So Dr Copperfield is advising against testing for B12 despite the following guidance …
New UKHSA guidance on metformin
For patients prescribed metformin, healthcare professionals should:
- test vitamin B12 serum levels if deficiency is suspected (for example, in patients presenting with megaloblastic anaemia or new-onset neuropathy) and follow current clinical guidelines on investigation and management of vitamin B12 deficiency (for example, see Clinical Knowledge Summary from NICE)
- consider periodic vitamin B12 monitoring in patients with risk factors for vitamin B12 deficiency, which can include being elderly; having a gastrointestinal disorder; keeping a strict vegan diet; taking concomitant medication including proton pump inhibitors or colchicine; or having a genetic predisposition to vitamin B12 deficiency, such as intrinsic factor receptor deficiency (Imerslund-Gräsbeck syndrome) and transcobalamin II deficiency
- administer corrective treatment for vitamin B12 deficiency in line with current clinical guidelines; continue metformin therapy for as long as it is tolerated and not contraindicated
- report suspected adverse drug reactions associated with metformin on a Yellow Card
Source: MHRA
Well then…
Lots of unpacking to do here, but first of all thank you to the lovely woman who sent me this, you know who you are!
Blogs like this one from Dr Tony Copperfield don’t really help anyone in need, but they serve to influence likeminded GP’s to behave as he does. With complete disdain for processes which could help to stop debilitating and permanent damage in patients. This is a shame as he clearly does understand the failings of the serum B12 test, the differences in assay kits used by different labs and the fact that certain drugs cause malabsorption problems. He can do so much better.
Utter despair…
Dr Copperfied feels utter despair at the MHRA. (I do too but for a very different reason, this time though, I feel like they are doing something right even if they are very late to the party). He feels that the MHRA shouldn’t be advocating more stringent testing of those on metformin. I disagree, because many people on metformin who are experiencing neuropathy are very often convinced by their GP’s that it is diabetic neuropathy and nothing can be done about it.
Serious consequences from B12 deficiency are vanishingly rare…
No they aren’t Dr Copperfield, unfortunately due to lack of knowledge of Vitamin B12 deficiency among healthcare professionals, they are all to common.
I want to introduce you to Paul and his tragic story. In an ideal world, I’d like to think that Dr Copperfield would have helped and treated Paul with the B12 injections he needed, rather than let him wither away both mentally and physically on incorrectly prescribed cyanocobalamin tablets. However, his attitude makes me think he would not have had the time or energy to do more than pat him on the head and send him away with tablets too.
Incidentally, at the foot of the first article regarding the advice to test for B12 deficiency, are comments from other GP’s. Some helpful, some not so helpful and this one which is a mix of both…
Dr Jane Wilcock, a GP in Salford, said: ‘It has been known for decades that vitamin B12 levels can be reduced by metformin use.
‘Minimising risks of neuropathy is important for people with diabetes and will reduce costs of management of neuropathy at NHS – medication and repeat consultations – as well as at person level.
‘Metformin is a common therapy for diabetes and diabetics have a structured recall in general practices with chronic disease review and blood consultation, at least annually. Therefore, it is not a disruptive of costly intervention to implement.’
But she added that ‘issues in implementation are that people with slightly low vitamin B12 often end up on a multiple injection regimens initially, regimens designed for pernicious anaemia’.
‘Many of them would cope with oral vitamin B12 and long-term, once corrected, dietary advice or continued oral therapy. Some will need injections, most not at the initial high rates of injection.’
No Jane, many of them would deteriorate on oral vitamin B12. This is because metformin doesn’t specifically ‘reduce’ vitamin B12 levels, it hinders absorption of B12 from food and therefore from oral tablets. I would urge Jane to please give patients regular injections (or teach them to self administer) because that’s what they need. Then they will happily heal and leave GP’s well alone.
Metformin-poppers
Away from his laptop, maybe Dr Copperfield is a kind and helpful GP. But here, his reference to his diabetic patients as ‘metformin-poppers’ – a term usually used when someone is addicted to or abusing drugs, could certainly lead the reader to think otherwise.
