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Old 10-17-2010, 06:50 PM
 
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Quote:
Originally Posted by Hopes View Post
Well, let's clarify. We're talking about B12 deficiencies and Pernicious anemia, not Iron anemia.

Routine tests run on pregnant women would identify Iron anemia, not deficiencies and anemia related to B12.
A complete blood count is part of routine prenatal testing nowadays.

According to this source: Complete Blood Count: The Test a CBC does test for pernicious anemia.
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Old 10-17-2010, 06:55 PM
 
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Quote:
Originally Posted by Dorthy View Post
A complete blood count is part of routine prenatal testing nowadays.

According to this source: Complete Blood Count: The Test a CBC does test for pernicious anemia.
I don't know how to be clearer. All the tests needed to identify B12 deficieny and perniscious anemia are not included i the CBC. It's complicated. There are many factors that can cause B12 deficiency that need to be tested to be certain there isn't a deficiency or anemia. For example, the CBC does not test the intrinsic factor. It's not included in the CBC. And there are two other tests that are not part of the CBC too.

I don't know why you don't believe me. I have to get off the computer because I have a meeting to attend. I'll research and name the specific tests and post them later when I have more time. Perhaps Katiana will find it and post if for me.
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Old 10-17-2010, 07:02 PM
Status: "Snow is coming for Christmas!" (set 1 day ago)
 
Location: Foot of the Rockies
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Quote:
Originally Posted by Hopes View Post
Well, let's clarify. We're talking about B12 deficiencies and Pernicious anemia, not Iron anemia.

Routine tests run on pregnant women would identify Iron anemia, not deficiencies and anemia related to B12.
Well, to be specific, the CBC would identify anemia from any cause.

Quote:
Originally Posted by Dorthy View Post
A complete blood count is part of routine prenatal testing nowadays.

According to this source: Complete Blood Count: The Test a CBC does test for pernicious anemia.
Not exactly. Your link says: "Mean corpuscular volume (MCV) is a measurement of the average size of your RBCs. The MCV is elevated when your RBCs are larger than normal (macrocytic), for example in anemia caused by vitamin B12 deficiency."

In other words, one cause of macrocytic RBCs is pernicious anemia. There are other causes. Further testing would be necessary.

Pernicious anemia tests and diagnosis

"If the CBC results confirm that you have anemia, you may need other blood tests to find out what type of anemia you have."
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Old 10-17-2010, 07:26 PM
 
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Quote:
Originally Posted by Katiana View Post
Well, to be specific, the CBC would identify anemia from any cause
Quote:
"If the CBC results confirm that you have anemia, you may need other blood tests to find out what type of anemia you have."
That's what I was wondering. Thanks.
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Old 10-17-2010, 07:36 PM
 
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Quote:
Originally Posted by Hopes View Post
I don't know how to be clearer. All the tests needed to identify B12 deficieny and perniscious anemia are not included i the CBC. It's complicated. There are many factors that can cause B12 deficiency that need to be tested to be certain there isn't a deficiency or anemia. For example, the CBC does not test the intrinsic factor. It's not included in the CBC. And there are two other tests that are not part of the CBC too.

I don't know why you don't believe me. I have to get off the computer because I have a meeting to attend. I'll research and name the specific tests and post them later when I have more time. Perhaps Katiana will find it and post if for me.
I do understand that a CBC can not diagnose B12 deficiency but it can detect anemia (and according to the lab that I quoted as well as Katiana it can detect anemia of any type) I understand that someone with severe B12 deficiency will most likely have pernicious anemia. I understand that if a patient tests positive for anemia then further testing will be needed in order to find out the cause of the anemia. I understand that B12 testing is not a routine part of prenatal care but that testing positive for anemia would be a red flag and the patient should then pursue further testing if the doctor is not proactive in doing so.
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Old 10-17-2010, 07:42 PM
Status: "Snow is coming for Christmas!" (set 1 day ago)
 
