Pernicious anemia

Germs

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Hi,I was diagnosed t1 19 years ago when I was 34 and my control has been pretty good on the whole but since my heart attack last October it's been spotty.
Just this week I was diagnosed with pernicious anemia and my doctor prescribed folic acid but told me nothing about the condition or cause so I've been googling and found it's a side effect of Metformin but nothing other than that.
Could you share your experiences of the condition, effects on your blood sugar control and any other information you may know?
Thanks in advance.
 
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kitedoc

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Hi @Germs, Reading up on your query and as from that background, not as medical advice or opinion: I would be rushing back to your doctor and asking why you were prescribed folic acid. People with low vitamin B12 (which occurs in pernicious anaemia amongst other causes) are rendered LOWER in serum B12 by taking folic acid supplements alone. If you cannot absorb Vitamin b12 , b12 injections are likely required long term., NOT Folate supps. (see section on this in Wikipedia)
Also to diagnose pernicious anaemia, a low B12 in conjunction with raised antibodies is required.
Metformin can cause low serum b12 as a side-effect (but cause unknown). Metformin does not cause pernicious anaemia per se.
Other causes of low serum b12 beside pernicious anaemia include: coeliac disease, inflammation of the bowel such as in Crohn's disease, infection with fish tapeworm, a long term vegan diet. References: Wikipedia - Vitamin b12 Deficiency
 

JohnEGreen

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I take folic acid because I have low folate I however do not have low B12. My daughter has pernicious anaemia and requires B12 injections long term.
 
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donnellysdogs

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Pernicious anaemia and you need b12 injections.....

Folic acid for low folate.

If low b12 due to not eating enough products with B12 then a B12 sublingual tablet can normally suffice.

If someone has PA, folic acid won’t do anything.
 
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Germs

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Hi @Germs, Reading up on your query and as from that background, not as medical advice or opinion: I would be rushing
Hi @Germs, Reading up on your query and as from that background, not as medical advice or opinion: I would be rushing back to your doctor and asking why you were prescribed folic acid. People with low vitamin B12 (which occurs in pernicious anaemia amongst other causes) are rendered LOWER in serum B12 by taking folic acid supplements alone. If you cannot absorb Vitamin b12 , b12 injections are likely required long term., NOT Folate supps. (see section on this in Wikipedia)
Also to diagnose pernicious anaemia, a low B12 in conjunction with raised antibodies is required.
Metformin can cause low serum b12 as a side-effect (but cause unknown). Metformin does not cause pernicious anaemia per se.
Other causes of low serum b12 beside pernicious anaemia include: coeliac disease, inflammation of the bowel such as in Crohn's disease, infection with fish tapeworm, a long term vegan diet. References: Wikipedia - Vitamin b12 Deficiency
Odd you should mention Crohns disease as I was diagnosed ibs which changed to ibd and now they suspect it may actually be Crohns. Thank you for the info.
back to your doctor and asking why you were prescribed folic acid. People with low vitamin B12 (which occurs in pernicious anaemia amongst other causes) are rendered LOWER in serum B12 by taking folic acid supplements alone.
If you cannot absorb Vitamin b12 , b12 injections are likely required long term., NOT Folate supps. (see section on this in Wikipedia)
Also to diagnose pernicious anaemia, a low B12 in conjunction with raised antibodies is required.
Metformin can cause low serum b12 as a side-effect (but cause unknown). Metformin does not cause pernicious anaemia per se.
Other causes of low serum b12 beside pernicious anaemia include: coeliac disease, inflammation of the bowel such as in Crohn's disease, infection with fish tapeworm, a long term vegan diet. References: Wikipedia - Vitamin b12 Deficiency
 

Oldvatr

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Pernicious anaemia and you need b12 injections.....

Folic acid for low folate.

If low b12 due to not eating enough products with B12 then a B12 sublingual tablet can normally suffice.

If someone has PA, folic acid won’t do anything.
Also, any diet that avoids the fortified grain products such as bread, flour, cereals etc will reduce the sources of B12 you get naturally. Marmite or meat products should compensate normally, but not everybody can use those. Vegans espcially can suffer B12 deficiency.

Another thing is that any B12 deficiency or folate deficiency or vit c deficiency will all act to reduce iron absorption, and that can also cause anemia.
 

Ledzeptt

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Hi @Germs

This NHS article seems to link B12 and folate deficiency, so I wouldn’t panic that your doctor has given you the “wrong” medication, although it is worth doubling checking:

https://www.nhs.uk/conditions/vitamin-b12-or-folate-deficiency-anaemia/causes/

I have pernicious anaemia treated with 3 monthly B12 injections. To answer your question, I have no ill effects, other than I start to feel tired in the weeks before my next injection is due i.e. one B12 shot doesn’t seem to last a full 3 months, but I’m not allowed to have them more frequently. It seems to have no effect on my blood glucose.

I have no experience of folic acid.

(My Diabetes is similar to T1 in that I’m insulin-dependent.)
 

kitedoc

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Hi @Germs

This NHS article seems to link B12 and folate deficiency, so I wouldn’t panic that your doctor has given you the “wrong” medication, although it is worth doubling checking:

https://www.nhs.uk/conditions/vitamin-b12-or-folate-deficiency-anaemia/causes/

I have pernicious anaemia treated with 3 monthly B12 injections. To answer your question, I have no ill effects, other than I start to feel tired in the weeks before my next injection is due i.e. one B12 shot doesn’t seem to last a full 3 months, but I’m not allowed to have them more frequently. It seems to have no effect on my blood glucose.

I have no experience of folic acid.

(My Diabetes is similar to T1 in that I’m insulin-dependent.)
Hi @Ledzeptt, The NHS article refers to B12 OR folate deficiency. Their treatments are separate, no matter the connections in their metabolism.
It is misleading to assume one treatment would cover either deficiency.