have Celiac Disease. Yes, you could, or a gluten intolerance. Try getting rid of gluten and see if you're less bloated and more energetic.

I read that bacteria in the stomach could cause B12 issues? Yes, H.Pylori can kill your B12 stores and irritate the places that absorb B12. B12 deficiency caused by H.Pylori often resolves with antibiotics and with B12 treatment.

6) Is follow up testing necessary to find out why I have vitamin deficiencies and why my iron is low? What specialist/s should I see for all of this?

Yes. Follow up in necessary. It's like you have a bunch of puzzle pieces going on, and someone needs to put them all together. It will be a long process. You may need B12 injections, special vitamins and testing to figure out why your counts are all so low. Good luck to you. I've been where you are, and it feels like a problem that won't be solved, but just don't give up pressing for answers. Let me know if you have other questions. To raise my iron, I use Floradix. It worked better that ferrous sulfate - in fact ferruos sulfate gave me throat ulcers that hurt my anemia more. I also get B12 shots every two weeks, a prescription folic acid, a multivitamin and a daily sublingual. With all those things, I'm getting along pretty well. Take Care.

As you can tell, I am concerned over what is going on with my body. I just want a direct plan and of course to start feeling better.

Thanks.[/QUOTE]

 
Old 07-02-2010, 03:20 AM   #5
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Re: Could I have Pernicious anemia?

Thank you so much for taking out the time to respond.

Quote:
Originally Posted by japlopper View Post

You could have PA or something else that bites the B12 levels. I have autoimmune hemolytic anemia and when it's active, my red blood cells explode, and no B12 is stored or processed.
Who should be testing me for PA and/or other anemias? Should I go to a hematologist?

2)
Quote:
Your iron could be low if you have a bleed somewhere. Stomach, intestines, etc. Could be a slow bleed over time can drain your iron. Or maybe you don't absorb iron or B12 as in Celiac's disease.
Would a GI doctor be the best specialist to help me determine GI causes?

I should ask for:

Celiac testing
H.Pylori
Other?

Quote:
I didn't see your folate levels listed. But Folate should be the high end of the level to be able to process the B12.
Here is my Folate level:

Folate 13.0 >3.3 - ng/mL
Interp: >5.4 ng/mL = Normal

How is the B12 and Folate connected?

Quote:
Yes, you could, or a gluten intolerance. Try getting rid of gluten and see if you're less bloated and more energetic.
I was down at Mayo Clinic because I have stomach dysmotility (my stomach either empties too quickly or too slowly) and they randomly tested me for Celiac through a blood test. I was shown to carry the gene for Celiac. My Mayo doctor suggested I try a gluten free diet to see if it would help the stomach. I know for a fact that in general I am sensitive to gluten based on how I feel while eating it.

Quote:
Y[I]es. Follow up in necessary. It's like you have a bunch of puzzle pieces going on, and someone needs to put them all together. It will be a long process. You may need B12 injections, special vitamins and testing to figure out why your counts are all so low. Good luck to you. I've been where you are, and it feels like a problem that won't be solved, but just don't give up pressing for answers. Let me know if you have other questions. To raise my iron, I use Floradix. It worked better that ferrous sulfate - in fact ferruos sulfate gave me throat ulcers that hurt my anemia more. I also get B12 shots every two weeks, a prescription folic acid, a multivitamin and a daily sublingual. With all those things, I'm getting along pretty well. Take Care.
Thanks so much for the information. I don't feel so alone and confused now.

See, I am currently seeing an endocrinologist for the Vitamin D Deficiency. Should I have him help me with the B12/Anemia situation/causes along with a GI doctor or should I go to a hematologist? What specialists should I see for all of this?

Thanks again.

 
Old 07-02-2010, 05:02 AM   #6
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Re: Could I have Pernicious anemia?

You probably need to start with your General Practitioner - do you have a good one? He/She could test for H.Pylori and give you B12 injections, so that would be a start. And yes, I would definitely go on a gluten free diet. I bet you're not absorbing B12 anymore. Then they can pass you on to the correct doctors. I have a great GP, but I see a hematologist for my hemolytic anemia and ITP. If I just had the B12 thing, my GP would probably handle it well.

I've learned that the whole B12/iron/folate combo is like a gas tank, and once you're low on one of them, the rest start to go low too. Example: You stop absorbing B12, then you get some B12, well, then your body goes into overdrive to produce new red blood cells, which taxes your iron and folate(folic acid). So then you can get low on iron and folate. If you're already low on iron and folate when you start to supplement with B12, then your body really starts to suffer and can't process the B12 correctly, so it's like filling a cracked gas tank. Really all of the things have to be looked at.

 
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