'Heartburn pills wrecked my life': How antacids can have serious side-effects
Last updated at 12:20 AM on 07th July 2009
Ordeal: It took 13 years for Andrea MacArthur to be diagnosed
For 13 long years, Andrea MacArthur struggled to cope with increasing tiredness and apparently random muscle and nerve problems.
By last Christmas, she was crippled with exhaustion.
The muscles in her right leg had stopped working and withered; she'd lost control of her bowel and bladder, and lost her sense of balance, which meant she couldn't walk far without a cane.
Although Andrea had seen dozens of specialists and underwent countless tests over the years, no one knew what was wrong.
Yet, just six months later, the 48-year-old farmer's wife from Tiree, Scotland, is transformed.
She no longer needs a cane; her energy levels are almost back to normal, and - for the first time in years - the mother of two is able to do everyday tasks, such as prepare family meals, without collapsing.
What is extraordinary is that her problems stemmed from the lack of an everyday vitamin, caused by medicine commonly prescribed for ulcers and heartburn - and that Andrea discovered the problem herself by searching on the internet.
Andrea was suffering from pernicious anaemia, because of a deficiency of vitamin B12. This vitamin is essential for producing red blood cells and for maintaining a healthy nervous system, specifically the fatty sheath that protects the nerve cells.
While B12 is available in our diet - from animal products, including milk, meat, fish and eggs, and fortified foods such as breakfast cereals - many people have problems absorbing it.
As a result, the fatty sheath around nerve cells begins to degrade, corrupting the messages being sent to the nerves and ultimately stopping them.
The first sign of pernicious anaemia is often fatigue. An estimated half a million people in the UK suffer from the condition, although many do not realise it.
It is caused by an autoimmune condition in which
the body starts attacking the cells in the stomach
necessary for absorbing B12, explains Professor
David Smith, a Bvitamin expert at Oxford University.
Stomach surgery and Crohn's disease can also damage these cells.
Vitamin B12 deficiency is especially common in older people, because high levels of stomach acid are essential for the body to absorb the vitamin, and as we age our stomachs produce less.
Acid-suppressant drugs given to people with acid reflux and ulcers might be another factor. A recent Austrian study showed that after only four or five months of taking such drugs, vitamin B12 levels began to drop in healthy men.
Last year, GPs wrote more than 32 million prescriptions for acid-suppressant drugs such as omeprazole and lansoprazole.
'I recommend that anyone who is on these drugs for more than a short period of time take a B12 supplement,' Professor Smith says.
Andrea's problems started after she underwent surgery to correct scoliosis (a sideways curvature of the spine).
Fish is a natural source of B12, which is also found in dairy products, meat, and breakfast cereals
Despite the surgery, she still suffered pain and was put on anti-inflammatory drugs as well as powerful antacids to protect her stomach from the potentially damaging effects of the drugs.
Andrea's first inkling that something was wrong came not long after the birth of her second child, Christine, in 1996.
'I noticed a stabbing pain in my right foot,' she recalls. 'Then it became severe pains in that leg. But I assumed it was due to the scoliosis, so I just took more painkillers.'
Six months later, Andrea, then 35, suffered a mini-stroke.
'It turned out that my blood pressure was very high, but the doctors couldn't understand why.' Andrea was seen by various cardiologists and was put on pills to lower her blood pressure.
'From then on I never felt well,' she recalls. 'I had bouts of terrible exhaustion and often felt lightheaded; sometimes I had to lie down for up to two days before my energy levels recovered.'
Then Andrea noticed her right foot could no longer grip properly. The muscles on the back of her right leg became floppy and she lost sensation in that leg from her hip to her toes.
But at this point she still believed her back problems were behind the symptoms, as did the consultants she saw.
'Walking became a real effort. I had to think about every step. It wasn't just the muscle problem - my sense of balance was affected.'
Over the years, she underwent ultrasound, MRI and CT scans, X-rays, a liver biopsy, a colonoscopy of her large intestine (a tiny camera was inserted into her bowel), an endoscopy of her throat and stomach (more cameras), and countless blood tests.
Her condition deteriorated, she lost control of her bladder and had another scan.
'But they still couldn't figure out what was wrong,' Andrea says. Despite this, she remained relatively upbeat. 'I always hoped that the next test would be the answer.'
B12 supplements - also available by injection - are recommended if you are taking acid-suppressant drugs for more than a short period of time
Her symptoms grew steadily worse. 'I had to stop driving the tractor and I lost out on many activities with my children. Fortunately, my husband Donald was very supportive.'
By last year her health was in a 'dreadful state'. Then, just before Christmas, Andrea was in an internet forum where someone mentioned pernicious anaemia.
Her curiosity piqued, she decided to look it up. 'When I saw the list of symptoms, it described me to a T.'
Her GP agreed to check for B12 deficiency, but the tests came back normal.
'Fortunately, I'd read up on it and knew some people have symptoms of B12 deficiency despite apparently normal blood levels.' So her GP offered to give her a B12 injection.
Within hours, she felt more alert and the pains in her right leg disappeared. Over the next few days her energy levels and her balance improved significantly.
After a week, her blood pressure had returned to normal (the nervous system helps regulate blood pressure) and after further injections, Andrea's health has been transformed.
Although she still needs painkillers for her back, her sense of balance has improved enough for her to discard the cane.
However, her right leg remains numb and her bladder and bowel function are impaired; she has been told they are unlikely ever to recover fully.
'The most shocking thing about Andrea's story is how common it is,' says Martyn Hooper, chair of the Pernicious Anaemia Society, a patient group.
'We have many members who have suffered permanent and irreversible nerve damage because of late diagnosis, when something as simple as the injection of a vitamin could have prevented the damage.'
The problem is largely the reliance on traditional blood tests. As Professor Smith explains: 'There is an over-dependence on these and not enough notice is taken of other symptoms.' There are now new tests for B12 deficiency that can get round this.
'But until these are more widely available, pernicious anaemia will continue to be missed unless the doctor takes notice of the signs and gives some trial injections of B12,' says Professor Smith.
Perhaps surprisingly, Andrea is not bitter about what's happened. 'There was no negligence on anyone's part, just a general lack of awareness and understanding throughout the NHS regarding this condition,' she says.
It seems she considers herself one of the lucky ones.