B12 deficiency

[holly56]

Hmmm, I'm just looking for advice on what kind of doctor I need to see to pursue this problem.  I am a 51 yr old female with Type 2 Diabetes and currently taking glucophage 1000mg once daily.  Saw my PCP for "memory loss" and she ran tests revealing a vitamin B12 deficiency, went in weekly for 4 wks for shots, then every 3 wks.  In researching this problem, I've found that many symptoms I have experienced for years can be attributed to this deficiency which include:  daily headaches that feel like I've been pounded on the top of my head w/a hammer that feels like it goes down through my c-spine and into my back which seem to improve right after the injection but come back toward the end of the 3 wk period, brain fog/memory loss, joint pain, loss of enjoyment in reading because my eyes get tired and vision seems to get blurred, cannot think of words (i.e., "that thing you wear on your head" for "hat"), some occasional numbness in left arm, right shoulder pain, and am unsteady in the dark (especially going down stairs)  I was also recently dx'd with an anal fissure from chronic diarrhea I've experienced for many (5+) years.  Many endo/colon-oscopies that show everything to be fine in that dept - no colitis (but w/fissure and B12 deficiency I suspect maybe Crohn's?) but have been on Prevacid since 1999 for severe GERD.  

I had my most recent injection last week, but had B12 level checked prior to receiving shot.  PCP called to tell me that for someone who gets injections monthly it isn't very high - 310.  So...what kind of specialist do I need to see?  A hematologist or a neurologist?  She thought I should see the GI guy to r/o Crohn's but I'm a little worried about the B12 level at this point and my memory loss.  I used to be a "sharp cookie" but it's fading fast...  Any ideas?

[holly56]

PS:  I forgot to say that I was dx's with HSP Vasculitis 1 1/2 years ago (by biopsy).  Could this also be related in any way?

[Super_sally888]

Hi Holly,  have you been checked for celiac disease.  this is cuased by your body not being able to tolerate gluten (found in wheat, barley, rye, oats).  this can contribute to B12 deficiency.  Also it is often a factor for people having tummy problems.  Plenty of on-line info if you want to research this more.
Do you take oral B12 between shots?  Ask your dr about this.
Maybe you need the B12 shots more often.
Good luck with all.

[gbboy]

Holly, I see a neurologist for b12 treatment. Was diagnost in April. Just went Monday and b12 level is only up to 238 from 94 when I started this adventure. Back to weekly shots. From what I have learned. Taking the medication to help with your stomach troubles, Prevacid perhaps, reduces the amount of HCl in the stomach which is needed to release food bound b12. If the b12 is not released from the food it cannot be absorbed in the gut. However unbound forms of b12, vitamins, would be absorded. Also there is some indication that perhaps the metformin used to treat type II may interfer with b12 absorption. That is not my problem. I have pernicious anemia. This is where the intrinsict factor needed in absorption step is being destroyed by the body itself. Thus only injections will help. B12 def. does cause many of the symptoms you are having including the forgetfulness and foggy brain. That is really frustrating not to know the words you used to. Wikipedia has a good article on it. Some what technical but it explains the absorption and conversion process. Other sites such as Medlineplus by NIH is good. I have been getting the shots since April and am finally rounding a corner. My brain is back to functioning (except close to when my next shot is), all the numbness is going away, I am not as tired any more. Apparently, it takes a while to rebuild the stores. Your liver should have a 3-5 yr store of the vitamin. So you are right you may have been over the years been slowly using up the stores in your liver until you really got bad. Also the neurologist told me that up to a point folic acid, another B vitamin, can take the place of b12 in certain body chemistries. If we have plenty of folate in our diets then the b12 problem could have been occuring for along time. She said that definitely the brain problems will go away and that most of the other problems will clear up also. It really depends on the damage that was done and how long the problem has been occuring. I think I will just be left with a strange feeling in one calf. I'll take it since I had head to toe numbness, stomach issues, vision problems, temperature problems, and losts of congative issues. Hang in there keep getting the shots, this will be my 3 round of weekly shots. If your gp is knowledgable you can just stay there or go to a neurologist or a GI person. The gp can check your blood for an antibody to determine if you have the pernicious anemia or not.
Good Luck.
B