See this journal : Long-term Metformin Use and Vitamin B12 Deficiency in the Diabetes Prevention Program Outcomes Study, which includes the following statement:
In 1969, Berchtold et al (1) reported evidence of vitamin B12 malabsorption in patients who had been treated with metformin for as little as 3 months. As early as 1971, Tomkin et al (2) recommended that all patients on long-term metformin therapy have annual serum B12 testing, based on a cross-sectional evaluation.
So over five decades ago Berchtold et al and Tomkin et al, recognise and recommend that metformin users are screened for vitamin B12 deficiency. The MHRA are only recently catching up – only for it to be ridiculed by some GP’s and neurologists in 2022. Is it any wonder all things in the B12 department are in such a mess?
If patients are put on metformin then absolutely, they should be periodically tested. They should also be listened to if they are ‘within range’ and experience B12 deficiency symptoms, after all, none of us are the numbers on paper results are we?
More frequent jabs…
Dr Copperfield is annoyed by “demands from patients that they should have higher doses or more frequent jabs on account of, guess what, not feeling better.”
If only he’d take a little time to do some research or even do some extra training he’d know that many people are grossly under treated with B12 injections. That they need enough B12 and folate to heal the nerves. He’d know that there is no evidence for the restrictive NICE and BNF Guidance and that his annoyance should not lie with his patients but firmly with his medical training . All healthcare professionals have been done a huge disservice by not being taught about B12 deficiency and nutrition as a whole. This fact does not however, excuse Dr Copperfield’s profession’s culture of blaming the patient for making his life a misery.
I observe many doctors while doing this work and I find the different reactions fascinating. Some don’t like to be offered new information especially by a lowly patient who can’t possibly be a clever as they are. Some throw their toys out of the pram if they are asked about anything that challenges their knowledge. Some will throw any paper research given to them straight into the bin in front of you. Some will tell you they are not interested in what anyone else says and it’s their way, or no way at all. Some, thankfully, are very receptive and willing to take on new information.
I know from my experience in helping people with poor mental health and B12 deficiency, that antipsychotics and antidepressants can be given out hand over fist. Upping doses, chopping and changing different brands to try and gain the required response, usually quietening and slowing of the patient. But if you want more life saving B12 injections than the doctor thinks is ‘right’, if you want to live your life functioning properly and heaven forbid, ‘feel better’ then woe betide you. That particular cupboard holding life saving B12 injections may be firmly locked and bolted.
A very intelligent and rational neurologist…said – ‘It’s the sort of thing that makes you want to retire.’
Personally I hope this particular neurologist does retire soon, if he hasn’t already. Very intelligent and rational B12 deficient patients could do without any help from him in regard to their B12 deficiency symptoms which may not be taken at all seriously until they reach the point of SACD. We patients, would like help to put the breaks on before we crash, but in order to do that we need high and mighty health professionals to learn how the car works. In short, we want to heal the ‘functional tingliness’ before it reaches a point of no return.
Clearly it’s all a bit too much for this pair of hardworking souls to actually put some thought into caring for their potentially B12 deficient patients. In their jaded view, these patients and the MHRA, have made it their life’s work to annoy the hell out of them and get in the way of their enjoyment of ‘patting patients on their heads’ and sending them on their jolly ways for something OTC. Maybe a lollipop would do?
I sincerely hope that one day Dr Copperfield gains an insight into how B12 deficiency actually impacts patients health. That he learns that misdiagnosis and late diagnosis can cause severe and permanent damage, affecting every aspect of the person’s life. Is that too much to ask?
Harm from undiagnosed vitamin B12 deficiency impacts GP Practices, it leads to multiple primary care appointments from very ill and often very confused patients.
It leads to GP’s sending patients from pillar to post with specialist referrals that would not have been needed.
It leads to an enormous negative impact on the NHS and ambulance services.
It leads to poly pharmacy and all the associated risks to patients.
It leads to unhappy, unhealthy patients, which leads to fractured family lives and loss of careers.
It leads to sectioning of patients who may never recover.
It leads to wheelchairs and disabilities, to carers for people who could have lived independently.
