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Suggest treatment for Vitamin B12 deficiency? - Online Doctor Chats

Date : 17-Apr-2014
User rating for this question
Very Good Posted in: Vitamins
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2585 Questions
User:have ehlers-danlos hypermobility type WITH vit b12 deficiency (and of late vit a but don't have result # yet how low... is that known as folate?) been taking b12 shot for yrs and have been am now in SEVERE weight loss 33 LBS IN maybe 2+/- yrs....5'6" then 130 now 95 VERY tiny boned....I JUST READ that b12 deficiency 'CAUSES WEIGHT LOSS' and that a SPECIALIZED B12 testing should be done seeing if enuff is even being given or being absorbed...I AM VERY UPSET THAT tho i reported often weight loss no-one did anything GEN.PRACT DOC here canada AND but had already been dx'ed with hashimotos and srogrens by ENDOc. HE IS ONE to tell gp to give twice monthly b12 shots BUT NO-ONE ever bothers testing its levels of staying in me I HAVE HAD TO DO ALL RESEARCH thyroid is fine at 1.09 ( i asked for free t3 &4 and take d3 with seems like DOING IT ALL MYSELF Aand am angry - have lost complete muscle mass too and wasnt that great I COULD LOSE MY LIFE nohting literally but wrinkles of skin now where I WAH ALWAYS SLENDER ANYWAY.....really just want to know how the heck do they know how much b12 injection to give anyone who cannot absorb so i cant from food how could I FROM A DAMN SHOT.... no specialists pls just basic medicine thanks
Doctor:Hi
Let me read your query for few minutes to be able to have a good discussion here.
User:and no is so nor have pernicious anemia
Doctor:Before I address your question, I would like you to know that vitamin B12 absorption tests are discussed for patients who are on oral b12.
Doctor:A healthy stomach and another factor known as intrinsic factor is required for oral absorption of b12.
Doctor:I don't think there is a test required to know how much b12 is available for absorption through iv injections.
User:is either classified as fat or water soluble and does that have bearing
User:i do not take oral as i said injeections
User:but dx shouuld NEVER BE by test first GOOD DOCTORS SEE AND NOTE AND ASK symptoms
Doctor:I read that part. Since you are on injectables you need not be worried about that.
User:oh really
User:also read:
User:Weight loss ; Numbness or tingling in your hands ... Etiology and clinical manifestations of vitamin B12 and folate deficiency.
Doctor:I understand what you say, good and experienced doctors use investigation only to support clinical diagnosis.
User:lately my whole fingers have gone in and out numb....it is not reynauds
Doctor:And with symptoms of weight loss and tingling malnutrition is one among the differential diagnosis.
User:at 5% or 10 lb weight loss not normal any doc SHOULD STOMP ON THAT now i have no muscles left you know what that means to my life yes ??
Doctor:As I said, numbness may be secondary to b12 deficiency.
User:no all other vits and minerals came back normal range even tsh selenium all hormones anything to thing thyroid and such
Doctor:If there is severe muscular atrophy, I think you should also consider consulting a neurologist
User:you know i can die
Doctor:to test your muscles.
User:i can walk ...if you skin where muscle used to be its not atrophy
User:if you read there is no muscle tone or muscles MY BUTT IS HANGING SHREDS of skin.,IS THAT NOT
User:catabolic wasting sir
User:are you a doctor
Doctor:Without an opportunity to examine you, I am unable to appreciate your condition better.
User:you read and were told BODY LOST ALL THAT WEIGHT FIRST IT TAKES ANY FAT STORES THEN IT WILL AND DID
User:TAKE MUSCLE TO SURVIVE
User:YES U MOST CERTAINLY ARE
User:THERE IS NOTHING I HAVE NOT TOLD YOU I ASKED ABOUT B12 AND WEIGHT LOSS OR IS VIT A FOLATE
Doctor:My opinions are entirely based on your description.
User:AND A ALSO SUPPORTS SOFT TISSUE
User:YOU DONT HAVE AN OPINION YET
User:WHAT IS EHLERS DANLOS SYNDROME TELL ME NOW IF YOUKNOW WHAT IT IS PLS
Doctor:And as I mentioned earlier, with significant weight loss and sensory disturbances, malnutrition and nutritional deficiency is definitely to be suspected.
