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[QUOTE=cgranulomatis;3873705]Hi HKK,

First of all welcome to the boards. Your question is a very interesting one, but I want to address one thing before I begin. In today's world with information being available at anyone's fingertips who has the internet, a lot of medical information goes around to people and unfortunately in many ways it's out of context. As a result, tension arises between doctor and patient mostly because doctors are horrible communicators--even if they are right about something! I'm not totally siding with your doctor, but if you look at the values you gave for your bloodwork, and you have some medical training, it's easy to see that vitamin B12 deficiency is not your problem.

Whenever someone has anemia, it is important to ask WHY. In your case, your anemia is almost certainly due to iron deficiency. Again, however, the question has to be asked, WHY do you have iron deficiency anemia? As a young woman with heavy periods, that is a good explanation to the underlying cause. Iron deficiency anemia is characterized, yes, by anemia, and evidence of low iron stores (i.e. a ferritin of <18), but there are other markers in your bloodwork which highly suggest longstanding iron deficiency. Your MCV or mean corpuscular volume (i.e. the average size of your red blood cells) is very low. Normal is between 79-97. Because your RBCs don't have enough iron to make hemoglobin, they end up becoming smaller. Additionally, your RDW is wide. What that means is that there is great variability between the sizes of your red blood cells. This suggests that rather than there being a DNA problem with your cells (i.e. in something like thalassemia) there is more of a problem in the blood getting iron. Some cells are able to get more iron than others and are thus bigger.

So what the heck does this have to do with Vitamin B12? Well, in vitamin B12 deficiency your MCV is normally LARGE. On average, people with Vitamin B12 deficiency have MCVs which are over 100. If you had BOTH iron deficiency and Vitamin B12 deficiency, your MCV would probably be in the "normal" range because the small RBC effect of the iron deficiency would "cancel out" the large RBC effect of Vit B12 deficiency.

Now on to your symptoms. I understand that your family has pernicious anemia, and yes, this does somewhat increase your risk for getting it; however, I would stop short of saying anything else. One common misconception by patients is that, if they list their symptoms to a doctor, s/he will be able to immediately tell you what disease you have. There is the idea of "specificity" of symptoms. To elucidate further, if someone walks in to the doctor's office complaining of a cough productive of green phlegm and a fever, well, that is pretty SPECIFIC for pneumonia. HOWEVER, most symptoms patients experience are very NON-specific. "Numb hands", "brain fog", "palpitations" (etc.) together do not point towards any one diagnosis at all. They are all very non-specific. This is why when people go to the doctor, it seems like the doctor isn't listening. What the patient thinks are important symptoms are rarely helpful in making a diagnosis. The doctor, however, DOES know the important symptoms, so s/he will often brush the patient's complaints off and ask specific questions. Unfortuantely, if the doctor is not a good communicator, this leads to tension.

WHOOOOOOO, that was a long-winded post, but aside from my explanation of anemia, does my explanation of specific vs. non-specific symptoms make sense?[/QUOTE]

Hi
Iam sorry but this is incorrect information here you state that B12 deficiency is clearly not her problem......Incorrect there is no B12 or HCY or UMMA results so I dont know how you can say that......
However if you are talking about PA that is different the blood now changes the cells become large...and the MCV is elevated...You still need to have the B12 checked in any case

You can have a B12 deficiency or insuffeciency without anemia.....And the symptoms listed are among them....I can list a whole lot of symptoms for your viewing it affects the whole body systems not just the blood it is serious in that it can cause a lot of damage with the correct type of B12 a lot are reversable.............I know as I am B12 deficient and I dont have anemia at all nor was my MCV elevated I had foggy head,numbness, fatigue,palpitations rapid heart rate loss of memory stomach issues concentration problems couldnt talk properly the list goes on and on..........My iron was on the low side as my ferritin but not severe vitamin D very low as was my folate........
Thyriod conditions are strongly linked with B12 and also celiac disease which can acuse B12, iron vit D and folate deficiencies.........

Cheers:wave:





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