It leads to clinical negligence claims.
It leads to unfulfilled and angry GP’s who vent about patients by writing acerbic and frankly, way off the mark blogs.
So I would say that if you are a GP “and your mouse is hovering over a haematology path lab form and you’re thinking, ‘To B12 or not to B12’ – please” ABSOLUTELY DO.
I’d love for Dr Copperfield to really get to grips with B12 deficiency, for him to see his patients in a new light, for him to be absolutely brilliant at identifying and treating B12 deficient patients well and as per their individual needs. For him to be going through his list of ‘heart sink’ patients and getting them in to diagnose all missed B12 deficiency. And for him to be able to sit peacefully each evening knowing that his workload is all the easier because he made a difference to all his previous annoying, hypochondriac patients who simply needed B12 injections ‘to feel better’.
Kindness always
Tracey
www.b12info.com
I despair at the attitude of this doctor. I wish they could experience our condition and know what it feels like. Maybe AI can develop an Ap that gives people like him the experience of the illnesses they so easily dismiss!
Tough if he has to look at more test results. It’s his job.
If a structural engineer or any other professional decided to ignore good practice they’d end up prosecuted!
I agree Sue, there’s probably parts of most jobs that the people doing them don’t like, it does seem that Dr Copperfield chose entirely the wrong career as I’m not sure he’s keen on any part of his job – bar the head patting of course.
I think you are being too kind to Master Copperfield and his rarely functioning brain. What the Dickens does “vanishingly rare” mean? He is a right wing Tory who should change his name to Uriah Heep as he must be the creepy friend of Steven female bottom-patter Barclay, saving money for the bankrupt nhs. GPs are the Uriah Heeps to a right wing brit government.
What the Dickens indeed Wrenford!
B12 deficiency/pA is in 3 generations of my family.
My daughter is left disabled from lack of knowledge of the devastating effects of undiagnosed untreated b1e and folate deficiency.
A brain mri ,lumbar puncture was done before a simple b12 blood test.
Blood tests, IFA tests too heavily relied upon.
Where has clinical judgement gone?
.
Where has listening to a patient after 7 yesrs not needing a gp gone?
Stress and depression now overused and ? MH problems.
It took a neurologist I saw for migraines who suffered from b12 deficiency himself to recognise just how limited training is.
Just how inadequate treatment 7s .
Just how underestimated the damage us .
He took a special interest.
For himself as didn’t fir the 2- 3 monthly regimes.
As for money.
My daughter has cost the NHS more on needless tests due to not listening and b12 not on ant tests that were run..
Her Gp did apologise for ‘missing it’
I bet he doesn’t again.
I cannot agree more and will briefly summarise my experience:
1: I was very fit, sporty, excellent nutrition.
2: I noticed weakness, fatigue, memory issues, tinnitus, intestinal inflammation.
3: I asked my GP repeatedly for help over 7 years.
4: my had done a B12 test 4 years before I ended up in a wheelchair, and lied, told me everything was fine
5: my GP onece I had gone private, showed him the result was 62, insisted on an NHS test to confirm, which was his downfall as by then I knew enough to get a copy, whereupon the phlebotomist had written ” we advised you X years ago this patient needs immediate treatment.
6: started treatment, I insisted on seeing a haemotologist, my GP repeatedly refused and stopped treatment after 2 weeks ignoring my insistance including my printout of the nice guideline which he threw in the bin in front of me saying he didn’t have time to read drivel.
7: months later, much bothering him to see a haemotologist, I did see one and bless her, she insisted I be given B12 shots and monthly too, however 2 months in my GP stopped my prescription ( as I had learned during the loading dose how to do it myself, no notice to me, I contacted him, he said he spoke to a friend and they agreed I ” must be full by now” !!! I reached out toy haemotologist, she wrote to him, he ignored her, I contacted PA society and Tracy here at B12 deficiency, finally he relented but wanted me to go for blood tests to measure my B12 levels, idiot.