Doctor:Ehlers Danlos syndrome is a connective tissue disorder
User:WELL TO ME TOO it would seem i would HAVE TO BE MALNOURISHED to have lost that mcuh
User:there is only viamin a that is not in normal....and we knew about b12 malabsorption issue (IS THE ILEUM THAT DOES aborb it?) yrs ago and began shots then
Doctor:Its absorbed partly from the gastric mucosa; but most of it is from the terminal intestines.
User:well then and i am losing weakened colloagen disoredered TISSUE ARENT I
User:what is an ileum
User:that is what this bloody doctor here told me absorbed it
Doctor:Ileum and terminal ends of jejunum forms the terminal ends of intestines.
Doctor:And if there are other vitamin deficiency, collage formation can be affected too.
User:then they try to say i have gastroparesis I DONT....all goes in all comes out AND I NEVER VOMIT and their test was GASTRIC EMPTY DELAY SHOULD not in your opion done with mE ION MORPH 6MG and gabapentin THAT WILL DELAY FOOD EMPTY PLUS TAKE AN APPETITE AND TRASH IT
User:ONLY ONLY VITAMIN A .....CAN IT CAUSE WEIGHT LOSS TOO
User:LETS STAY ON TRACK OF WHAT TESTS I HAD AND ALL RESULTS....THEY ARE I HAVE LEFT TO HOPE ON
Doctor:The vitamin deficiencies are end results of malnutrition.
User:NO-ONE should have 4 hr gastric empty test should be given 9 hrs to empty
Doctor:Weight loss is part of symptoms of malnutrition.
User:I KNOW!
User:but would it make a diff if they tested for malabsorp or maltrunti
Doctor:Therefore vitamin a deficiency is not cause of weight loss.
User:should come out to read the same to me if not being absorbed then in malnutrition
Doctor:Did your doctors perform an endoscopy / colonoscopy.
User:what kind of horrid game are they playing at this my life
User:what on earth for
Doctor:I am extremely sorry, if your primary doctor hasn't treated you to your satisfaction.
User:i dont like invasive until what it isnt has been ruled out.....what would they loook for possibly making injuried with their stupid scope
Doctor:You can consult a gastroenterologist who are experts in handling malabsorption symptoms.
User:shes NO EXPERT! i have
Doctor:If you have significant weight loss it is essential that we look into your stomach and intestines.
User:she wanted to do what you said BUT WOULD NOT SAY anything other than for seeing organs ok J OR G L TUBE feeding
User:THEY ALLL JUST THINK I HAVE GASTROPARESESIS and i do not!
Doctor:They will need to take samples from intestines and study under microscope to understand if something else is causing it.
User:she did not say that at all see they all lie
Doctor:You have an option to take a second opinion from a gastroenterologist.
User:someelse what CBC is fine no stomach cancer no bleeding ucler can cause this kind of yrs weight loss with no pain
User:sir i asked you you are 2nd opinon
User:speciment for what
Doctor:Like I said earlier, gastroenterologist are the right experts to handle you.
Doctor:You can ask her for a referral.
User:no
User:you were aSKED what u would be looking for and why a biopsy neede
User:you can tell i kinda know them
User:endocopy polpys and or cancer
User:sorry colonoscopy
User:endor
User:endo can only reach to upper inner
Doctor:Since you have significant weight loss, I would test for chronic infection, intestinal infestations, malabsorption syndromes such as celiac disorder, polyps and definitely intrinsic factor deficiencies.
User:duodenum yes?
Doctor:Endoscopy can reach to the first part of duodenum.
User:that is what IS A HUGE KNOW A.I. AONG WIHT HASHIS AND SROGIs......celiacs
User:NO SCOPE TELLS THEM THAT
Doctor:The rest of the bowel can be studied through colonoscopy.
User:I'VE HAD A COUPLe OF BAD BACTERIAL STOMACH INFECTS YEARS MANY AGO.......
Doctor:I think you should consider consulting a gastroenterologist one who knows about these procedure.
