Pernicious Anemia and natural birth

[Bellyjaby]

Hi all,

I have a B12 deficiency and have been "diagnosed" with pernicious anemia. I say "diagnosed" as what I hadn't realised is that my previous GP hadn't run the appropriate tests. My new GP is convinced I have malabsorption issues of some kind, but is bound by the fact I haven't had the appropriate tests. So they won't give me the injection before 12 weeks is up. I'm due on 1st Oct, my nex jab is due after 27th Sep.

My problem is that the B12 just isn't lasting whilst I'm pregnant. I experience low symptoms around 6 weeks rather than 10. By the time of my last jab not only was I completely exhausted, had the fuzzies and suffering major migraines but I was suffering limb numbness, tingling, palpatations, nausea and dizziness. Going up a flight of stairs either made me collapse or vomit and just turning over in bed gave me terrible palpatations. All these symptoms disappeared within a week of having a jab.

I've been upfront with my midwives and consultants and said there's no way I'm going to be able to give birth in that condition. They originally offered me a top up jab, but are now saying they can't do that any more under NHS guidelines. So I've requested an elective csec. They are listening to me but are still telling me I should try a normal birth.

Am I really mad wanting a csec if I'm in this condition? My DD was emergency csec, so I know what it's like and am aware of the risks. Has anyone managed to give birth naturally during a B12 low?

Thanks and sorry for the long post.

If the B12 is running out then they need to give you more Why on Earth wouldn't they give you another jab when you obviously need it (even if they need to do a blood test to 'confirm' this, then that should only take a day or so!). I have epilepsy and if my blood work showed I wasn't at a therapeutic level of the drug I need then they would increase the amount I take until I was at a therapeutic level regardless of what actual dose I was on (esp. during pg as blood volume increases so dilutes the drug even more). What makes B12 special??

I had pernicous anaemia with DD3's pg, the tablets did nothing as my B12 just kept going down so I had injections which luckily worked and I had a normal hospital delivery (was a planned home birth but after 3w of pro-dromal labour DD3 had passed mec. so we went in to be on the safe side). There is no way I could have given birth with the pernicous anaemia not under control!

My elderly aunt has PA and has just had a 'crisis' due to undiscovered bowel cancer (it was causing bleeding so she was losing more B12 than the injections were putting back). She sounded to be in a similar state to you and the surgery called an ambulance for her and she had 4 units of blood to replace the loss (and extra B12 IIRC).

I really hope you can get a Dr with some sense as it sounds like you REALLY need your B12 jabs now not in 2m time! Untreated or under treated PA can lead to permanent nerve damage and even death in extreme circs so they really need to pull their finger out before you get seriously ill.

Sorry about your aunt, I hope she's ok.

I'm stuck with the beauty of new NHS guidelines. "evidence" says 12 weeks is plenty, but evidence is not based on pregnant women! I had a serum b12 at 8 weeks last time and my levels showed 290. In other countries that gets you treated. Here, it needs to be 248 or 200 and below depending on which lab is used (248 for mine). But my new GP is thankfully knowledgable enough to know that having had a B12 jab my levels will be artificially high, and serum B12 isn't reliable until the injectable form is out of the system. And acknowledges that i start feeling the drain when my levels are borderline. BUT the guidelines say no treatment before 12 weeks unless serum B12 is very clinically low. I'm a lot happier with this GP than the one who told me I was a "lazy bitch who didn't eat properly" but couldn't tell me what I needed to eat for B12...

Have been given some sublingual to try this time, but there's no guarantee it'll work. Outside of pregnancy I seem to cope with the regime better. I'm there saying baby takes iron and all the other vitamins, why won't it be taking my B12 too? "that's what pregnancy vits are for" I get told then have to repeat I can't absorb the tablet form of B12 so they aren't helping there!!!

Glad to hear I'm not the only one who feels like that at least. Nice to know I'm not nuts!

I think the true measure of B12 status is by testing cerebrospinal fluid but it's not exactly a standard test. I read somewhere (I can't find it again though!) people can have 'normal' B12 levels in their blood but be B12 deficient in their spinal fluid which can cause problems. I don't think getting a lumbar puncture would be recommended though!

I'd say you have a higher need for B12 in pg so would need higher/more frequent dosings but I'm definitely not a Dr so what do I know!

I hope you put in a complaint about the 1st GP - pernicous anaemia makes you 'lazy' (well flipping shattered all the time!) and it doesn't matter what you eat if you don't have any intrinsic factor to digest B12 in food.....

I have had some symptoms of B12 anaemia this pg (or possibly folate anaemia as I have had that last year due to my epilepsy meds depleting my folate levels) but all tests have come back normal so I don't have an answer to the tiredness and heart palpitations.

Ha - thik I'll avoid the lumbar puncture for now! There's another one tht measures active B12 but I think it's just private. It's shown itself as quite good as its highlighted that some people with normal levels of serum B12 have little or no active B12 available to them, and in other cases why some people with low seum B12 are fine as nearly all is available to their systems.

I'm slowly beginning to suspect that drs may not know best ;)

Definitely going to put in a complaint, but am leaving it until I have a diagnosis first. I just want to add more fuel to the fire.

Are you able to get hold of sublingual B12? I hear it's quite good for those who can't absorb the traditional way. It may help you with those symptoms, assuming it works for you of course!

If you can get it in a shop I might try it but I doubt the GP will prescribe seeing as my last B12 was 'normal'. Worth a try if it is though!

They really should be doing something for you - if you are having nerve issues you need B12, why are they not getting that??? Really sorry you are having to deal with the bureaucracy and red tape when pg, so not what you need!

Yeah, the GP wouldn't give me sublinguals either but a friend gave me some. The solgar ones are the ones that you'd be given at boots if you were prescribed them. They're on amazon as well as at odd stockists. But I've not even tried them yet as I'm only 4 weeks from my last jab, so shouldn't really be recommending yet!

Its very irritating and whilst I'm not getting sympathy, which is a major improvement, I seem to be stuck in a loop of "not allowed to". I think my GP may be good enough to run me an urgent serum B12. its just sad that I'm going to have to get to that level first. Here's hoping sublinguals do it for me!