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Low b12?

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Posted 9/2/2011 6:58 PM (GMT 0)
Feeling tired a lot lately, so I asked my GI doctor for a b12 test, since they surgery I had 3 months ago did remove part of the area that absorbs b12.

My question is, can I still have low b12 and normal HGB/HCT?

Just curious while I wait for the fax so I can get the blood work done.
Posted 9/2/2011 9:45 PM (GMT 0)
Oddly enough I have short bowel syndrome after ileo and many surgeries to remove bits of small bowel and by all rights I should have low B12 and my GI thought I'd been having monthly injections for years. However, my B12 is more than normal which is why he thought I was already having them. So just one more thing that my body goes against the medical text books and I don't eat things high in B12 either, must admit my diet is actually pretty rubbish - high fat, high salt, high calorie and low fibre to make 4000 calories a day.

I have had low HGB/HCT and normal B12 so maybe it is possible in reverse.
Posted 9/2/2011 10:01 PM (GMT 0)
Your body stores B12, sometimes for years. It all depends on how high your stores were before your surgery or when your surgery was, you may never need B12 supplementation. I didn't need to start B12 shots for almost 12 years after my first resection which was when my terminal illeum was removed. Most people would have needed supplementation long before that. Also every doctor is different in their interpretation of "low". I have had 4 different GI doctors look at my B12 results and all have interpreted them differently, to the point where one had me come in for emergency B12 shots because he thought I was way too low, but my regular GI had looked at the same tests a month or so before and said I was fine. My current GI thinks I can cut back to once a month from every other week, but I am borderline normal now, so I want to stay where I am and my GP is fine with that. It really is a bit subjective.
Posted 9/3/2011 1:32 AM (GMT 0)
From the Journal of the American Geriatrics Society, 1996: "The doctors conclude that the levels of serum vitamin B-12 concentrations currently considered normal in the United States may be too low and should be reassessed. The lower limit of 200 pg/mL is based on the level which causes abnormalities in the blood (pernicious anemia). In contrast, the lower limit in Japan and some European countries is 500-550 pg/mL and is based on the level which causes mental manifestations such as dementia and memory loss."

In other words, if your B-12 level is between 200 and 500, some of your doctors (the ones who aren't fully informed) and most of American labs will declare your level to be normal. Better-informed doctors will tell you that your level is way too low.

American seniors, in particular, have B-12 levels that are too low, which leads to a big increase in dementia. Most European nations give their seniors B-12 supplements or injections, to make sure that their B-12 level is over 500.

Our health care system sucks.
Posted 9/3/2011 1:46 PM (GMT 0)
I'm in UK and after recently talking to my GI and GP about this my level is at nearly 700, they will start shots monthly if drops below 550 in normal healthy people but I'm having them as a precaution but have to check every other month on my blood tests to ensure doesn't go over 1000, as too much can cause as many problems as not enough.
Posted 9/3/2011 10:39 PM (GMT 0)
Glad you're in the UK for this one! And I had no idea that there could be such a thing as too much B-12. Thanks for the information. I'll have to look it up to see what the bad effects are (not that I ever have a chance of having too much B-12).
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