Doctor:Hope I was clear.
User:what do you mean INTRINSIC FACTOR DEFEFIENCY i just had about 20 tubes blood taken out of me in fact the prof of endoc teach hospt here IS TAKIGN TESTING OF G.I. she is in same hosp!!
Doctor:hello
User:continue with why b12 deficiency and now i ask again what vit if FOLATE
User:B12 DEFICIENT YEARS OF INJECTIONS eds hypermobility type
User:not folate pls what vit is it
User:lost 35 lbs in +/- 2 yrs,,,,,,,,,,, am now 95 all muscle gone too and they failed TO NOTICE HERE IN CANADA AS KEPT REPORTING!
User:ow
User:gastic delay stomach test SHOULD BE 100 90% AT 4.5 HR S
User:all tests were done for every vit min only A came back not right doint know results yet
User:B12 SHOTS FOR YRS
User:b12 deficiency KNOWN WEIGHT LOSS ISSUE
User:is vitamin A KNOW AS FOLATE
User:STOP READING BACK PLS
User:AND AND ANSWER QUESTIONS I PAID TO ASK
Doctor:All right
Doctor:I have a brief idea of what your concerns are now
Doctor:please ask me your questions now
User:IS VITAMIN A KNOWN AS FOLATE
Doctor:No
Doctor:Your answer is no
Doctor:Vitamin A is not known as Folate
User:but vit a IS INTEGRAL TO SOFT TISSUE AND GONE
Doctor:Vitamin B 9 is folate
User:BONE
User:now........
Doctor:For your clarification
Doctor:Vitamin B9 is Folate
Doctor:Vitamin B12 is Methylcobalamin
User:if i am on 6 mg morph and 900 gabapentin THAT WOULD SURE DELAY FOOD EMPTGYING SAYS DOCTOR XXXXXXX
Doctor:And Vitamin A is just Vitamin A
Doctor:Is it clear to you?
User:THEY EXPECED ME TO EMPTY IN 4 HRS HAHAHA
User:I READ 9 HRS SHUD BE GIVEN or TITRATE OFF KNOWN prolbelm drugs
Doctor:why was the gastric emptying performed?
User:sir you know i have lost way too much weugggtththth STOMACH
User:GASTROPARESIS TEST
User:THEY TRY TO SAY I HAVE IT I DO NOT
User:IN ONE END OUT THE OTHER NEVER EVER VOMIT
User:INSANE
Doctor:sorry about that
User:THE ASK FOR COMPLETE DRUG LIST AND THEN DONT READ IT? U THINK A STOMACH WOLULD TAKE LONG TO EMPTY ON MORPHINE YES OR NO
Doctor:YES is your answer
User:AND WHAT CAN B12 (OR LACK OF IT)]EVEN IF INJECTED WHO SAYS IT IS BEING ABSORBED PROPERLY??? EVEN BY INJECTION DO TO CAUSE SEVERE LOSS
Doctor:morphine delays gastric emptying
User:AND GABAPENTIN AND CLONAZEMPAM AT VERY LEAST DULL APPETITE
Doctor:B12 deficiency can cause weight loss
Doctor:yes, Clonazepam can dull appetite
Doctor:Not so very often with Gabapentin
User:SO NOW IF I DONT AGREE WITH THEM OR TRY TO ASK ABOUT THIS 4 test that definitely oh YES YOU DO HAVE GASTRPARESESI IN GO THE TUBES INTO YOU!!! ......... omg
Doctor:You need not have to go for the procedure,if you do not wish
Doctor:have you got your answers?
User:eds and also i have hasmimotos thyroid MANY MANY NITES OF NO LITTLE SLEEP IS AT 1.09 tsh ......but bad bad stress here HOW ABOUT ADRENAL OR PITUITARY DOCS INSTEAD OF INSISTEING ITS STOMACH
User:I DID THE PROCEDURE HUH?
Doctor:You could see an endocrinologist
Doctor:That would be better
Doctor:You mean the tubes were already passed in to you to check for gastroparesis?
User:no that IS NOT THE TEST u do ...you do the nuclear med gastruc empty 4 hr delay one
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