General Medicine

» Elaine Moore - Symptoms

Hi,
We usually test people for PA when they have signs or symptoms of dementia or cognitive changes. Vitamin B12/Folic acid levels and thyroid function tests are part of the initial dementia work-up to help make sure there aren't treatable conditions causing the problem. When these tests are normal, Alzheimer's disease is suspected, but there are currently no good diagnostic blood tests for it.

PA would also be suspected in anyone with blood tests showing anemia, which would be indicated by a low hemoglobin, hematocrit or red blood cell count. Symptoms of anemia include fatigue and pallor.
In new conditions of anemia, doctors often order iron levels, ferritin, and vitamin B12/folate to help determine the cause. A high MCV (large red blood cells) would suggest PA, but as I mentioned the MCV could be normal if iron deficiency (small red cells) is also present, and other conditions could cause a high MCV.
When PA is suspected, the antibody tests for anti-intrinsic factor and anti-parietal cell antibodies can help confirm this disorder.

If you're genetically predisposed to developing PA, you can help prevent it by any of the ways in which you strengthen, not stimulate, your immune system, particularly avoiding sugar, saturated fats and environmental triggers including allergens and radioioidine.

You can treat PA with vitamin B12 and folic acid dietary supplements. Prescription-strength doses are usually used initially. Even though intrinsic factor is needed to absorb B12, small amounts are diffused through the ileum. This makes oral supplements effective although initially injections may also be used.

In dementia, proper testing is essential because this condition is treatable. Taking large amounts of folic acid, though, can mask the deficiency, which is why we always run both vitamin B12 and RBC folate levels.

Let me know if you have more questions, Elaine