Vit B-12 and other serum levels

[ShelleyWeiser]

I was diagnosed at age 50, 2 years of Vitamin D megadoses due to vitamin D deficiency and Hyperparathyroidism. Then 2 more years with an endocrinologist, then GI endoscopy and biopsies. My villi were 90% Marsh 4, 10% Marsh 3c. Positive for IgA, DGP-IgA, both have gotten higher, on a gluten-free diet. I  have  two of the HLA-DQ alleles. I have iron deficiency anemia, I get infusions as needed. My absorption is not good. My serum levels of vitamin B-12, are elevated but I don't take supplements. My body has been asymptomatic or the exact opposite symptoms. How do I know if my vit B-12 serum levels are an accurate indicator of my absorption levels? I have elevated calcium and HPTH, due to have surgery next month. My diagnosis was 15 years ago and I have had no improvement. I recently heard about B-12 and Intrinsic Factor and Pernicious anemia. I am exhausted from all the research I have done, since Dr. has not been much help at all. I really really appreciate any advice. Thanx, ShelleyWeiser

[trents]

Welcome to the forum, @ShelleyWeiser!

If you had pernicious anemia, you would not have elevated B12 serum levels. By definition, pernicious anemia is caused by an inability to absorb B12.

Are you still consuming dairy products and oats? Do you use NSAIDs regularly? Are you on blood pressure meds?

[knitty kitty]

Welcome to the forum, @ShelleyWeiser,

No, serum B12 levels cannot be used as an indicator of absorption.  

Your Marsh scores are a better indicator of poor absorption.  Have you had an endoscopy to check for healing in the intestines recently?   Your high Anti-Gluten antibodies could be a reaction to Casein, the protein in dairy that causes the same reaction as gluten does.  You could be getting glutened from your diet (if you eat outside your home) or medications. 

Have you been checked for nutritional deficiencies?  Poor absorption leads to vitamin and mineral deficiencies.  In Celiac Disease, it's very common to have nutritional deficiencies, even on a gluten free diet.  

B12 can be stored in the liver.  B12 is released in Non Alcoholic Fatty Liver Disease.  NAFLD is common in Celiac Disease.  Thiamine Vitamin B 1 is needed for the liver to function properly and store B12.  Fatty deposits in the liver occur if there's a Thiamine deficiency.

B12 needs Pyridoxine Vitamin B 6, Folate Vitamin B 9, and Riboflavin Vitamin B 2 in order to function and make blood cells.  If there's a Pyridoxine deficiency, B12 cannot be used, so the liver releases more B12. 

There's eight essential B vitamins.  They all are interdependent on each other to function.  In Celiac Disease, it's common to be low in all the B vitamins because they cannot be stored for more than a few weeks (excepting B12 Cobalamine and Pyridoxine B 6).  The B vitamins are water soluble and easily lost in diarrhea, emesis, and constipation.  Some medications can affect absorption of the B vitamins. Some medications can cause deficiencies in certain B vitamins like Thiamine B 1.  

High Calcium levels can occur if there's a deficiency in magnesium.  Has your magnesium level been checked?  Magnesium keeps calcium in the bones.  Low magnesium can cause high serum calcium levels.

Have you been checked for vitamin and mineral deficiencies?  

P. S.  For your research...

https://www.researchgate.net/publication/378102935_The_clinical_significance_of_calciummagnesium_ratio_in_primary_hyperparathyroidism_unveiling_a_clinical_association

And...

Falsely Elevated Serum Vitamin B12Levels Were Associated with the Severity and Prognosis of Chronic Viral Liver Disease

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5355842/

And...

The Many Faces of Cobalamin (Vitamin B12) Deficiency

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6543499/

And...

Insufficiency of B vitamins with its possible clinical implication

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7417807/

And...

Association between serum vitamin B6 concentration and risk of osteoporosis in the middle-aged and older people in China: a cross-sectional study

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615830/

Edited August 22 by knitty kitty
Added post script

[ShelleyWeiser]

Knitty kitty,
WOW!! You guys have record response times. And you ask questions that I never would have thought to ask. I look forward to having my migraine gone by tomorrow, so I can re-read your reply. Why do the migraines always think they are the BOSS? 
Thanx for your time to reply and help all of us. Shelley 🥰

[knitty kitty]

Riboflavin Vitamin B 2 helps with migraines. 

I had migraines so bad while deficient.  Thiamine B 1 helps with brain fog.

Hope you feel better!

Keep us posted on your progress!  

 

[trents]

knitty kitty, if B12 was not being absorbed, as in pernicious anemia, how could ShellyWesier's serum levels of B12 be elevated? She does not mention getting B12 injections.

[GardeningForHealth]

15 hours ago, ShelleyWeiser said:

I was diagnosed at age 50, 

What were your lab results?

Quote

Positive for IgA, DGP-IgA, both have gotten higher, on a gluten-free diet.

What were those lab results? Hoping TTG-IgA and TTG-IgG is on there too.

[knitty kitty]

On 8/21/2024 at 10:30 PM, ShelleyWeiser said:

My diagnosis was 15 years ago and I have had no improvement. I recently heard about B-12 and Intrinsic Factor and Pernicious anemia. I am exhausted from all the research I have done...

 

I interpreted that Shelley was researching Pernicious Anemia and Intrinsic Factor.  I didn't see where she had been diagnosed with it.  If she had been diagnosed with Pernicious Anemia, she would have been given B12 shots.

The liver can store B12 for several years.  So B12 deficiency symptoms may not appear right away.  B12 when released from the liver is in a storage form that needs to be changed (methylated) to become an active form.  The inactivated form may build up in the serum if there's deficiencies in other vitamins needed to methylate the inactivated form of B12.    Pyridoxine B 6, Folate B 9, Riboflavin B 2, and Thiamine B 1 are needed to methylate Cobalamine B12.  

The essential water soluble B vitamins work together.  Supplement all eight together.

P. S.  To make red blood cells, we also need copper and Vitamin A.  

With malabsorption like Celiac Disease causes, it's more likely that malabsorption happens to all the vitamins and minerals, not just one or two.  Fat malabsorption (those yellow floaty stools) results in malabsorption of the fat soluble vitamins, Vitamins A, D, E, and K.  Vitamin A can be stored in stored in the liver, so deficiency symptoms may take awhile to appear.  Too much Vitamin A is a bad thing. Talk to your doctor before supplementing.  

Edited August 23 by knitty kitty
Added post script