pernicious anemia

[pplilaccavy]

I recently was informed that I also have pernicious anemia. I have started recieving B-12 injections. Does pernicious anemia and thyroid issues go together? I am wondering that if once I have my surgery, and finally get some medications to regulate my TSH, if the anemia will improve? Anyone with any thoughts about this?

[ifupleze]

Go to www.allthyroid.org and search pernicious anemia.  It might give you some answers.

[kitty9309]

Yes, they can. Hypothyroidism and pernicious anemia are both autoimmune diseases. As far as I have read, treating the thyroid will not fix the low b12. You will need b12 supplementation for life. Not too bad, really.There is recent research that suggests that oral b12 if as effective, if not more so, than IM b12.

Pernicious Anemia in 2 csaes of Subclinical Hypothyroidism- article:

Macrocytic anemia associated with autoimmune thyroiditis can result from
malabsorption of either folate or vitamin B12. As many as 10% of the patients
with hypothyroidism, caused by autoimmune thyroiditis, have pernicious
anemia.

[Avee3]

Yes, they can be related.  I have pernicious anemia (PA).  I don't have hypo or hyper thyroidism but my research of PA did come across a link between PA and other autoimmune disease like thyroid, type 1 diabetes, and ulcerative colitis.  I recently had a benign mass removed from my thyroid so, maybe, this is how my thyroid issues presented.

Do you/your doctors know "why" you're B12 deficient?  It can be result of diet (if you don't eat enough B12 rich foods) or malabsortion.  My PA presented neurologically, rather than anemia.  They found my B12 to be low but then they had to figure out why.  First, they tested for methylmalonic acid.  High levels indicate B12 deficiency.  Mine was very high. Then they tested to see if my body was creating antibodies against parietal cell or intrinsic factor (both required for absorption of B12).  I had antibodies to intrinsic factor.   Thus, we knew that is wasn't a matter of me not eating enough B12 enriched foods.  I'm not able to absorb B12 through food.  Now, I take 1cc of B12 monthly and feel great.

The tricky thing about B12 related anemia is that the anemia can actually be corrected by taking folic acid or eating foods rich in folic acid. If this happens, your anemia gets better but your body is still NOT absorbing B12 and you may go on to develop other symptoms, including neurological symptoms.  So if your anemia goes away without taking B12 don't consider yourself better.... keep taking your B12.  I attached a link that describes the available tests to determine the "why" part:

http://www.emedicine.com/neuro/topic439.htm

Good luck!      

[Avee3]

Hmmm.... I took a very low dose of Effexor (37.5) for a couple of years and then developed nodule.  I wonder if Effexor is just a very common med and so are thyroid nodules, or if there is a connection.  I didn't know it was listed as a "rare occurrence".... interesting.

[Avee3]

Sorry...post above regarding Effexor intended for another thread!

[kitty9309]

Thanks for the info on PA. I am in the testing stages and am waiting on the results.
I am glad you could add your personal experience for pplilaccavy. Helps me, too. Do you mind if I ask what your presenting symptoms were? How quickly did they resolve?

Kitty

[Avee3]

Kitty,

My presenting symptoms of pernicious anemia were mostly neurological - tingling/stabbing pain in feet and hands, migrating pain especially in my legs, and profound leg weakness.  My memory and concentration had also gone south.  One night, I actually forgot how to get home.  I was 29 when I developed symptoms so I knew it wasn't old age.  I also found myself to be very depressed.  It took a smart doctor and a few months to get a diagnisis because I was never anemic.  This type of presentation is not so common and often confused for MS. It took me about 1 month of shots to start mentally feeling better and about 6 months for the neurological symptoms to subside.

Do they think you have PA?  

