[Lilian (OP)]

I'm 49 and had megaloblastic anaemia diagnosed 7 yrs ago and - rather than have a bone marrow biopsy - decided to see if B12 and folate vitamin tablets would help. They did and a blood test a couple of months later was clear. I've been taking 800mcg folate and 1000mcg B12 since then and, but for the past 4/5 months reduced the B12 by half. Started to feel very tired again recently, so I increased the B12 to 1000mcg twice daily. After a few days on this, the tiredness has gone. Is there anything else I should do or not do? Can I go on safely taking the tablets as a maintenance dose (and is the original dose OK)? Should I have any investigations as to the root cause? I'd be grateful for advice.

Lilian

[Rokitansky]

Seems ok to me. If the cause of your lack in B12 is gastric mucose atrophy, you may fell into trouble with iron absorption, also. This may be due to achlorhidria or hypochlorhidria in your gaster.

You might want to check  your blood iron, as a prevention. Ask your physician, also.

The other thing you could do is gastroscopy.

[bezoar]

If by megaloblastic anemia, you mean pernicious anemia, then you would do better to take the B12 by injection.  Pernicious anemia means you are missing the intrinsic factors needed to absorb the B12 from you digestive tract.  A bone marrow biopsy isn't necessary at first.  A Schilling test would give the answer to whether or not you're able to absorb B12 from your GI tract.  This involves a 24 hour urine collection, and provided you collect all your urine, and don't have any problems with your kidneys or the lining of your small intestine, you'll get your answer.  You need to know the cause of the anemia before you know how to treat it, but probably, it is pernicious.

[Rokitansky]

quote:Originally posted by bezoar

If by megaloblastic anemia, you mean pernicious anemia, then you would do better to take the B12 by injection.  Pernicious anemia means you are missing the intrinsic factors needed to absorb the B12 from you digestive tract.  A bone marrow biopsy isn't necessary at first.  A Schilling test would give the answer to whether or not you're able to absorb B12 from your GI tract.  This involves a 24 hour urine collection, and provided you collect all your urine, and don't have any problems with your kidneys or the lining of your small intestine, you'll get your answer.  You need to know the cause of the anemia before you know how to treat it, but probably, it is pernicious.

It also may be due to Absorption disorders concerned with surgical removing of distal ileum, or increased bacterial flora in the guts, or lack of B12 in diet (vegetarians)....

I think orraly given B12 is used to treat the lack of it, commonly.

[Lilian (OP)]

Thanks for your replies. I'll ask for a Schilling test. I'm not vegetarian and haven't had surgery of GI, but do have problems absorbing fat e.g. dairy products like milk and cheese - in fact have almost given up eating these.

Lilian

[bezoar]

The fatty intolerance could be related to the gallbladder, or if just milk products, could be a lactose intolerance.  Might not be at all related to the anemia.

[Donnah]

Lilian, if I were in your shoes, I'd be doing research on the process of absorbtion through the GI tract (and some cleansing of the bowel).  Was there something that changed in your life just about (or before) the time the problem arose?

[qazibasit]

you lack the intrinsic factor which absorbs the vitamin B12 and these vitamin B12 matures the Red Blood Cells (RBCs) and thus the size of the RBC increases thus it is called as megaloblastic anemia.