Learn about Methylcobalamin, the active form of B12 that is the quickest to act.
Sometime after this letter, I called Sally Stabler who was kind enough
to take my call and talk to me for twenty-five minutes.
She hates being an expert witness, so she said no to that.
But talking to her answered most of my questions.
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My letter to vitamin B12 researcher, Sally Stabler
My current email
address is:
Methylcobalamin1@
msn.com
Health Boundaries Bite
Thank you to
everyone who's left a
message. I had no
idea I would get so
many lovely messages
when I put this
response box on this
page.
Karen M. Kline
Santa Fe, New Mexico 87501
December 19, 2002
S. P. Stabler
University of Colorado Health Sciences Center
Denver, CO 80220
Dear Dr. Stabler,
I have read three of your articles:
1.) Cobalamin Deficiency in White and African American Elderly Women,
1999,
2.) Metabolic evidence that deficiencies of vitamin B-12 (cobalamin), folate,
and vitamin B-6 occur commonly in elderly people, 1993, and
3.) Cerebrospinal fluid methylmalonic acid levels in normal subjects and
patients with cobalamin deficiency, 1991.
I saw that you worked with D.G. Savage and J. Lindenbaum on Cerebrospinal
fluid methylmalonic acid levels, and was particularly interested in that, since I
am finding their Neurologic aspects of cobalamin deficiency to be highly useful in
preparing my malpractice case against doctors who failed to diagnose my
pernicious anemia.
My reason for bringing the action, is to raise awareness of B12, which is much
more easily administered, than the effects of its deficiency are cured, once they
have persisted for some time.
In my case, when I was taken to hospital, May 1997, as a result of a suicide
attempt (Dalmane and carbon monoxide), my B12 tested at 141. The physician
diagnosed “profound anemia” and “personality disorder,” the later apparently on
the basis of my suicide letter, which talked about IRS abuse I had suffered. (U.S.
News & World Report used some of my experiences in an article published
April, 1996.)
I was given a shot of B12, which I don’t remember because of all the Dalmane.
During the following months, despite telling my doctor that my mother has
pernicious anemia, I was told only that my B12 had been low. I bought B-
Complex tablets and took them by the bottle, ate liver (but not a pound a day)
and had no increase in my B12 level. Over two years, I had a few more B12
shots, but mostly I had to beg for them, since my level reached 241.
On Christmas Eve, December 24, 1998, a different doctor diagnosed pernicious
anemia and had a nurse show me how to give myself shots.
With a shot a month, I began to improve so that I was able to take a job, just a
desk clerk job, whereas I had been a successful Realtor, but still it was a major
step. However, I couldn’t hold the job because I could not remember room
numbers I had just assigned: so, keys I made didn’t match, and I entered wrong
numbers into the phone machine. The more stressed I became, the worse I did,
till I was fired.
Luckily, I was in Chapter 11 and had an adversary proceeding re violating the
automatic stay, so I had to get an expert witness, which led me to Dr. Michael
Baten, a neurologist. I am ever grateful to the opposing attorneys, because Dr.
Baten suggested I take more B12, especially when I was under stress. Also, he
had me keep a timeline, showing my B12 shots, symptoms, B12 test results, etc.
I had been unable to go to three places, like the grocery, Kinko’s and the post
office on one trip, because I could not remember all of that, which was
distressing. But, taking more B12, I was able one day, to think while I drove of
someplace else I wanted to go and plan the route, and go both places. It was like
Christmas, a gift, exciting and wonderful: I was suddenly younger. Up until then,
one of my main occupations was to remain calm when I was confused. I would
constantly reassure myself, “It doesn’t matter. If you do one thing in a day, that’
s fine.”
Also, my legs used to jump at night, waking me, and they hurt. After quite a lot
of B12, that stopped. But an odd sensation persisted, so that I feared it would
not go away: it was a feeling in my legs and thighs as if a small animal were
inside, trying to get out, it was less painful than it sounds, but was major
disturbing. And, I often had a feeling of something crawling on my legs and
arms. I would think there was a spider, jump, and brush it away, though really
there was nothing there.
Both of these sensations mostly went away, for which I am grateful.
But problems remain: my toes are numb, my right thigh is often numb, which I
only know if I touch it, but can’t feel my touch -- I’ve fallen when a cord was
around my right leg, and I didn’t feel it -- recently, my feet go numb, so that I
feel as if I’m falling -- I have fallen, but did not get badly hurt, like the time with
the cord, and there are my memory and cognitive skills which are impaired: not
long ago I spent a day reading about certain Constitutional amendments, next day
I couldn’t remember which ones. Mostly, I have to write things down, then hope
that I can find the notes when I want to use them. Sometimes I don’t remember
there’s something I want to use.
I think the opposing attorneys, seeing me as too ineffective/forgetful to win,
advised their clients not to settle when I offered to settle for $30,000 ($5,000
from each defendant) and an agreement that they would promote B12 education
in the community, which I thought they could easily do by asking the television
stations to participate, newspapers, etc.
However, I did do my Chapter 11, (1997-2000) where I was allowed to read
what I wanted to say. And, I can copy things, and put them together in a
compelling way, given the time.
So, if you were to agree to be an expert witness for me, I don’t think you would
be embarrassed in court. (I imagine that might be a fear, given that I’m pro se.)
In terms of paying you, I believe that I will be able to do an equity loan in
February. Right now I’m low on cash resources because while I was less
mentally functional, a very clever man was able to take several thousand dollars
from me. Luckily, I was able to stop him from taking my home.
Some of the questions I have to address, are whether or not I have pernicious
anemia, or some other malabsorption problem. I didn’t test right for Intrinsic
Factor antibodies to show that I have PA. I read articles that said only about
60% of the tests are accurate for PA. But now there seems to be evidence that
there are other causes for the symptoms of PA, than lack of intrinsic factor, and
other names for the disorders.
