[Marlene]

There are other reasons that can cause low B12. Many who do, don't have a specific clinical reason identified. Anyone over 50 will most likely have lower levels due to lower levels of stomach acid which means they are not able to fully digest food to get the nutrients out of it. An imbalance of the gut flora will cause malabsorption as well as create food intolerances usually to wheat, gluten, dairy and eggs. The overgrowth of bad bacteria consumes what ever B12 you take in, leaving less for you to absorb. The use of antacid and the other GERD medicines impair proper food breakdown. If your pancreas is not up to par, then the digestive enzymes may be insufficient to fully digest what you've eaten. The stress of the transplant and long time illness can deplete what you have. As well as medications. Many are know for depleting nutrients. There are many possibilities. The problem is that they are usually sub-clinial and get dismissed. But over time, it all adds up.

Your gut issues would play a big factor in your body's ability to breakdown and absorb what you need.

B12 is need for every cell in the body and is needed for proper DNA/RNA replication. Everyone is different and a deficiency will effect people in different ways. Along with low B12, there are probably other nutrients impacted. It's not easy to figure it all out and to correct it quickly. But getting additional B12 is easy to address while you try work through all your issues.

I know you feel let down by Mayo so express your anger over it and find a way to put it behind you. It will just eat at you if you don't. Their reaction to your issues is not personal, it just exposes their limitations. They feel they did their part....the transplant. We all know it takes more than that for people to improve and heal. After these severe treatments for MDS/SAA, we all want to return to a better quality of life but some are left with new issues from treatment. Restoring counts and feeling like crap is not acceptable. Just remember, no one cares more for your health than you. Even though we had a great team at Hopkins and locally, there were things we had to take into our hands to fix/improve after treatment.

Let us know how your appointment goes today and keep the faith. You will figure it out.