It was all going too smoothly.  Everything was starting to slot into place regarding the problems with treating Pernicious Anaemia and there is now substantial evidence that the reason why some patients need much more frequent replacement therapy B12 than others is all down to genetic mutations in the cell receptors.  The science is there, but has yet to be applied to the practical problem of identifying patients’ individual needs.  That was why I travelled to Manchester on Friday (four hours by train each way – cramped, noisy trains without any charging facilities for my laptop – I mean, 2016 and all that) to meet with a clinical researcher who has done some work in this area.

As I said, the scientific basis for individual treatment plans is now established, or at least could be used to explain why many patients need more frequent injections than others.  This in itself is a recent development and my meetings with several academics at the end of last year were extremely positive and encouraging.  And then there was the meeting on Friday where I was hit with an unexpected problem.  Because the diagnostic tests used to determine any absorption problem are so unreliable, it will be almost impossible to recruit significant numbers of patients to take part in any in-depth study.  As was pointed out to me, just because a person tests positive for the intrinsic factor antibody doesn’t mean that he or she will have Pernicious Anaemia – it could be a false positive.  And where does that leave us with all the thousands of people who test negative.  And what about those whose deficiency is due to some other issues such as medicines, or dietary intolerance.  It’s a huge problem because any recruited cohort would have to be positively and unconditionally suffering from Autoimmune Metaplastic Atrophic Gastritis – and unfortunately there are other reasons apart from Intrinsic Factor Antibodies that can cause AMAG.

So what do I do now?  I arrange a meeting between all of the interested parties and invite them to discuss how to get around this problem.  And while they discuss this, I’ll pour the tea (and coffee) in the hope that the beverages will help to provide a solution to the problem.  More on this later….. probably later in the year.

Now you may be wondering why there is a picture of somebody’s toes on here – well it’s simply that I made the deadline for a piece in a national magazine for podiatrists which has been accepted and will appear in the March edition of the magazine.  Did you know that Podiatrists are able to prescribe B12 injections?  Me neither….now there’s a possibility for progress.