Case Study:

Ellen – aged 70

B12 serum level: 256

Symptoms experienced:

  • Acute iron-deficiency anaemia
  • Depression
  • Breathlessness
  • Aggression
  • Bed bound

Ellen was in her late 70s, suffering from acute iron-deficiency anaemia, kyphoscoliosis, severe arthritis, and depression.

Due to her anaemia, doctors were convinced she had internal bleeding. She was subjected to multiple investigative procedures and was hospitalised for months – emerging without any concrete diagnosis. Her treatment included multiple iron transfusions and blood transfusions, these had no lasting impact on her anaemia. She was given a gastroscopy and colonoscopy – both were negative for a bleed. During several visits her friend asked nursing staff about possible Vitamin B12 deficiency, sadly she was ignored.

Ellen was discharged almost in the same state in which she had been admitted. She was bed bound, remained crippled, breathless, aggressive and depressed. She was so increasingly unpleasant it affected her family relationships. Her plummeting iron levels and lack of diagnosis meant she was readmitted to hospital for a capsule endoscopy. This was also negative, and medics could not explain her iron deficiency anaemia. ‘Anaemia of chronic disease’ was recorded in Ellen’s notes.

Ellen was given high doses of methotrexate and prednisone for her pain, swollen joints, and muscle problems. Methotrexate inhibits the absorption of folate, so she was prescribed a folic acid tablet – once a week. Ellen was eventually tested for B12 deficiency however her doctor’s ignorance meant they would not not consider it possible for her to have a B12 deficiency with a serum B12 level of 256. They were unaware of the inaccuracy of the serum B12 test and were relying on tests rather than listening to their patient, understanding her many symptoms and looking at the whole clinical picture.

Whilst Ellen’s health drastically deteriorated family members also raised the possibility of B12 deficiency with many specialists involved in her care. This was always rejected due to the serum level being ‘within range’ and therefore to the uneducated medics this unfortunately means, ‘entirely normal’.

Ellen read about iron deficiency anaemia in ‘Could It Be B12? – An Epidemic of Misdiagnoses’, by Sally Pacholok R.N. and Dr. Jeffrey Stuart, and began treating herself. In the beginning she started taking high doses of methylcobalamin drops sublingually, and with the help of her family accessed regular B12 injections. For the first time in years her iron levels suddenly stabilised and then improved.

Her friend wrote to Ellen’s consultant about this, including a copy of the book with a chapter highlighted (2nd edition, Chapter 13, pp 282-284). This section so closely described Ellen’s experience, it could have been written about her. Her consultant rheumatologist now agrees that the profound improvement in her iron levels can only be accounted for by the regular B12 injections.



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