Anemic from low B-12 absorption

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Dear Dr. Donohue: A friend was informed by her doctor that she has pernicious anemia. He didn't give much information. Would you please give details about this illness? -- O.R.

Dear O.R.: The basic story is that pernicious anemia comes about from a lack of vitamin B-12, but the whole story is much more involved. The vitamin deficiency doesn't come from a lack of ingesting too little B-12; it comes from the inability of the vitamin to penetrate the digestive tract and get into the blood.

For absorption, B-12 needs intrinsic factor, a special product made by stomach cells. Because of an immune attack, stomach cells stop their production of intrinsic factor. No B-12 gets into the blood and, from there, into the bone marrow, and the red-cell count drops -- anemia.

All anemias have common symptoms: listlessness, weakness, mental sluggishness and breathlessness on exertion. One striking symptom of pernicious anemia that is not present in other anemias is a beefy, red, sore tongue.

B-12 deficiency also shows up in the nervous system. Nerves lose their protective covering, and a host of symptoms results -- walking trouble, peculiar sensations, a disturbance of position sense and often personality changes.

The treatment is to give B-12 by injection. The injection bypasses the need for intrinsic factor. Once treatment is started, anemia symptoms quickly go. Nerve symptoms, however, can linger much longer.

Oral treatment is possible also, once the body's stores of B-12 have been replenished. A person has to take large doses of the vitamin to overcome the lack of intrinsic factor.

Dear Dr. Donohue: I have been getting terrible leg cramps at night. My doctor said to drink tonic water. Does this work? How? -- A.K.

Dear A.K.: Quinine used to be a popular treatment for nighttime leg cramps. The Food and Drug Administration, acting to protect the public, took quinine off the market as a muscle-cramp remedy because of quinine's potentially dangerous side effects. Treatment of muscle cramps didn't justify its use. It is still available for malaria treatment.

Tonic water contains quinine. An 8-ounce glass has 41 mg, a fraction of the dose used for leg-cramp treatment. That amount of quinine is safe. Many people praise tonic water as a cramp cure, but the evidence for its effectiveness isn't on solid ground. It won't hurt you to try it.

Dear Dr. Donohue: I am 83 and was in excellent health until eight months ago, when I got hit with a family marital problem. My problem now has to do with my family doctor. He said I have anemia and too few platelets, and he advised me to go to an oncologist to get a bone-marrow test.

I have a friend who has known me well for a good many years and was highly regarded in his profession as a hematology and oncology doctor. He said if he were in my place, he would not go for treatment at my age. He said there is not much new treatment for that area of disease. What do you think? -- J.W.

Dear J.W.: I think your oncologist friend has the cart way in front of the horse. He has no idea what the diagnosis might be, so how can he say there is not much in the way of treatment? See what the oncologist has to say. The drop in your blood count and platelet counts might not call for special tests like a bone-marrow test and might not entail any difficult treatment.

For readers: An oncologist is a cancer doctor. A hematologist is a blood doctor. Most doctors in these fields are both -- oncologist-hematologist.

Dr. Donohue is unable to answer individual letters, but he will incorporate them into his column whenever possible. Readers may write him at P.O. Box 536475, Orlando, FL 32853-6475. Read more of Dr. Donohue at health section, heraldtribune.com.



Last modified: December 27.

Wheat in the process of growth and development, need a variety of nutrients. If malnutrition, the lack of some nutrients, will be from the external morphology WHEAT SEEDLINGS shown corresponding symptoms. Therefore, in accordance with BarleyLife denim production can be judged by the performance of the symptoms need element type, do the right remedy, timely application of fertilizer-to ensure a healthy seedling growth.n

SSP with Shuijiao Oxfam. At the same time foliar application of 5% solution of SSP, or 0.2% potassium dihydrogen phosphate solution, every seven to 10 days, a jet, even spraying 2 or 3 times.

Third, wheat potassium deficiency, first of all, old leaves from the lower part of the tip, leaf edge began to turn yellow, leaf weak, and curly, brown and gradually change. Veiny green stalk thin and weak, irregular tillers, as fewer ear, resulting in uneven grain is easy Lodging belonging potassium deficiency disease. Remedy: Mushi 10 kilograms of potassium chloride or potassium sulfate, and Sashi plant ash, Mushi 100 kilograms, but also foliar application of 0.2% solution of potassium dihydrogen phosphate, every 7 to 10 days time, even Spray 2 to 3 times.

Fourth, when the leaves WHEAT SEEDLINGS zinc deficiency chlorosis, leaf bleaching, shorter section of the plant small, central prematurely dry leaf margin shrinkage, root darken, and air Unfulfilled many grains, grain weight lower. Remedy: per mu in the jointing stage foliar application of 0.3% of the zinc sulfate solution, 5 to 7 days a spray, spray-2 to 3 times.n

B deficiency disease. Remedy: foliar spraying 0.2% borax solution, every seven to 10 days, a jet, even spraying 2 or 3 times.

6, wheat, iron deficiency, mainly in the incidence of new foliage, yellow tissues, the upper leaves may become yellow and white. Tip leaf edge and will gradually expand to wilt. Remedy: foliar spraying 0.2% of the ferrous sulfate solution, every seven to 10 days time, even spraying 2 or 3 times.

7, wheat Mo at first in front of the leaves, brown leaf change, and then the entire bottom of the heart of the exhibition, along parallel vein in small yellow-white spots, and even into line gradually, flake, and leaves before the final Department dries up, the whole of the severe dry. Remedy: foliar application of 0.5% solution of ammonium molybdate, every seven to 10 days a spray, spray with 2 to 3 times.

8, wheat Mn deficiency, with Mo similar symptoms, but lesions in the leaves in the rear, diseased leaves withered after curly, in front of the leaf gradually withered. Remedy: foliar application of 0.2% manganese sulphate solution, every five to seven days a spray, spray with 2 to 3 times.

9. Leaf edge in the lower leaves turn yellow green organizations gradually lost veiny show green leaf edge upward or downward curl, leaf wilt late belonging to magnesium deficiency disease. Remedy: foliar application of 0.3% magnesium sulfate solution, from 7 to 10 days a spray, spray with 2 to 3 times.

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