Location: Foot of the Rockies
70,103 posts, read 60,710,459 times
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Quote:
Originally Posted by Dorthy View Post
I do understand that a CBC can not diagnose B12 deficiency but it can detect anemia (and according to the lab that I quoted as well as Katiana it can detect anemia of any type) I understand that someone with severe B12 deficiency will most likely have pernicious anemia. I understand that if a patient tests positive for anemia then further testing will be needed in order to find out the cause of the anemia. I understand that B12 testing is not a routine part of prenatal care but that testing positive for anemia would be a red flag and the patient should then pursue further testing if the doctor is not proactive in doing so.
Most OB/Gyns are not skilled in hematology, would probably refer the patient.
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Old 10-17-2010, 07:45 PM
 
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Quote:
Originally Posted by Katiana View Post
Most OB/Gyns are not skilled in hematology, would probably refer the patient.
Are you saying that if a patient tests positive for anemia the OBGYN would refer the patient to another doctor or specialist for further testing? They would still be able to get the testing done, right?

Last edited by Dorthy; 10-17-2010 at 08:01 PM..
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Old 10-17-2010, 07:51 PM
 
Location: N of citrus, S of decent corn
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Human babies are meant to have human milk. Can they live on some powdered, chemical concoction from a can? Sure.
There are many women who are very successful at breast feeding exclusively. I was not one of them, but I made sure, either by nursing or pumping, that my babies got breast milk for at least 3 months and then I switched to formula. If I could have done better, I would have, but at least I thought they got off to a healthy start.
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Old 10-17-2010, 08:03 PM
 
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Quote:
Originally Posted by Dorthy View Post
I do understand that a CBC can not diagnose B12 deficiency but it can detect anemia (and according to the lab that I quoted as well as Katiana it can detect anemia of any type) I understand that someone with severe B12 deficiency will most likely have pernicious anemia. I understand that if a patient tests positive for anemia then further testing will be needed in order to find out the cause of the anemia. I understand that B12 testing is not a routine part of prenatal care but that testing positive for anemia would be a red flag and the patient should then pursue further testing if the doctor is not proactive in doing so.
Any deficiency is dangerous to a baby being fed breastmilk. Severe shouldn't be the standard.

When mine was first identified, it was a severe deficiency, but not outright anemia at that time. The reason is because of the intrinsic factor wasn't causing complete anemia at the time. It was partially preventing absorption at the time. As a result, my body could absort some B12 via diet (my diet sucked since I didn't eat much meat). At that point, I had severe symptoms. I literally fell asleep while standing in the living room having a conversation with my husband---and I was in mid sentence. He had to catch me.

I had damage to my short term memory and concentration (that was never fully corrected via treatment). I had terrible muscle pain, spasms, etc. I was sick constantly. Prior to getting that bad (and it wasn't even classified as anemia at that time), I was always a tired person. Operating for decades on low B12 can cause serious, permanent damage---just like outright anemia.

I wouldn't want my children to start their lives with low B12 intake because neurological damage can be permanent. As I mentioned, I have never fully recovered even with treatment. I have permanent neurological damage.

The CBC alone won't dectect a B12 deficiency, which is different from anemia. A deficiency can be just a permanently damaging.


Quote:
Laboratory Tests

Frequently ordered to diagnose and monitor B12 and folate deficiency:

B12. If low, a deficiency is indicated, but it does not identify the cause. If normal, a folate deficiency may still be present. May be ordered to monitor the effectiveness of treatment.

CBC (Complete Blood Count). A group of tests ordered routinely to screen for blood cell abnormalities. It measures cell types, quantities, and characteristics. With both B12 and folate deficiency anemia, the amount of hemoglobin may be low and the red blood cells (RBCs) are abnormally large (macrocytic or megaloblastic). White blood cells and platelets also may be decreased.

Folate. Either serum or RBC folate may be tested. Some believe that the RBC folate is more clinically relevant. If either is low, it indicates a deficiency. If normal, a B12 deficiency may still be present. May be ordered to monitor the effectiveness of treatment.

Seldom but sometimes used to diagnose B12 and folate deficiency:

Methylmalonic Acid (MMA). Sometimes ordered to help detect mild or early B12 deficiency.

Homocysteine. Occasionally ordered. May be elevated in both B12 and folate deficiency.

Ordered to help determine the cause of a B12 deficiency:

Schilling Test. Once frequently ordered to confirm a diagnosis of pernicious anemia. This test is no longer generally available.

