GP refusing to give B12 injections

[willpwuk]

Hi Everyone,

I've had my b12 check the other day which came back as: 351 pmol/L.

My gastro says that anything below 400 warrants injections however my GP thinks otherwise. I literally had to sneak a look at the screen before she closed off my results as for some reason she hates giving me the numbers instead she takes a quick glance and says 'it's normal'

I saw a brilliant post on here with a printable document discussing that anything between 200-500 should warrant more testing and the patient should be considered deficient, however i can't find it.

Would anyone be able to link me to it so i can print it out and shove it (nicely ) in my gp's face, please?

Thanks!

 

[Glockola]

Ask them to test for MMA. The methylmalonic acid (MMA) test is used as a sensitive test for early or mild vitamin B12 deficiency.

If the MMA is normal, then you do not have any deficiency.

I do not agree with your gastro, anything below 400 pmol/L does not warrant injection. Usually the lower end of normal is 250 pmol/L.

I do not understand why you think you are deficient?

 

[SN8888]

Sublingual B12 is supposed to be effective (I'd guess liquid is better than tablets??). You wouldn't have to rely on your Dr or get shots.

 

[willpwuk]

Ask them to test for MMA. The methylmalonic acid (MMA) test is used as a sensitive test for early or mild vitamin B12 deficiency.

If the MMA is normal, then you do not have any deficiency.

I do not agree with your gastro, anything below 400 pmol/L does not warrant injection. Usually the lower end of normal is 250 pmol/L.

I do not understand why you think you are deficient?

It was my gastro that flagged the result because of the weakness i've been having in my legs along with the neuropathy, hypoactive reflexes, canker sores on my mouth, red sore tongue etc. He's Japanese though, and said that in Japan anything below 500 in Japan is considered deficient and considered i'm symptomatic and my levels fall within the 'low normal' range injections would be beneficial.

 

[Womble]

WOuld be your gi who would manage that unless the gi had written and asked them to.
Mine are a tad higher than yours and it’s not classed as defiecient.

 

[Glockola]

It could be that you are deficient in other B vitamins. Red sore tongue sounds like some kind of vitamin B deficiency. How is your folate?

If anything under 500ng/L would be classified as deficient, that would mean more than half the world population would be deficient. I don't think so.

 

[willpwuk]

I guess it depends on what the reference ranges at the labs are mostly but while doing research (i'm studying at medical school.) There's a lot of contradiction on what is considered a normal b12 level or not. Some people become symptomatic when they're levels are within the 'low normal range' and like Glockola said that's why the MMA test is usually done to confirm the deficiency because the regular b12 serum test isn't 100% unless the case is severe.

 

[Glockola]

Correct, if unsure you should always check the MMA and Homocystein levels.
But usually 250ng/L is the "gray zone". And anything below 150ng/L almost always indicate deficiency.

 

[Womble]

I guess it depends on what the reference ranges at the labs are mostly but while doing research (i'm studying at medical school.) There's a lot of contradiction on what is considered a normal b12 level or not. Some people become symptomatic when they're levels are within the 'low normal range' and like Glockola said that's why the MMA test is usually done to confirm the deficiency because the regular b12 serum test isn't 100% unless the case is severe.

No I agree with you totally, it was more in reference to the fact that the gp won’t do anything unless it’s written down somewhere several times... speak to your gi etc
‘Functional b12 deficiency’ is what I think you mean? Lab ref ranges seem to broadly follow ‘who’
But it seems that they ignore the functional part

 

[Glockola]

That is why the MMA is the only definitive test for B12 deficiency.

 

[shamrock15]

The injections are really not that difficult to do. I used to do my own for several years until I was told about sublingual B12. Now that is the approach that I use and they have kept my levels in very good shape.

 

[Womble]

That is why the MMA is the only definitive test for B12 deficiency.

Nhs reluctant to do further tests, is what I meant x

 

[Anna's Bandit]

Please tell me what MMA is. Thank You.
Also, years ago I gave myself B12 shots at home. Then at one time I went to a Hematologist office for a B12 shot once a month. Now I take B12 tablets from the drugstore. Are B12 levels noted on a Comprehensive Metabolic Panel blood test ?

 

[Glockola]

Please tell me what MMA is. Thank You.
Also, years ago I gave myself B12 shots at home. Then at one time I went to a Hematologist office for a B12 shot once a month. Now I take B12 tablets from the drugstore. Are B12 levels noted on a Comprehensive Metabolic Panel blood test ?

No you have to specifically ask for B12 and/or MMA.

 

[Pug Gamer]

I have a b12 deficiancy also. I had my loading dose (3 times a week for 3 weeks) then when it came to my next one 3 months later my GP refused and said im back to normal. When i saw my GI a few months later he asked how my injections are going, i told him they wont do it as im normal. He looked and said your deficient in your last 2 bloods and will need them for life. My GP refuses so my GI and IBD nurse are going to be forcing them. The NHS is a joke atm. I have so many symptoms and yet they say there "just below normal and not worth injections" but thats a lie. I had the same with Vitamin D, GP refuses my 100,000IU and said i need to take over the counter (paid by me) 10,000IU. That worked out at 10 pills instead of 1 and i cant afford to pay the cost!

 

[Glockola]

The NHS is in bad shape and looking to only get worse. Here in Sweden the health care system is basically falling apart completely. We have the same system as in Britain.
Many hospital beds are empty because sections has to be closed. There is a huge shortage of staff and the problem has been neglected for years.
They let the patients sleep in the corridors and behind the reception desk. Nightmare!

 

[Womble]

I had no idea, I naively thought you’d have a great service

 

[ronroush7]

So sorry,Glockola