Vitamin B-12 is a large, complex molecule involved in a variety of functions within your body, including some related to digestion. B-12 deficiency is relatively common in the United States and is the cause of many false diagnoses because it can mimic some diseases and be an underlying cause for others. Your gallbladder is important for fat digestion and its function is connected to B-12 levels. If you have abdominal pain, consult with your doctor and ask him about getting your B-12 blood levels measured. Your gallbladder is a small organ that sits below your liver and injects bile into your small intestine when you eat fatty foods. Bile is made in your liver, but processed and concentrated in your gallbladder, and effective at emulsifying fat. Your gallbladder needs a good blood supply and B-vitamins to do its job efficiently. Under certain conditions, stones can form in your gallbladder and cause inflammation, diffuse abdominal pain, nausea, vomiting and bloating. According to “Human Biochemistry and Disease,” vitamin B-12 blood levels below 200 picograms per mL indicate a deficiency, although symptoms can take up to a few years to manifest.
B-12 deficiencies are more common than previously thought because the vitamin is quickly depleted by a variety of substances, such as alcohol and many pharmaceutical products, and it is difficult to absorb due to its large size. You need between 2 and 3 micrograms per day of B-12. If you have problems absorbing the vitamin, you may need at least 500 micorgrams, according to “Vitamins: Fundamental Aspects in Nutrition and Health” The absorption of B-12 in your stomach and intestines requires intrinsic factor, which is absent in those with pernicious anemia. According to “Nutrition and Public Health,” up to 15 percent of American adults older than 65 may have a vitamin B-12 deficiency called pernicious anemia. Pernicious anemia is an autoimmune disease in which your body is unable to absorb enough B-12 from the digestive tract. It occurs after long bouts of stomach inflammation or infection that destroy the stomach mucosal cells that make intrinsic factor. Without intrinsic factor, you are unable to absorb B-12.
Common symptoms of pernicious anemia include weakness, a sore tongue and numbness and tingling sensations. Other symptoms can mimic a gallbladder attack, such as abdominal pain, nausea, heartburn, vomiting, constipation and a sense of constant fullness. As such, pernicious anemia may be misdiagnosed as gallbladder inflammation or dysfunction. With B-12 deficiency, not enough red blood cells are made in your bone marrow or the ones that are made are too large and immature to function properly. These large deformed red blood cells can clog the spleen and gallbladder. According to “Biochemical, Physiological and Molecular Aspects of Human Nutrition,” anemia caused by lack of B-12 increases the risk factor for the formation of gallstones. Gain 2 pounds per week Gain 1.5 pounds per week Gain 1 pound per week Gain 0.5 pound per week Maintain my current weight Lose 0.5 pound per week Lose 1 pound per week Lose 1.5 pounds per week Lose 2 pounds per week
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PBS changes cause concern for the vulnerable Government to scrap paracetamol from PBS Sofia Belmonte was just eight years old when she had a stroke in 1978."I lost all my functions so I had to learn to talk, to walk all again," she said."You'll slowly stop moving, you'll stop talking, your body functions won't function so you end up like a vegetable."Back then doctors were mystified by little Sofia's condition.The stroke was the final catastrophic event that ended months of seizures and years of health problems.It would taken even more time and a team of researchers at Yale Medical School before doctors discovered what was making Sofia so sick.Eventually they discovered a rare genetic disorder that affected her metabolism.She is thought to be one of only 40 people in the world with the condition.The official diagnosis is: Combined Cobalamin C Defect with Methylmalonic Aciduria and Homocystinuria.But really it is a fancy name for saying Ms Belmonte's body cannot turn vitamin B12 in food into its active form in the body.
She needs about three vitamin B-12 injections each week to stop amino acids building up in her body and causing another stroke. Do you know more about this story? For Ms Belmonte, access to these injections has suddenly got harder.She's a disability pensioner and her monthly medication bill is already in the hundreds of dollars. Sofia Belmonte has a petition to get B12 shots back on the PBS. Now the Federal Government has added to that bill by removing subsidies for her Vitamin B12 injections from the Pharmaceutical Benefits Scheme (PBS).It means what used to cost her $6.30 now costs her $30 a week; over a year that's more than $1,500.It was part of a push to stop people spending more on medications by prescription that were actually cheaper over the counter.But people like Ms Belmonte have become unintended victims of the crackdown.Off-the-shelf B12 medications do not work for her because they are chemically different.Despite representations from her doctors, the PBS would not make an exception for people with medical need.
Dr Kaustuv Bhattacharya said he and metabolic doctors from the Australian Society of Inborn Errors of Metabolism wrote to the PBS stating it was imperative B12 injections were funded.There are others with conditions similar, but not the same, as Ms Belmonte who also need regular injections."We informed the PBS that our patients required these injections as part of treatment for their rare genetic condition," Dr Bhattacharya said."Some of my other patients are really severe."Untreated, these patients can become blind, be institutionalised, have intellectual deficit, having severe and permanent brain injury, paralysis and even death."In this case, as in several others, the PBS has not listened to specialist advice for therapeutic interventions from experts in rare diseases."Vitamin B12 injections are not the only drug people like Ms Belmonte struggle to access."One of my medications, which is folic acid, I used to get for what would be now $6.30," she said. Neo-B12 Injections are now harder to get under the PBS.
"But now I have to pay $140 to get it made by a special chemist because what's on the shelf isn't exact enough to make my body function."Ms Belmonte has started a petition calling on the Government to reconsider its position on the Neo-B12 injections."For rare people like me and for people that have cancers or have dementia or have broad spectrum diseases, they should get their medicines on the PBS," she said.Rare Voices Australia executive officer Nicole Millis said people like Ms Belmonte often fell victim to a health system that did not cater to them in areas that ranged from diagnostics to medications."Unfortunately I'm not surprised, we've heard of a lot of examples like this," she said."The health system is not geared to respond to rare disease, it's geared towards diseases with larger patient cohorts."There's very few treatments for rare disease and often when there is a treatment developed it can be quite expensive and it can be difficult for patients to access it without government support."
In this case, government doesn't understand the importance of the medicines and just with a blanket policy change rare disease is discriminated against."In a statement, the Federal Health Department said the legislation governing the Pharmaceutical Benefits Scheme did not allow exceptions for individuals."When purchased without a prescription, the cost for a box of three vitamin B12 injections should be very similar to the PBS concessional co-payment of $6.30," the statement read."However, pharmacies are private businesses, so the price may vary from pharmacy to pharmacy.Four decades since her stroke, Ms Belmonte still suffers some of the side-effects from the stroke and has a range of symptoms related to her rare condition.The threat of having another stroke always looms large."The thing is I know I can go back there any time, it's in the back of your mind," she said."If the levels become unbalanced it can take you back so you're in the shell of a body and you won't be able to communicate to people."