More than you care to know about B 12

OK, so I got a pile of labs done to try to figure out why I feel so lousy. They were all "normal" according to the Endocrinologist.

But, you know me...Tricare has made me very cynical and I only trust doctors as much as I trust Tricare, which is not much. My B 12 lab came back as 399. Normal range is 211-911. Sounds good, right?

Well, if you dig around a little, you will discover that in Japan and some European countries, the bottom of the range is 500. Why 500? When you get under 500, that is when some neurological and other odd symptoms start popping up. I don't know why the US has set it at 200. Under 200 is SEVERE depletion and irreversible damage could be going on. The ideal target is around 800.

So in someone with Hashimoto's, the reaction to gluten can also damage other parts of the digestive tract, including this "intrinsic factor". Intrinsic Factor binds to a normal B 12 cyanobalmin and makes it methylobalmin which is digested in your body. Without that IF bonding, your body doesn't know what to do with the cyanobalmin it gets from food. Therefore, over time, that B 12 level nosedives because your body isn't getting B 12 anymore. Even if you go to supplement to make up for it, you have to be very aware of what form you are taking. Most of the B 12 vitamins you see on the shelf is cyanobalmin which the Hashi body can't use. It has to be methylobalmin.

I've copied some of the info from Google health for anyone who gives a flying fig. I tried to emphasize the neurological and odd symptoms I've been having. It makes sense to me that this might be a possible thing to treat. It probably can't hurt. I just need to find some methylobalmin B12. Target doesn't have it.

I'm also posting for posterity a rather unflattering picture of my lower eyelid. According to Dr. Oz, this should be a healthy red. In people who are anemic, it is pale. Not sure if the pic does it justice, but mine is almost as white as my eye. I would love to see a pic of this on someone who is healthy to see what color they have.
Overview
Pernicious anemia is a decrease in red blood cells that occurs when the body cannot properly absorb vitamin B12 from the gastrointestinal tract. Vitamin B12 is necessary for the proper development of red blood cells.
Pernicious anemia is a type of megaloblastic anemia.
See also: Anemia


Symptoms
Too little vitamin B12 gradually causes nervous system (neurological) problems. The neurological effects may be seen before anemia is diagnosed.
Symptoms may include:
Bleeding gums
Diarrhea
Fatigue
Impaired sense of smell
Loss of deep tendon reflexes
Loss of appetite
Pallor
Personality or memory changes
Positive Babinski's sign
Rapid heart rate
Shortness of breath
Sore mouth
Tingling and numbness of hands and feet
Tongue problems
Unsteady gait, especially in the dark



Causes
Pernicious anemia is caused by a lack of intrinsic factor. Intrinsic factor is a protein produced by the stomach that binds to vitamin B12. The combination of vitamin B12 and intrinsic factor is absorbed in the lower part of the small intestine. When the stomach does not make enough intrinsic factor, the intestine cannot properly absorb vitamin B12.
Very rarely, infants and children are born without the ability to produce enough intrinsic factor. Pernicious anemia that occurs at birth (congenital) is inherited. You need the defective gene from each parent to get it.
More common causes of pernicious anemia include:
Weakened stomach lining (atrophic gastric mucosa)
The body's immune system attacking the cells that make intrinsic factor (autoimmunity against gastric parietal cells)
Autoimmunity against intrinsic factor itself
The disease begins slowly and may take decades to fully establish. Although the congenital form occurs in children, pernicious anemia usually does not appear before age 30 in adults. The average age at diagnosis is 60.


Risk factors include:
Family history of the disease
History of autoimmune endocrine disorders, including:
Addison's disease
Chronic thyroiditis
Graves disease
Hypoparathyroidism
Hypopituitarism
Myasthenia gravis
Secondary amenorrhea
Type 1 diabetes
Testicular dysfunction
Vitiligo
Scandinavian or Northern European descent

In addition to pernicious anemia, other causes of vitamin B12 deficiency include:
Certain drugs, including colchicine, neomycin, and para amino salicylic acid (used for tuberculosis treatment)
Gastrointestinal disease (stomach removal surgery, celiac disease, Crohn's disease)
Infection (intestinal parasites, too much growth of bacteria in the small intestine)
Metabolic disorders (methylmalonic aciduria, homocystinuria)
Nutritional problems (strict vegetarians who do not get vitamin B12 supplementation, poor diet in infancy, or poor nutrition during pregnancy)