Is macrocytosis common in Sjogrens (and/or APS)?
My consultant wants to check my B12/folate levels but since I already supplement with high doses of those I wonder if the macrocytosis is either caused by something else altogether, or I'm not absorbing the B12 and folate adequately, or I'm not balancing them properly.
Any thoughts/advice anyone?
thanks, JudyCoppernob
Sorry Coppernob, I have never heard of this complaint before,
Will have to google it later. Whatever it is I sure hope you don't have it!
Keep us posted, Dolly
I had to look it up. It could be.
Description
Macrocytosis is the enlargement of red blood cells with near-constant hemoglobin concentration, and is defined by a mean corpuscular volume (MCV) of greater than 100 femtolitres (the precise criterion varies between laboratories).
Causes
Most commonly (especially when the increase in size is mild, and just above normal range) the etiology is bone marrow dysplasia primary to alcohol abuse and Chronic alcoholism. Other causes may include:
* Megaloblastosis (Vitamin B12 or folate deficiency; or DNA synthesis-inhibiting drugs)
* hypothyroidism
* reticulocytosis (commonly from hemolysis or a recent history of blood loss).
* liver disease
* myeloproliferative disease
* Pregnancy- is the most common and requires no treatment as female will return back to normal post-partum
Hi Judy. Was your indication of macrocytosis a high test result of MCH? I too have neuro symptoms and a high MCH. It is true a shortage of B12 can cause neuro symptoms. This is because the body uses B12 to repair nerve tissue and without it, nerves can begin to fall into disrepair. However, as the 'myeloproliferative' entry in Joe's list indicates, neuro problems can result in a shortage of B12 as a symptom rather than a cause as damage due to disease causes the body to run out of the restorative material. I too have been supplementing B12 with no change in my underlying condition. To me this is a sign macrocytosis is a symptom rather than a cause. I should go through all my tests results though to see if a hypothyroid test was in there. Good luck to you making sense of it all.
People with B12 absorption generally have a shortage of something called "the intrinsic" factor that is found in the stomach. I can't remember from whence it comes but with all of us taking the medication for GERD there could be some common ground here. Also, the intrinsic factor could be something that is secreted in the stomach and enough is not bein produced and secreted due to Sjogrens.
When we dry up the gastric juices in the stomach I would bet that we also lose some of the intrinsic factor. I think that it would be wise to ask your doctor just where he is coming or going with this and what is expected, ie., increase in some symptoms/need for B12 injections, etc. Generally the B12 is given in the injection for better absorption. The pills don't get absorbed very well. I know there is a sublingual form now but I don't know what the track record is. Let us know what you find out. Irish ;D