Monday, 27 July 2009

Some good news from my biopsies

Patrick Comerford

This morning I was told the results are back from my tests and biopsies two weeks ago. The results confirm Sarcoidosis I can begin looking at the options for treatment next week. But the good news is that the biopsies show no tumours, no cancers and that there is no TB.

Meanwhile, apart living with sarcoidosis, I have been learning in the past few months to live with a severe deficiency of Vitamin B12.

Initially, I was on a course of Vitamin B12 injections every second day. Eventually this was reduced to one injection a week. Now I go to my GP for an injection once a month, and the next injection is due later this week.

Vitamin B12 occurs naturally only in animal products, including eggs, meat and milk, and in a particular strain of nutritional yeast. And so, my deficiency of B12 can be traced directly to my vegetarian diet of almost 40 years, and my natural dislike for the taste of cow’s milk.

B12 deficiency is common among vegetarians and vegans who do not take B12 supplements. In vegans, the risk is very high because none of their natural food sources contain B12. One American study found blood levels below normal in 92% of vegans, 64% of lacto-vegetarians, and 47% of lacto-ovo-vegetarians who did not supplement their diet with B12 – although recent research suggests that these figures may even be higher than first suggested. This deficiency is also very significant in parts of Africa, India, and South and Central America, where there are low intakes of animal products, particularly among the poor.

Vitamin B12 is found in foods that come from animals, including fish, meat, poultry, eggs, milk, and milk products and fortified breakfast cereals. Other sources include nutritional yeast, fortified soy milks, and fortified energy bars.

This condition is brought about by an inadequate dietary intake or impaired absorption of Vitamin B12. In serious cases, this deficiency has the potential of causing severe and irreversible damage to the nervous system, including sub-acute combined degeneration of the spinal cord.

Early and even fairly pronounced deficiency of B12 does not always cause distinct or specific symptoms. Common early symptoms are tiredness or a decreased mental work capacity, decreased concentration and decreased memory, irritability and depression.

Sleep disturbances may occur, because B12 may be involved in the regulation of the sleep wake cycle by the pineal gland, through melatonin. The neurological signs of B12 deficiency, which can occur without anaemia, include sensory disturbances due to damage to peripheral nerves caused by demyelination and irreversible nerve cell death. The symptoms include numbness and/or tingling of the extremities, impaired sense of smell, loss of appetite, disturbed co-ordination and, if not treated in time, an ataxic gait, especially in the dark when there is less visual reference, a syndrome known as sub-acute combined degeneration of the spinal cord.

B-12 deficiency can also cause symptoms of mania, psychosis, fatigue, memory impairment, irritability, depression and personality changes. Other symptoms include shortness of breath, which can occur when walking just a few yards and migraine headaches.

Vitamin B12 can be given as intramuscular injections. After half a dozen injections over the first couple of weeks, the body stores of B12 n the liver are refilled but have to be maintained for the rest of a patient’s life with monthly to quarterly injections.

My GP and those he referred to me have been quick in diagnosing my deficiency of Vitamin B12 and in putting me on a course of supplementary injections. The next injection is due on Friday.

This deficiency and the regular injections I need would be enough to cope with at the moment. Having to cope with Sarcoidosis too just makes it all more difficult and more demanding. But I am glad I know what’s wrong. With all the prayers and support and love I have received, and with the professionalism of my GP and the consultants I have been seeing, I know I’m coming through to the other side.

Now I'm packing to head off to England for a few days in Somerset and Wiltshire. I’m visiting Bristol, Bath, Calne and Quemerford, a small village where I have ancestral roots. Thanks to all for prayers and support. I may have Sarcoidosis – but it will never have me.