Quote:
Originally Posted by Daisy
Thanks so much for all the advice. I got some helpful information form the Gluten File that I will take to my appointment tomorrow. I know they are working on a referral to a GI specialist for me so if she doesn't want to do the testing, I'm sure he will.
Cara, I pulled out some of my previous labs and I found a B12 test from May 2006. It was 390 and it says the normal range is 200-1100. Is that too low?
.  |
In my opinion, YES, 390 is TOO LOW. Japan uses a cut off of 500. I have a few articles on B12 deficiency that says anything under 400 should be considered suspicious, especially if neurological (or other B12 deficiency symptoms) are present.
My B12 level was 294 (150-1100) after 3-5 years of symptoms, that had really started to progress in scary ways the last six months. I've always wondered what my B12 was at when I first
started having symptoms. If you haven't had a chance to read the B12 deficiency and B12 symptoms pages on TGF, take a quick look....way down at the bottom of the right bar. I think there is at least a chance that some of your symptoms might be related to B12 deficiency. You might want to ask for the additional tests (methylmalonic acid and homocysteine), but even if those were normal, I think taking 1000mcg daily of oral methylcobalamin might help. Always with a multivitamin with good B-complex coverage.
With the really low iron, too, you are a good candidate for celiac screening. Try to be sure they include the antigliadin antibodies, now considered optional. For some of us, the antigliadin antibodies were the only clue we had.
Cara
Quote:
From: Laboratory Diagnosis of Vitamin B12 and Folate Deficiency
A Guide for the Primary Care Physician
Christopher F. Snow, MD
"As discussed above, patients with Cbl deficiency may have overt neurologic disease in the absence of hematologic findings. Patients with neurologic symptoms and signs and a normal complete blood cell count
require a modified diagnostic approach because of several considerations. First, folate deficiency is an
unlikely cause of neurologic disease. Second, the neurologic disease of Cbl deficiency may be irreversible
if treatment is withheld or delayed; because Cbl therapy is non-toxic, the risk-benefit ratio favors treatment in questionable cases. "
From: AAFP on Vitamin B12 Deficiency
"Diagnosis of vitamin B12 deficiency is typically based on measurement of serum vitamin B12 levels; however, about 50 percent of patients with subclinical disease have normal B12 levels."
From:
Disorders of cobalamin (Vitamin B12) metabolism:Emerging concepts in pathophysiology, diagnosis and treatment Lawrence R. Solomon, 2006
"Since cobalamin, methylmalonic acid and homocysteine levels fluctuate and neither predict nor preclude responses to cobalamin, cobalamin therapy is suggested for symptomatic patients regardless of the results of these diagnostic tests."
|