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Pernicious Anemia and Vitamin B12

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DoctorQuestion
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Pernicious Anemia and Vitamin B12
Posted: 04-20-08 11:00am

I was initialy diagnosed with pernicious anemia 16 years ago when my Hemoglobin dropped down to 3.5. I am currently receiving B12 shots for my anemia and have been for one year however I was started on the shots when the Trinsicon pills I was getting stopped working dropping my B12 level from it's normal 900 to 156. My hempglobin is fine. I am tired I ache all over, I get short of breath climbing stairs, I get chest pains and my digestion is not great. Dispite the monthly shots my B12 is only 260 after one year of monthly shots. My current doctor told me to add 1000 mcg of B12 daily which I have but my levels are still low. What could be causing this? Should I see a specialist and if so what kind of doctor would that be? I had my galbladder removed two years ago. could that have caused any change in the absorbtion of the Trinsicon? shouldn't the injections be working since they bypass the digestion system?


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Immune Disorders Answer A4001
Posted: 04-29-08 21:44pm

Pernicious anemia is a type of megaloblastic anemia. Pernicious anemia is caused by disturbed absorption of Vitamin B12. Absorption of the Vitamin B12 is disturbed because the so called “intrinsic factor”, which is produced in the stomach, is missing. The Intrinsic factor becomes missing in cases of chronic atrophic gastritis. Was chronic gastritis proven in your case? Other reasons for deficit of Vitamin B12 could be: diet with less Vitamin B12, presence of intestinal parasites, intestinal disorders and genetic defects of Vitamin B12 transport and cell intake.


Every laboratory has its own referent values for Vitamin B12 level in the serum so I can’t judge about your values because you didn’t tell me the referent values for Vitamin B12 in the serum. For evaluating the anemia condition 2 parameters are very important: hemoglobin level and MCV (erythrocyte volume). You told me that the hemoglobin was fine but nothing about MCV. As long as the hemoglobin level and MCV are OK there is nothing to be worry about.


Gallbladder removal should not disturb the Vitamin B12 absorption.
Injections with Vitamin B12 should work.


You may want to consult a hematologist and gastroenterologist about your condition.





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