In line with guidance provided by iwantgreatcare I would like to offer these constructive suggestions to Dr Kirsty Harkness: Despite UK medical professionals persisting in their mistaken belief that B12 deficiency is a blood condition which can be reversed by raising levels of B12 in the blood to normal, this is not, and never has been, the case. Recently this misconception has been highlighted by a clinical review in the BMJ which evidences that the calibrations of the serum B12 test are misleading with regard to diagnosis and wholly ineffective in establishing when a deficiency has been treated. It also evidenced that B12 deficiency causes a dysfunction of DNA metabolism affecting all cells and not only those in the blood. This results in nerve damage and permanent physical disability in 6% of patients whose deficiency has gone untreated for longer than 6 months. This article can be found here http://www.bmj.com/content/349/bmj.g5226 The symptoms of neurological damage caused by B12 deficiency correlate with those of Tabes Dorsalis, and are very distinctive in that the patient loses sense of proprioception - the ability to distinguish where their limbs are when vision is reduced or impaired. It also ultimately means that the affected muscles will suffer atrophy if they do not receive the correct treatment. I attended a consultation with Dr Kirsty Harkness to assess my muscle damage after a deficient B12 blood test went overlooked for a year. I also had to self medicate with the equivalent of a 6,000mcg loading dose to raise my levels to 178 which meant I was so low in B12 I was still deficient even after the recommended loading doses. However my medical records were not amended to include this information although I did provide the details to Dr Harkness. I was suffering with muscle deterioration, loss of proprioception and pain. It was also recorded, by my GP on the day before my consultation with Dr Kirsty Harkness, that I was unable to bend my left knee. Dr Harkness did a physical examination which did not include tests with eyes closed. This is a requirement when testing for neurological damage as a result of B12 deficiency. She reported that I did not fail the Romberg Test. However the test was only performed with eyes open, not eyes closed. Three other doctors performed the test with eyes closed and I failed - this is entirely consistent with neurological damage from B12 deficiency. Neither did Dr Kirsty Harkness find the knee problem which had been recorded only the day before. Neither did she measure or note, that my left leg above the knee, is 4 cms narrower than my right. Nor that my left quads don't work on flexion. Nor that my weight had fallen from 57kg to 49kg. It subsequently went down as far as 42kg. Neither did she find that my left bicep fails to function on flexion. The scenario would appear to be a simple one: Dr Kirsty Harkness believes that when it comes to B12 deficiency it is a blood condition and once B12 levels are raised to normal all is rectified and that is why she failed to perform the requisite tests and record physical observable injury. The truth is that B12 deficiency causes neurological damage which can appear with or without anaemia. The accuracy of the test with regard to diagnosis is extremely dubious and this can be confirmed by visiting BMJ Best Practice B12 Deficiency which has recently been updated. The diagnosis and prognosis sections are extremely interesting. The serum B12 test with regard to assessing if neurological damage has been reversed has no relevance. No blood test can do this. All the serum B12 test can do is say that the blood is now normalised, nothing else. It cannot even be assured to prove that further damage is not on-going. Dr Kirsty Harkness and B12 deficiency do not sit well together. I am aware she is unhappy with my initial review and has had it removed. I screenshot all of my posts and, even if this (second) review remains unpublished, I can guarantee it will appear in a print publication. Additionally, my B12 deficiency is caused by a condition called hypochlorhydria, a lack of stomach acid. I had to pay privately to have a test done to prove this. No action was taken. This is a pre-malignant condition and no recommended referrals were made. It is unfortunate that Dr Kirsty Harkness appears to be offended by my review but had it removed rather than choosing to respond. Because I am a very tenacious individual who managed to survive despite the negative impact caused by Dr Kirsty Harkness and her ilk and that alone should indicate that I will not let this matter lie until I am convinced she, and others, have learned from this experience. And here is an additional piece of information which might help clarify the waters when it comes to Dr Harkness and her broad-brush opinion of me and my 'cognitive' problems, which she ultimately decided I had: Prior to this moment in time, July 2016, the last sick leave I had was in 1998, and, when I attended Dr Harkness's surgery she managed to make me feel like the laziest malinger on the planet. And this doctor is still afraid to admit she got it wrong. Which convinces me that she will still be getting it wrong with other patients. I hope this review provides the necessary level of constructivism and allows this doctor to upgrade her skills and knowledge which is a prerequisite of practising professionals.
Dr Harkness was completely dismissive about a previous significant b12 deficiency causing neurological damage. She overlooked or made the choice not to record hard neurological evidence. It is particularly worrying when high profile neurologists are dismissive of an illness which is now known worldwide to cause permanent neurologic injury - the Michael J Fox Foundation are researching it in light of Parkinson's disease - yet prominent UK neurologists are not even giving it fleeting consideration provided b12 levels are returned to normal. B12 deficiency is not a blood condition - it is primarily a neurological condition and neuro damage is not rectified simply by returning serum b12 levels to normal. It cannot. Even more disturbing is the fact that even when doctors such as this are informed of the facts, they obstinately refuse to review the situation in light of the oversight. Please see the BMJ 4.9.2014 Vitamin b12 deficiency by Hunt et al if you are vaguely interested in understanding the metabolic dysfunction caused by a b12 deficiency. Neurologists are, apparently, not interested.
Short link to review Dr Kirsty Harkness: http://iwgc.net/eekno