The joys of biochemistry

Ok,

So...I got back a perplexing test result back today.

Ok, so not so perplexing to me, but perplexing to the doctors that have so far refused to believe that I, with no formal years in medical school (as a Ph.D. or nearly so in Biomedical Engineering has no relation or merit to the discussion), could have hypothesized one of my biochemical problems correctly.

In their rejection of my hypothesis (albeit temporarily so, as they have said they'd get around to checking it once they're done with an unending litany of "usual suspects"), the results are perplexing.

In my own little world, they are not.

Now that I have everyone thoroughly confused...the results:

A few days ago, I took a vitamin B12 and B6 levels check, while I was still on my sublingual daily dosing. Even though I technically "hyper-overdose" daily, after 6 months of this hyper-overdosing, I was still within normal parameters, albeit on the higher end of the scale.

Then I stopped the dosing, and prepared for an absorption test a few days later. Within a couple of days I was feeling bad, and by the third day I was feeling like hell, and today I have been barely mobile from my perch near the computer.

I was supposed to have that test this morning, so we took a "baseline" level after 4 days of not dosing. The results came back tonight (granted, through the private arm of local medicine, not the socialized arm, ergo the speedy service, though at a premium. :) ). In 4 days, I had lost 40% of my serum vitamin levels, and was within 10% of being considered a candidate for under-performing absorption.

In 4 days.

That is what perplexed the doctors. This should not really be possible, unless i was actively chelating the drug or something horrid like that. The body accumulates B12 VERY slowly in the liver, and loses it as slowly. In patients with a diet-induced deficiency, the signs can take up to 2 years to appear from when they begin to lose B12.

So, 4 days was a bit of a shock to them.

Talking it over with a couple of more open-minded doctors (who, sadly, are not the ones actually treating me at the moment, nor can they), we went over the biochemistry of absorption: B12 mixes with intrinsic factor (IF) in the gut, and then is absorbed into the body, and eventually fixed in the liver. However, B12 forms a complex with IF, it does not necessarily get absorbed, in normal circumstances, on its own.

The medicine I have suspected of doing damage to me is supposed to damage this IF. Thus, most of the vitamin may not actually get bound to any IF at all as it passes through the gut, and simply passes through due to a concentration difference (massive hyperdose vs. picogram/mL normal levels in blood). Once circulating freely in my bloodstream it is biochemically available to the various processes that need it, but without being attached to active IF, it is not being stored in that great B12 accumulator/capacitor the liver.

So, if I STOP taking the supplement, the body proceeds to eliminate all the free-floating B12 in serum through normal metabolism and renal function, and then it is not replentished from the source that never accumulated in the liver. And voila - miserable Juan.

At the moment, this is all my own conjecture, backed up by a couple of medical opinions unaffiliated with the case.

This has pluses and minuses. Plus: I think I've got some good on-paper proof that there's a problem, and I think I can point to a reasonable biochemistry reason for the problem. I may even get one of these guys to listen to me.

Minus: I'm hosed as far as how dependent I'm going to be on these sublingual supplements, and may eventually have to graduate to weekly injections.

Plus: The easy and widespread availability of these injections and oral treatments.

So, I still feel like CRAP, but I am back on my supplement, and we'll see how the next 24 hours fare.

All for now.