8: my haematologist wrote insisting he send me to a neurologist and that I see her every 3 months ( because she didn’t trust him not to stop my B12 again”, he said he was sending me to a friend of his, and that neurologist said ” B12 deficiency, and Pernicious anemia cannot cause nerve damage, nerves just don’t work like that, you must be making it up” I swear I cried so much in the first few years, it was only the PA society my haematologist and Tracy here that stopped me from killing myself.
I have learned a lot, but first and foremost is don’t trust doctors, they can be morons just like anyone else, and get your test results, you don’t have to be a scientist like I was, to read them, and fight, fight ,fight.
It is when GPS like Mr Copperfield are allowed to use their professional title to publicly shame diabetics and gaslight B12 deficiency sufferers, and still do not get struck off, that you know you can only count on yourself and people like Tracy that actually have a clue and actually want to help you.
I should also mention that my GPS response to everything I brought to him over the 7 years, from tinnitus to weakness, to shortness of breath, every issue, his response was ” have some antidepressants ”
B12 can affect your mood, banging your head against the brick wall of wanted stupidity,( I say wanted as they could educate themselves if they were bothered) that will affect your mood, the pain from nerve damage, the fatigue all affects your mood, and the treatment is not antidepressants, it is simply B12 in a syringe, costs the NHS less than a pound.
So to all my fellow B12 deficiency family out there I say , you are right, check your facts and get your own test results, you are entitled just in case like my GP they try to withhold them, they can’t, legally, and fight, if you fight, you can have the support of Tracy the PA society and the B12 deficiency group, and you can win, it may take time but please hang in there, your life matters, your health matters, and even if it’s too late to reverse the damage, like me, you can still have a wonderful life once you get your B12 💙💙💙
Fleur thank you so much for taking the time to share your horrendous experience.
It is incomprehensible to most people outside of the ‘B12 world’ that some people on deaths door, literally have to fight or even beg for a life saving vitamin from those gate keepers who have absolutely zero understanding of how to talk to, listen to, or care for patients.
You are an inspiration. ❤️
The editor of Pulse Today published this blog with “metformin-poppers” in it & all the inaccurate information? Dreadful.
As there are many GP vacancies & GPS are having to see increasing numbers of patients, it’s strange that they, & Dr Copperfield, aren’t thanking patients for researching & bringing evidence-based information to their attention.
I agree Claire, it’s an absolute shocker!
Thanks for sharing, Tracey. This article both angered and upset me deeply. Perhaps Dr Copperfield might like to sit in on one of my clinics and listen to my patients talk of their feelings of unexplainable exhaustion, memory loss, neuropathy, balance and continence problems. Patients who have had their B12 injections stopped suddenly after many years, and are now faced with the prospect of forgetting how to care for themselves, forgetting their family and friends, failing to recognise hunger and thirst. While Dr Copperfield reaches for his mouse and avoids ticking a box, I’m left reaching for a tissue as I break devastating news to patients whose lives could have taken a much brighter path.
I’d hope that if Dr Copperfield sat in on your clinic Karen, that it would cure his disdain for B12 deficient patient’s ‘wanting to feel better’.
Sadly, like many situations no one gives two hoots about a subject unless it directly affects them or someone they love. The problem for doctors is that they need to care deeply about their patient’s welfare in order to do a good job. Some simply just don’t have it in them.
Thank you for taking the time to comment.❤️
I totally agree with everything you have said. I failed 2 dementia tests in the surgery 18 months ago after my counsellor (gp diagnosed depression) noticed I was not using correct words when talking to her. They then did a B12 test. I only had traces of B12, not recordable. My mum had passed away the previous April – dementia (although many of her problems the same as me), my brother at 66 passed away this April Dementia. I did manage to get a b12 test done for him, his levels the same as mine.
