Hello Eugene,
I understand how you feel; my symptoms were labelled as being "all in the mind" for decades before the real physical causes were discovered. You are welcome to read the pages About Me and Doctors-Apathy on my web site (URL at end of this message).
I agree with the comments, by mrsd and glenntaj, about the possibility of vitamin B12 deficiency.
Your B12 result, of 209 pmol/L (was this pmol/L, or ng/L?) does not exclude the possibility of vitamin B12 deficiency. According to experts, a B12 level of less than 295 pmol/L, in the presence of symptoms, should be investigated further. I suggest that you download a copy of the following article for your doctor:
Vitamin B12 Deficiency, Oh and Brown, Am Fam Physician 2003;67:979-86,993-4.
Figure 3 shows the recommended diagnostic flow chart.
This is reference BG1 on my web site; you can find links to many other articles on B12 deficiency on my References page.
I also suggest that you read the following article about the relationship between B12 deficiency and gastritis caused by Helicobacter pylori, my reference BR5:
Review article: is there a link between micronutrient malnutrition and Helicobacter pylori infection?, J. Salgueiro et al, Alimentary Pharmacology & Therapeutics, Volume 20 Issue 10 Page 1029-1034, November 2004
The best available tests for B12 deficiency are methylmalonic acid and total homocysteine.
It is essential that, for diagnosis of B12 deficiency, you do not take any form of B12 supplements or injections before having these tests. I have explained the reasons for this in detail, on my web site, and have copied the warning to the end of this message.
I suggest that you read all of the pages in my section Information and Advice for Patients, as well as the two references mentioned above.
Please let us know if you have any further questions. If you prefer a private discussion, you are welcome to send me an Email from the Contact page of my web site.
Paul
Quote:
Test First - Before Commencing Treatment
I strongly advise anyone with suspected vitamin B12 deficiency to test thoroughly first then, if necessary, urgently commence treatment. If you take any treatment for vitamin B12 deficiency first then you risk masking other causes of symptoms, especially folate deficiency; you also lose the opportunity to use the best available tests.
If you either take B12 supplements, or have B12 injections, before proper diagnosis then you do not know whether or not you actually have a vitamin B12 deficiency. This is because the tests recommended by experts, methylmalonic acid and homocysteine, are used by comparing levels before and after treatment.
Once you have already started treatment, I cannot advise you to stop in order to find out. This is because, if you are deficient, you could suffer harm by ceasing treatment for the time it would take to return to your original B12 levels.
My own research shows that it can take a very long time, after ceasing treatment, for your serum B12 vitamin level to fall to a level suggesting a deficiency. This is very dangerous because neurological damage, caused by cellular deficiency, can occur even at high serum vitamin B12 levels and with normal haematology. This is why it is so important to get the evidence of disease before taking the supplement or having the injections.
Is it worth having the blood tests? You will need to decide for yourself, but consider these possible unacceptable scenarios:
1. No blood tests, no treatment, with B12 deficiency:
* Increasing disability
* Eventual irreversible damage or death likely
2. No blood tests, taking supplements or having injections, no B12 deficiency:
* Unnecessarily taking supplements, or having injections, for life
* Risk of masking folate deficiency
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If anyone wishes to discuss my advice about testing first, then I suggest starting a new thread, perhaps called "why test first?", rather than using this one.