Intrinsic Factor Binding Antibody. Interferes with B12 binding. It may be present in those with pernicious anemia. This is a specialized test that is not commonly available.

Intrinsic Factor Blocking Antibody. A protein that prevents B12 from binding to intrinsic factor. It is present in more than 50 percent of all patients with pernicious anemia.

Parietal Cell Antibody. An antibody against the parietal cells that produce intrinsic factor. Present in a large percentage of pernicious anemia patients but may also be seen in other disorders.

Vitamin B12 Deficiency
As you can see, B12 levels aren't even part of the CBC. My doctor ran the B12, folate and intrinsic factor tests at the same time he ran the CBC. As you can see, the first grouping of tests with the CBC is the STANDARD for identifying B12 deficiency, not the cause of B12 deficiency. The reason is because the CBC is not the be all and end all of identifying B12 deficiency. There's one other test, but it's not mentioned on this particular website. I'll post it when I find it.

I want to stress that some of these additional tests need to be tested at the same time as the CBC, not just to identify a cause fo a B12 deficiency or anemia. The CBC doesn't show B12 levels or examine the intrinsic factor, which is needed to absorb B12 into the body. And you don't need to have outright anemia to have a serious problem. Your CBC could be fine and you could still end up with permanent neurological damage. The CBC ran alone is not good enough.

Quote:
Originally Posted by Dorthy View Post
Are you saying that if a patient tests positive for anemia the OBGYN would refer the patient to another doctor or specialist for further testing?
It depends on the doctor. Patients need to be knowledgable so they can insist on testing that is needed----just in case.
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Old 10-17-2010, 08:11 PM
 
4,267 posts, read 3,094,112 times
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Quote:
Originally Posted by Hopes View Post
Any deficiency is dangerous to a baby being fed breastmilk. Severe shouldn't be the standard.

When mine was first identified, it was a severe deficiency, but not outright anemia at that time. The reason is because of the intrinsic factor wasn't causing complete anemia at the time. It was partially preventing absorption at the time. As a result, my body could absort some B12 via diet (my diet sucked since I didn't eat much meat). At that point, I had severe symptoms. I literally fell asleep while standing in the living room having a conversation with my husband---and I was in mid sentence. He had to catch me.

I had damage to my short term memory and concentration (that was never fully corrected via treatment). I had terrible muscle pain, spasms, etc. I was sick constantly. Prior to getting that bad (and it wasn't even classified as anemia at that time), I was always a tired person. Operating for decades on low B12 can cause serious, permanent damage---just like outright anemia.

I wouldn't want my children to start their lives with low B12 intake because neurological damage can be permanent. As I mentioned, I have never fully recovered even with treatment. I have permanent neurological damage.

The CBC alone won't dectect a B12 deficiency, which is different from anemia. A deficiency can be just a permanently damaging.



As you can see, B12 levels aren't even part of the CBC. My doctor ran the B12, folate and intrinsic factor tests at the same time he ran the CBC. As you can see, the first grouping of tests with the CBC is the STANDARD for identifying B12 deficiency, not the cause of B12 deficiency. The reason is because the CBC is not the be all and end all of identifying B12 deficiency. There's one other test, but it's not mentioned on this particular website. I'll post it when I find it.

I want to stress that some of these additional tests need to be tested at the same time as the CBC, not just to identify a cause fo a B12 deficiency or anemia. The CBC doesn't show B12 levels or examine the intrinsic factor, which is needed to absorb B12 into the body. And you don't need to have outright anemia to have a serious problem. Your CBC could be fine and you could still end up with permanent neurological damage. The CBC ran alone is not good enough.


It depends on the doctor. Patients need to be knowledgable so they can insist on testing that is needed----just in case.
Yes, I understand that a CBC will not test specifically for B-12 deficiency. I understand that further testing would be needed in order to diagnose a B12 deficiency. I understand that a CBC would diagnose anemia.

So a person with B-12 deficiency does not necessarily have anemia? If someone with B12 deficiency is tested for pernicious anemia they could test negative? That's what I'm wondering.

ETA: Isn't Vitamin B12 deficiency even more dangerous during pregnancy?

Last edited by Dorthy; 10-17-2010 at 09:16 PM..
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