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Previous Low B12 & Iron now pregnant
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Previous Low B12 & Iron now pregnant

Hi,

In Dec of 2010 I had 2 blood tests one showing B12 at 125 and another showing B12 level of 92. I was given 6 injections in 2 weeks and then tested again approx 3 months later, that test put my levels in the 200's and so the doctor decided no further injections were necessary.

Around 6 months to a year later another blood test showed that my iron stores were really low and so I was prescribed iron pills. Again I took the dose had a repeat blood test and the next test was normal.

I am now pregnant for the second time. My medical problems which sparked the testing and B12 diagnosis arose shortly after my son was born. I have been taking prenatal supplements since I discovered that I am pregnant. Then at 6 weeks a scan showed twins! Unfortunately at 7-8 weeks I lost one of my twins but am now carrying a healthy baby (14 weeks). During my 1st midwife appointment (while I was carrying the twins) I explained that I was concerned regarding my B12 levels as I had low B12 treated with injections and low iron stores previously, I am aware that while pregnant a baby will drain your vitamin stores.

To my surprise the midwife said that they won't test my B12 levels as they will not treat it while in pregnancy! Is this really true? Seems dangerous to me? Should I request a blood test from my doc anyway?

During my midwife appointment the midwife did the usual blood screen (doesn't include B12 level). The results came back normal on everything but showed high MCHC. Does this mean anything?

I have read that low B12 can be linked to low Folic Acid which is obviously not great in pregnancy. I have also read that a mother giving birth with a low B12 can mean a baby with low B12. I don't know how true this is.

Thanks for reading
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Vitamin B12 deficiency may cause severe birth defects (including neural tube defects much like a folic acid deficiency), and increases the risk of infertility, miscarriage, and preterm birth.  An infant born to a mother who is vitamin B12 deficient is at risk of vitamin B12 deficiency.

Studies also have shown that mothers who are vitamin B12 deficient have low levels of vitamin B12 in their milk.  Vitamin B12 deficiency may develop in the breastfed infant by 2 to 6 months of age, but may not be clinically apparent until 6 to 12 months. Signs and symptoms of vitamin B12 deficiency in infants include vomiting, lethargy, anaemia, failure to thrive, hypotonia (low muscle tone), and developmental delay/regression.

Both folate and vitamin B12 deficiency elevates an amino acid called homocysteine.  Numerous studies in the medical literature have indicated that elevations in homocysteine have a direct correlation with the risk of developing a heart attack, stroke and increases the risk of Alzheimer's disease and dementia.  Data reveal that homocysteine levels above 6.3umol/L cause a steep, progressive risk of heart attack. A book i highly recommend: The H Factor Solution: (Homocysteine The Best Single Indicator Of Whether You Are Likely To Live Long Or Die Young) by James Braly MD, Patrick Holford.

Vitamin B12 deficiency results in trapping folate in a form unusable to the body.  Taking folic acid can also mask a vitamin B12 deficiency.  Vitamin C, zinc, vitamin B12 and folate are co factors for iron absorption.

Vitamin B12 deficiency is found in cerbrospinal fluid at 550pg/mL. Japan and various countries in Europe have increased the vitamin B12 serum range to a minimum of 550pg/mL.  Vitamin B12 serum is also inactive B12 therefore not accurate. Your body stores will be lower than what is on paper. Optimal B12 serum levels are over 800pg/mL. A test to aid in diagnosis of a vitamin B12 deficiency is a urinary methylmalonic acid (UMMA) test.

In 2006, a study found that sufficiently high doses of oral B12 was as effective as intramuscular injection in treating vitamin B12 deficiency.  An older study, from 1998, concluded "In cobalamin deficiency, 2 mg of cyanocobalamin administered orally on a daily basis was as effective as 1 mg administered intramuscularly on a monthly basis and may be superior."

Elevated MCHC is called hyperchromic anaemia. This is where the red cell count is low, but the cells themselves are abnormally large and carry abnormally large amounts of haemoglobin, the protein that carries oxygen around the body.  This condition can have many causes including a poor diet, pernicious anaemia, difficulty absorbing or storing nutrients from food, problems producing red cells, gastrointestinal disturbances, impaired liver function, pregnancy, hypothyroidism, leukemia, alcoholism, and problems maintaining enough functioning red cells.

Vitamin B12 injections and supplements are considered safe during pregnancy.  Check with your doctor if you are concerned.  

Causes of vitamin B12 deficiency include:

Decreased stomach acid
Atrophic gastritis
Pernicious anaemia (autoimmune disease)
Helicobacter pylori
Gastrectomy, intestinal resection
Gastric bypass surgery
Malabsorption syndromes
Crohn’s disease
Celiac disease (gluten enteropathy)
Chronic pancreatitis
Bacterial overgrowth (small bowel)
Fish tapeworm
Alcoholism
Malnutrition - eating disorders
Vegetarianism
Advanced liver disease
Transcobalamin II deficiency
Inborn errors of B12 metabolism
Certain drugs (eg: acid blockers)
Nitrous oxide
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