I had to fight to get more than the loading does of B12 injections, I now self inject on a weekly basis & source the b12 myself. I finally got to see a Neurologist 2 weeks ago who patronised me regarding my arguements with my GO re. B12 injections. I pointed out to him that is about time he did further research reB12 and updated himself on the consequences of not treating his patients correctly. It didn’t go down well!! I answered his questions & did his tests, he thinks I may have the same as my mum & brother, frontal lobes dementia (I am 63). Now waiting for a scan to confirm. He did say my GP should have referred my when I failed the dementia tests. Sorry if this is disjointed message, between dementia & still working a stressful job, and anger, my brain is not working properly
Terri, thank you so much for sharing your experience here. I am so sorry to hear of the battle you are still enduring. The word ‘fight’ is so commonly used in reference to B12 deficiency because at one time or another many of us fight to be tested and then fight for treatment.
I sincerely hope that Dr Copperfield might read the comments here and drastically change his attitude. Wishing you the very best, Tracey x
Well done Tracey. It’s bad enough dealing with symptoms, without having to deal with pompous medics who need to up their CPD knowledge and skills, only to be labelled neurotic and annoying.
Thank you Evelyn, I sometimes wonder if there’s a pomposity module in medical training. I had a personal overload of that recently, the ‘best’ one being a locus who told me I’d had a chest infection, sinus infections and headaches, even when I said “none of that is true” he proceeded to pompously prescribe me antibiotics and in doing so stated “I know you won’t take them” He was only correct about that last statement.
Very best wishes
Tracey
I am also suffering low B12 I’m 5’2 normal weight and been active and eaten healthy all my life now I am in pain & foggy brain out of energy daily and now have 10week B12 injection instead of 12week but symptoms don’t ease up for long sadly. Reading Dr Copperfield’s views are very worrying as pointed out many times on many posts more educating is needed for doctors regarding B12. It may just be a vitamin to most but it’s a genuine life saver to them that need it and need it more often than Gp thinks. It’s not about the result on paper it’s about how patient feels and GP listening to the patient properly if they care enough too.
Tracey. As someone whose life was almost extinguished by a B12 crisis only two years ago, this article offends me greatly and makes me very sad indeed. My story is a long one and too long for a comment on an offensive article.
I am not only a patient who was diagnosed with PA at 15 years old but as a retired nurse with 30 years of experience someone who is trying to make small inroads into how Vitamin B12 and Pernicious anemia is treated and managed in the UK. I have set up a small private clinic to try and show Doctors that there is a better way to manage and treat Vitamin B12 deficiency.
I would really like to work with you as you are an amazing advocate in this area.
thank you for all your hard work.
Thank you for your kind words Sahara! I think those who have worked for the NHS and walked the path like you have make a real difference!
Very best wishes
Tracey
Before I came to live in Spain 23 yrs ago. I had been under my UK GB for low blood coun,t an for those six months he had given me iron tablets. After telling him I was going to live in Spain. He gave me enough iron tablets for 3 months. After a week here decided to doctors for blood test, which was a week away. We went to local chemist, an he said he would do one but results wouldn´t be back for a week he would let doctor know. When going back home a hour later had the police at the door. You go back to Chemist now, urgent. He told me my blood count was so low that I had to go to the hospital immediately. They kept me in hospital for two weeks, having tests done every day. The results were they could only find that I was short of B12 Two pints of blood and letter from hospital for my doctor I was to have so many Be B12 injections aweek then one a month fo the rest of my life. Beginning of last year I start to feel upset, worried, tired, an very stressfull. so went doctors to ask if I could now have 2 injections as I felt so low. No. your B12 is nornal, I do not know why your still having them. I said don´t you dare stop them you have letter from consulant they were for life. He said no I wouldn´t do that. So a local private doctor has been giving me one injection a month, I´ve been feeling my old self untiil 4 weeks ago I haven´t had that extra injection an now feel that old feeling jumpy, stressful so Monday starting back on my extra injecion an I know within aweek I will be back go normal. I´m now 84 coming up. So please everyone check check don´t let anyone tell you B12 won´t make a difference go your live. IT WILL.
Excellent advice Pat, thank you. “No. your B12 is nornal” is so often quoted by GP’s that they must have some poor patient’s who need to be on B12 for life believing this rubbish. All this does is makes both the patient and the GP bark up entirely the wrong tree looking for the root cause of all their swiftly returning B12 deficiency symptoms. Perhaps we should get the Spanish police over to tell them how urgent B12 injections are!