Also, I don’t know if extended B12 deficiency causes PA, which some articles
seem to indicate. If that were the case, then because I raised my B12 level,
maybe the added B12 in my system fostered Intrinsic Factor. If my B12 level
had again been 141, then would I have shown a lack of Intrinsic Factor?
Personally, I would like to see our national “low” for B12 raised to the low used
in Japan and Europe, which I understand from www articles is 550. I know that
when my level, which I try to keep high, drops to 550, I begin to have bleeding,
more tingling, numbness, vision and memory problems, depression, and other
symptoms.
I was sad to read that R. Carmel had said, "Extending suspicion of deficiency to
persons with cobalamin concentrations of 140-258 pmol/L appears to provide
more disadvantages than advantages.” Am J Clin Nutr 1999.
It seems to me that if work like yours shows that deficiency occurs commonly in
elderly people, that raising the “low” level, would help catch the problem before
irreversible damage is done.
I wrote to NBC, CBS, ABC, etc. trying to get their health experts to cover this
subject, but I haven’t seen any such coverage come on the news. I also wrote to
several news magazines, with similar results.
If my case goes to trial, and you were an expert for me, then maybe the case
would spur media coverage, which would be good for B12 deficiency sufferers,
known and unknown, if I won, which I would hope to do.
This is such a busy season to be asking for help. Plus, as an academic you may
be on holiday, and not timely receive this. Thinking to speed up the process, I
tried to e-mail you, but I received the response that you were not accepting mail
from unknown origins, or something like that.
My e-mail address is ProSeChallenge@AOL.com
Hoping to hear a favorable response from you, I remain,
Sincerely,
Karen M. Kline
Karen M. Kline
Copy: R. Carmel
Well, I just searched Gale for “Stabler”, rather than “cobalamin” and found
many more articles, or perhaps more accurately, abstracts.
1.) Association of folate intake and serum homocysteine in elderly persons
according to vitamin supplementation and alcohol use. 2001.
2.) Vitamin B12 deficiency and depression physically disabled older women:
epidemiologic evidence from the Women’s Health and Aging Study. 2000.
(For several reasons, this interests me: “Conclusions: In community-
dwelling older women, metabolically significant vitamin B (sub 12)
deficiency is associated with a twofold risk of severe depression.” When
my doctor finally got me to agree to take a Prozac look-alike, Sarafem, of
which she gave me several sample boxes, I had (about two months later)
adverse reactions: bleeding gums, my period, shaky hands, incontinence
(not fun), severely decreased memory, increased problems with mental
organizing, my chest hurt, I felt nauseous, my feet wentnumb: so I felt I
was falling. Her strong interest in me taking it may have stemmed from the
“personality disorder” diagnosis, 1997.)
3.) Effects of parenteral cysteine and glutathione feeding in a baboon model of
severe prematurity. 2000.
4.) Racial differences in prevalence of cobalamin and folate deficiencies in
disabled elderly women. 1999.
5.) Vitamin B12 deficiency in older people: improving diagnosis and
preventing disability. 1998.
“Vitamin B12 deficiency may not be a reliable indicator of general health in
older patients, as it is a common occurrence in the elderly.”
But, would general health in older patients improve, if the “low” for B12
were raised to 550, so that older patients, and others, were more likely to
receive more?
6.) Vitamin B12 deficiency in the elderly: current dilemmas. 1997.
“Research efforts should be directed toward determining practical methods
for diagnosing and treating vitamin B-12 deficiency in the millions of
elderly subjects with undiagnosed deficiency.”
I love this.
7.) AIDS-associated non-Hodgkin’s lymphomas as primary and secondary
AIDS diagnoses in hemophiliacs. 1996.
8.) Relationship among homocyst(e)ine, vitamin B-12 and cardiac disease in
the elderly: association between vitamin B-12 deficiency and decreased left
ventricular ejection fraction. 1996.
“In conclusion, vitamin B-12-deficient patients had significantly lower left
ventricular ejection fractions than nonvitamin B-12-deficient patients.”
I wonder if this is why my chest hurts when my B-12 is low.
9.) The use of homocysteine and other metabolites in the specific diagnosis of
vitamin B-12 deficiency. 1996.
“In conclusion, elevations of methylmalonic acid and total homocysteine
are very sensitive and specific in diagnosing vitamin B-12 deficiency and
can be used to help differentiate vitamin B-12 deficiency from folate
deficiency.”
Does this mean that once I had years of B-12 shots, that this test, which
was then given to see whether or not I had PA, could no longer be
effective for that purpose?
10.) Elevated methylmalonic acid and total homocysteine levels show high
prevalence of vitamin B12 deficiency after gastric surgery. 1996.
“In the 15 people who received treatment, elevated levels of methylmalonic
acid and homocysteine decreased, confirming the diagnosis of vitamin B12
deficiency.”
So, this sounds like after years of treatment, these tests can’t then be used
to determine whether or not B12 deficiency existed. Are they equally
unsuitable for saying PA didn’t exist?
11.) Effects of vitamin B12, folate, and vitamin B6 supplements in elderly
people with normal serum vitamin concentrations. 1995. (Whole article was
given)
“Higher metabolite concentrations in the blood suggesting vitamin B
deficiency in elderly people may normalize after vitamin supplementation.”
That’s it, then. So, from the perspective that I’m no longer vitamin B12
deficient, I am said to no longer have pernicious anemia, which is then
transposed into saying I never had PA., according to the opposing
attorneys. Is that what you say?
*** Since I can’t use any of this in court without the author to back it up, I
really need you.
