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Nataylia--Welcome to the boards! No you are not going crazy! :round:


If you prove to be B12 deficient, by blood work, or by resolution of symptoms with therapeutic trial of B-12 then your doctor needs to[U] find out why you were B12 deficient[/U]. 200 is usually the number that will be treated with IM injections, a therapeutic dose. You are correct many people will present with symptoms which can occur for some under the 500 mark. You are just way too low. The doctors actually like it to be much higher at the top of the range and over for others, not the bottom of the range depending on the problem. I can tell you from my experience a normal B-12 for myself is 850 and up with supplements, and I supplement with B-12 sublingual.


B12 deficiency can be caused for a variety of reasons, not just autoimmune pernicious anemia which seems common here. Other causes of B12 deficiency can be from the following: diet, specific drugs ([B]PPI, H-2 blockers[/B], alcohol abuse, nitrous oxide, antacids, metformin, etc.) also [B]malabsoprtion syndromes [/B] which are common in many are([B]Celia disease [/B][gluten enteropathy], Crohn's disease, H.pylori, bacterial overgrowth of the small bowel, transcobalamin II deficiency, inborn error of B12 metabolism, surgical (gastric bypass, stomach or small bowel removel, injury, ulcers, etc.), radiation therapy to[B] ileum [/B]or stomach.

Also, you need to keep an eye on that ANA if it is high as you say. It's telling you something. It can be caused by a variety of things as you well know by now, I am sure. If I were you, I would ask for a PA, Celiac and Ferritin test from your doctor for starters. It is possible to have a low ferritin as well, many people do. You just haven't hit bottom yet to become anemic or show on your labs perhaps, however, you have a problem or your numbers would be much higher. As long as you are in range many doctors don't treat, but you can on your own with a sub-lingual B-12 under the tongue. You should research B-12, cause and treatments. You can do that right here on the HB's boards.

Regarding your ANA it can take literally years to get a diagnosis so hang in there and don't let it go. You may have more than one thing happening at this time.

Have you had your thyroid checked as well, if not it would be a good idea. Many symptoms are a cross over of something else, not just anemia or deficiency. It often can be a combo of things. If you are malabsorbing B-12 you should have a vitamin panel done as well there are usually other things off not just one thing. If I were you I would see a GI doc, the one that specializes in malabsorption syndromes. I would also revisit the Rheumy. There is a reason for this. Take care and keep us posted. FLFLOWERGIRL:)





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