Thank you for taking the time to comment and I hope you start to feel back to great soon Pat.
very best wishes
Tracey
Hi Pat,
Thank you for sharing this, it makes a good point about how the UK is in the dark ages regarding B12 compared to the rest It f Europe.
I have family in Europe and they are all appalled at the situation here in the UK regarding B12. B12 ampules are found in every chemist in every country my family is in, ready to buy by anyone without prescription, and yet in the UK you can’t get what you need even though you have been diagnosed and with a prescription . I personally get a little parcel from my family from Europe every month to help me meet the deficit in my UK NHS prescription levels 😉
“MetFormin poppers”. Who is responsible? As with many other medications, half the world is on what big Pharma wants to make money from.
Here in Australia, a middle aged man was put on metformin for his diabetes. His wife meanwhile, took his diet in hand, he lost weight and had blood glucose measures around 6, every morning. But the doctor still wanted him on metformin. In the end he stopped it himself and his blood glucose remains Normal. What literature are doctors served up? How come they do not think? Perhaps medical training should include courses in logic and philosophy of science as they do in Psychology.
Thank you for your comment Barbara, I agree!
I am both astonished and saddened to read the level of ignorance exhibited by the blog GP. As a balancing story, my PA journey began approximately 20 years ago when I attended my GP with symptoms of numbness, tiredness and pins & needles. The GP was on the right track and prescribed iron tablets initially, then when I got worse he thankfully referred me as a hospital in-patient where I was finally diagnosed with PA (inherited from my mother). A Schillings test was subsequently carried out to confirm the diagnosis and monthly B12 injections prescribed, which I now self-administer. In my story I feel the medical profession performed well.
My only gripe is that having suffered several conditions in recent years that I believe could be directly linked to my PA i.e. stenosis of the spine, abdominal gastritis, prostate cancer and even a stroke in one eye. Dissapointly, each of the specialist consultants I have dealt with in connection to these conditions would not acknowledge that my PA could play any part. So just like in the example of the blog GP, I would say that ignorance (and lack of research) is still unfortunately very prevalent across the medical profession.
Hi David, I agree, there are/were some good GP’s who know how to manage B12. The Schilling test was a very useful diagnostic tool and I think that if it were still around there would be far less messing around. Yes it still astounds me that clinicians can be unaware of the fact that B12 deficiency affects all body systems. It appears to be a compartmentalised condition affecting only the blood. Many, would not think to check for B12 deficiency in cardiac health or poor mental health.
Very best wishes
Tracey
I lost all my 40’s due to an ignorant GP like this. I was so ill I had to stop exercising, was unable to work, was in bed most of the day and couldn’t even walk around the block without getting out of breath. I was ‘diagnosed’ with CFS which I didn’t agree with. I ran up debt, couldn’t work and lost friendships.
Even the Gastro dept I was referred to didn’t have an understanding of B12’s effects (I was discharged once I got B12).
But when my B12d was diagnosed after 5 years, the GP withheld further treatment after the initial loading doses despite them being life changing.
It took a referral to rheumatology to help get them reinstated after they saw the huge drop in my level in a matter of weeks.
This same GP surgery recently told my mum that B12 injections were old fashioned. I had to intervene as 3 GPs wanted to give my mum tablets.
GP attitudes need to change, we are the ones suffering with ruined lives when it can easily be solved by giving the correct treatment that we need to function and correct frequency of B12 injections.
Arianne, I am so sorry to read about your experience. Thank goodness you were able to intervene with your mum! ‘Old fashioned’ is a new one on me, but I expect that patients wanting to feel better is an ‘old fashioned’ concept for some GP’s. Thank you for taking the time to comment.
Very best wishes Tracey
A brilliant analysis and response to Copperfield. Doctors of his kind are a danger to the health of sick people and their actions compound the appalling situation that B12D sufferers experience. Sadly, they are part of the problem and not part of the solution. I have heard that another GP, who I don’t know, called the issue of B12D ‘a fad’.