[kitty9309]

I think I may. I suggested testing to the doctor. Get blood drawn tomorrow. Along with mild hypo, my ferritin is only 9 and I know that a low b12 can be a reason why the body may not absorb enough iron. I have disequalibrium, though I pass all the neuro/ear testing. Also muscle twitching, which did subside somewhat when I was taking b12 a month ago. I stopped the b12 supp. when I knew I was going to ask for tests, so maybe it would be more accurate. The muscle twitches are back full force, so it has to be related.
Wow- I'm glad for you that a doctor suspected that for you. A firend of mine just told me that her friend was just dx w/ low b12 after thinking she had MS. Probably similar to you situation.
Thanks for replying.  I've read that mega dose sublingual or oral is as effective as shots. Do you know anything about that?

Kitty

[Avee3]

Muscle twitching.... I can't believe I forgot about this one.  It was one one of my more troubling symptoms.  It went away rather quickly after starting B12.  I have seen research that says if you take a high dose of oral B12 some of it will be absorbed.  There is also sublingual that's absorbed much better, and even nose spray.

My ferritin was recently tested and found to be low - I think 8.  My B12 is normal so we're not sure why the ferritin is low.  We suspect diet (I'm vegetarian) or heavy periods, or a combination of the two.  I started taking iron last month and I feel good.  My Vitamin D was also quite low so I've been taking Vit D as well.

Anemia can cause disequilibrium, as can B12 deficiency.  I was light headed and very dizzy during that time...another bad symptom I forgot about.  These symptoms were subtle at first and developed slowly.  Finally, one day, I realized I was having trouble walking and that was when I started seeing doctors.  It was a tough thing to go through because by the time I got help I was really sick and no one could initially figure it out.  I thought I would be sick forever but, thankfully, I did get better.  Just be sure your doctor runs the proper test.  Lab values for B12 aren't sensitive enough.  You must test methymalonic acid.  It's a metabolite that elevates in the presence of B12 deficiency.  If it's elevated, then test for antibodies.  If you have difficulty getting your doctor to test these things go see an hematologist.  They usually do the proper testing.

Hope this helps!

Best,

Avee

[kitty9309]

Wow- that sounds so much like me!
I now realize that my dizziness was mostly gone when I was tring to get pregnant, pregnant and nursing. I have 2 kids- same pattern. Maybe it was the b12 or iron in the prenatal vitamins that helped me feel better. I just recently put that timeline together in my head. It may be more of those 2 things than my thyroid causing the most trouble.
I did get the serum b12 as well as MMA and nutritional homocysteine. And CBC, ferritin, folate, iron, TIBC.
Did you see a hematologist? I will wait for my results and then see about doing that.
Also, do you know if taking sublingual b12 proir to testing would have screwed it up. I work in the lab, but I can't get a straight answer to this. I stopped the b12 2 weeks prior and then forgot and tooh 3000mcg sublingual on Monday. I had blood drawn today. I'm glad I did the other 2 tests w/ b12 if that did skew the results.
I see you are not set up for messages. I would like to keep contact if you are willing to discuss this if my results are low. I think more people on this forum should be aware of low b12, since so many symptoms mimic hypothyroidism, and they can be related.

pplilaccavy-
Sorry I took over the thread. I hope you could glean some info for yourself from my back and forth with Avee3.

Kitty

[Avee3]

After seeing lots of neurologists and other docs, it was a very smart internist who suspected the B12. He consulted with a hematologist about what tests to run and then made my pernicious anemia diagnosis.  In my experience, most general practitioners will not test for methymalonic acid or antibodies because they're more specific tests.  A hematologist or endocrinologist will usually test beyond the standard labs in this area.

I don't know if the sublingual will skew results.  My thought is that it might raise your serum B12 level but if you're deficient, your MMA will still be elevated.  The way I understand B12 is that it's stored in your liver and the body uses it as necessary.  I'm not sure how this relates to the tests.... If they come back normal, tell your doctor you took the sublingual and ask for re-testing in 3-6 months.  Then you'll know for sure.

Let's definitely stay in touch.  I changed my profile so I could accept messages.  Let me know if it doesn't work.

Best,

Avee