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My work is a labour of love
6:01am Friday 3rd November 2006 in Health Features
A family doctor from County Durham has developed a revolutionary theory which could have a huge impact on patient health. Health Editor Barry Nlson investigates.
IT was clear that something extraordinary was happening. In a crowded East Durham meeting room one patient after another was standing up to tell their story of how a simple course of vitamin injections had changed their lives.
The first to speak at Peterlee Leisure Centre was Betty Ritson, a patient of Horden GP Dr Joseph Chandy, who has defied medical convention by finding previously undiagnosed vitamin B12 deficiency in hundreds of people over the last 25 years.
According to the long-serving family doctor, vitamin B12 deficiency may affect up to 12 per cent of the UK population, and is massively under-diagnosed by NHS doctors.
Vitamin B12 plays a vital part in the manufacture of red blood cells and if the vitamin is lacking, the patient may go on to develop one of a number of conditions.
Controversially, Dr Chandy believes B12 deficiency must be suspected in all patients with unexplained neuro-psychiatric symptoms or unexplained anaemia.
The GP thinks many patients with B12 deficiency fall through the net because many symptoms are not recognised. These symptoms can range from severe depression to paralysis.
Several patients on his books were diagnosed with multiple sclerosis, an incurable degenerative disease, but have responded well to B12 injections. Others who lost the sight of an eye or collapsed in the street or at home have also been diagnosed with vitamin deficiency and have benefited from the injections.
Dr Chandy has battled for decades to persuade the medical establishment to listen to his controversial views. He has also developed a more modern way of diagnosing vitamin deficiency, which replaces an approach which dates back more than 150 years.
The slightly built 60-year-old medic is hoping to persuade Health Secretary Patricia Hewitt that the NHS should adopt his new diagnostic approach. He is convinced this will improve the health of thousands - if not millions - of patients and ultimately save the Health Service billions in unnecessary diagnostic procedures and treatment.
A B12 test costs just £3.37 and a six-month course of injections costs £28.
Betty Ritson is a feisty patient who was suffering from a range of chronic illnesses until she was diagnosed with vitamin B12 deficiency.
"If it wasn't for you, doctor, I wouldn't be here at all, I would be fertilising my own flowers," said Mrs Ritson, triggering applause among the doctor's passionate supporters.
Mrs Ritson was just one in an audience of around 100 people, mostly patients, who attended a press conference earlier this week at Peterlee Leisure Centre.
The event, organised by Dr Chandy with the backing of the B12 Committee, a support group made up of former patients, was to call for a revolutionary break with medical tradition. According to Dr Chandy, his innovative approach to diagnosing vitamin B12 deficiency could transform the lives of thousands of patients.
Within a few minutes another patient, Ian Marley, who had complained of a lack of energy and constant tiredness before being diagnosed as being B12 deficient, climbed to his feet to blurt out: "I feel on top of the world, happy-go-lucky. I feel absolutely wonderful. So thank you."
Another patient - a woman called Jacqueline - rose to her feet.
"I had dizzy spells, pins and needles and felt numb down one side. Eventually I keeled over in Peterlee town centre," she said, adding that her hospital consultant suggested her problems were all in her mind.
But after being diagnosed with vitamin B12 deficiency and being given a course of monthly treatments, her problems disappeared. "I feel wonderful after my injections and I know when I need them because my concentration goes and I drop things," she said.
A few minutes later another of Dr Chandy's patients - a woman called Rosemary - told her own story.
"I was diagnosed as a possible multiple sclerosis case. I used to fall over. I lost the vision in my left eye," she said.
Like the other patients, she responded well to the B12 injections and was restored to health. "If I didn't have the injections I wouldn't be here. You are the best thing since sliced bread," she said.
The cheers and enthusiastic applause which greeted this comment showed the unusual bonds which exist between Dr Chandy and his patients.
Since the early 1980s, when Dr Chandy first put his unconventional views on B12 deficiency into practice, around 750 patients at his East Durham practice have been given either B12 supplements or injections.
Remarkably, Dr Chandy claims the vast majority of his patients have benefited from his highly unusual treatment regime.
Until recently, NHS hospital specialists have taken a dim view of this maverick GP's diagnostic approach.
But after a review of Dr Chandy's work, his novel approach to the diagnosis and treatment of B12 deficiency has been cautiously approved by Dr Jonathan Wallace, consultant haematologist at Newcastle's Freeman Hospital.
His 'pathway of care' was endorsed by Easington Primary Care Trust in July - although that organisation has been swallowed up by the new County Durham Primary Care Trust which was established last month.
Dr Chandy's conviction that vitamin B12 deficiency could be the cause of many illnesses began when he was a young doctor in India, more than 40 years ago. He began to wonder whether there could be any link between the ill health of Hindu patients and their vegetarianism.
Vitamin B12 deficiency can be caused by a number of factors, including a vegetarian or vegan diet, because B12 is found in meat, liver, fish, eggs and milk.
But many people - and Dr Chandy believes this figure to be much higher than the conventional view - lack the ability to absorb vitamin B12 from their diet, meaning the only way this balance can be redressed is by injections.
He experimented by giving some of his Hindu patients B12 injections. In most cases their health improved.
All of this was still on his mind when he moved to the UK and set up in practice in County Durham back in 1970.
As a single-handed GP looking after more than 3,000 patients he didn't have much spare time, but what time he had he devoted to researching the role played by vitamin B12 in maintaining good health and what might happen if a patient was deficient. He became convinced that the threshold of vitamin B12 deficiency used by NHS doctors to measure this condition was far too low.
It took him a decade before he was able to start treating UK patients. His first patient - a woman called Glenys - was in the audience on Monday.
"I was in a terrible state, as weak as a kitten," she said. "I was diagnosed with pernicious anaemia. Since then I have been getting the injections for more than 20 years."
Because of difficulties in getting permission from the NHS to continue with injections, Glenys was denied B12 injections for two years. "They tried tablets but they didn't work. I needed the injections because I wasn't taking the vitamins out of my food," she said.
Her health declined during these two years but since the injections were resumed she says she has enjoyed good health. "I am 60 years old now and there is nothing wrong with me," she said, proudly.
Dr Chandy believes many people are unable to extract vitamin B12 from their food. The vitamin is known to be essential to maintain a healthy nervous system and Dr Chandy suspects this is why a deficiency can cause inflammation of the nerves and dementia.
Dr Chandy's remarkable story was featured in the BBC television documentary Inside Out, shown earlier this week.
Catherine Iceton, a 30-year-old mother from Peterlee, told how she was able to stop using a wheelchair and walk normally again, despite being diagnosed with MS, after a course of B12 injections. "It is surreal. I have to pinch myself. I have woken up from my nightmare," she told cameras.
Another patient featured on the documentary, Jeannette Chapman, 36, from Peterlee, revealed how B12 injections helped her recover from severe depression and allowed her hair to grow back.
On the same BBC film, the Newcastle-based consultant haematologist Jonathan Wallace, who reviewed Dr Chandy's methods, said it was "possible" the GP was right after all.
Dr Chandy may well have the last laugh when his research is published in a leading journal in the near future.
More than anything, the veteran family doctor wants to be able to pass the burden on to other, younger doctors.
"I am a tired old man. I can't fight any longer," Dr Chandy told his audience of admirers. "It is the truth. I love my patients, this is the reason I have done all this."