Insecure doctors guard their knowledge and domains like embattled feudal barons. Many are scientists with little empathy for, curiosity or interest in people. They need to either do some intensive soul-searching and personal growth or find another area in which to use their scientic knowledge. They are not allies of their patients.
Thank you for taking the time to comment and for your kind words Hilary. I agree entirely. I was really shocked when I went with a patient to see their GP and this particular GP did not make eye contact with them at all. Just positioned staring at the computer. This particular GP is head of the Practice and every other GP has to run ‘B12 injection requests’ past this GP in meetings on Friday afternoons.
Mostly they are refused. It is a game of control and power for this tyrant and it appears none of the other GP’s feel able to challenge his unbridled contempt for B12 deficient patients.
Thank you for your ‘humble’ opinion, Tracey. I’d much rather have your informed opinion based on research and evidence than the ‘opinion’ of this arrogant, dismissive, ignorant ‘doctor.
Thank you for your kind comment Judith!
In my recent battle with doctors with my own health, one GP told me “I’m not interested in what anyone one else says, here’s what’s going to happen”. Needless to say, his total ignorance of the facts and information I presented ensured that what he thought would happen, didn’t.
Whilst I never wish ill on others, I will make an exception today and say ‘here’s to you becoming seriously deficient in B12 one day Dr Copperfield, either through old age or the various other reasons and finding yourself in the land of unsympathetic/ holier than thou medics. What a seriously pedestal perched bigoted individual you are. Unbelievable!
Hi Sue, I understand that Dr Copperfield may well be a pseudonym for a couple of GP writers. I would like to think that whoever penned this one would be willing to re visit B12 deficiency if someone they love was affected. It would be good for them to read the comments here and reassess their stance – but I imagine we will never know!
I have been reading such comments fir at least 20 years niw. Nothing has changed Re B12. Recently a well intentioned dr retested my B12, which was “sky high” from sublingual methylcobalamine. Nurses explained he would lose his licence if he went against the rules and knowing I had injections with me comforted me by saying I could use it when Igot home. As B12 interacts wuth another inherited metabolic disease called porohyria. . Some comfort.
What I would like to know is, what enzyme is necessary for B12 to be absorbed in tge jejenum.
I am a retired Neurophysiologist who took an interest in B12 deficiency when I diagnosed my father-in-law with Pernicious Anaemia in about 1980. He only had Neurological symptoms and even in those days he was given an appointment to see a Neurologist in six months. Aware that he would almost certainly suffer permanent neurological damage before receiving any treatment, I presented him at UCH A&E. Fortunately, at that time their Physicians were sufficiently well informed to confirm my diagnosis and he received monthly injections for life. He was very grateful if less pleased by the pain of a bone marrow biopsy that they insisted upon to prove haematological changes at the cellular level. Since then, I have tried to keep abreast of the literature regarding B12 deficiency and I came upon this doctor’s misguided diatribe as feedback for the article about metformin’s effects on the absorption of B12 in Pulse. I was appalled by his response and one or two other ‘snide’ comments from others. I would like to record my appreciation for your blog which I commend as a suitable riposte.
Can I also say that I was very sorry to read your latest blog regarding your emotional trauma following attacks on your motives and lack of medical training. There cannot be enough good sources of information about the facts and fallacies regarding the impact that this deficiency can have. I presently have to spend most of my time caring for my wife and her inherited auto-immune disorders so I have not had the time to explore your site. However, what I have read has impressed me. You are obviously a good communicator and I wish you every success.
Dear Stewart, thank goodness you took your father in law to A & E! I agree that things were so much better in the B12 world in the early 80’s treatment wise, but like your father in law, I would have been put out by a bone marrow biopsy!
Yes the snide comments on this particular Pulse blog from doctors are shocking. We can only hope that one day they see how they have been done a disservice by not being properly trained nutrition wise and rectify their mistakes.
Thank you for your kind words about the site and your good wishes, it’s very much appreciated.
Wishing you and your wife well, Tracey
What a terrible attitude for a doctor to have. Thanks for fighting in our corner Tracey! You’re the best 💜
Thanks for your lovely comment Imogen!