Cat,

Very frustrating. Unfortunately, most often people can't educate the doctor, but fortunately in this case they can usually take care of themselves on this issue.

What dosage is the B12 you are taking orally? If it is small (for example: 3 mcg, 20 mcg, or such), your level should not increase if you have pernicious anemia (lack of intrinsic factor). At least the doc knows the difference between "pernicious anemia" and "megaloblastic anemia." And apparently the doc also knows that you could be losing the ability to produce intrinsic factor. Those are WAY more than most know.

What the doc likely does not know, is that if you are taking more than a couple hundred mcg at a time you're B12 level is likely to stay about the same or increase on the oral doses. If the doc thinks that rules out "pernicious anemia, he is wrong.

And, in addition, some people would still have more B12 due to the shot. So, the fact that he gave you a shot and now wants to use oral B12 doses to see whether you have "pernicious anemia" does not inspire confidence.

Fortunately 1000 mcg or more of methylcobalamin each day will probably be better than shots.

And I do hope you will read Cara's celiac info. It is probable that gluten sensitivity has not been ruled out.

rose