We are getting more and more calls from GPs whose patients have asked them to talk to us (but please let us know if your doctor is going to call us so that we can be prepared) but yesterday we had our first international call – from a doctor in Calcutta.

The problem he had was that he had three patients, one who had all the symptoms of B12 deficiency but his serum B12 was just over the threshold used to determine a deficiency, another patient had all of the symptoms, had low B12 in his blood but the Intrinsic Antibody Test proved negative; and a third patient who had Sub-acute Combined Degeneration of the Cord Secondary to PA.

“I’ve read the guidelines” he told me, “but am I right in thinking that I can now diagnose PA without the IFA test proving positive?”
“I thought so – what about the patient whose serum B12 is just over the threshold?”
“Do as the guidelines say – ignore the test and treat to prevent neurological problems”.
“That’s what I thought. And how often should the Sub Acute patient be treated?”
“Every other day until there’s no further improvement”.
“Thank you so much, and thank you for telephoning me back so quickly”.

Imagine the scene – three patients sitting quietly waiting to see whether the telephone call would lead them to receiving a diagnosis and adequate treatment. Glad to be of assistance.