Pernicious Anaemia Society

How important are loading doses?

Hi all, was diagnosed in Dec 2012 with B12 def and put straight on 3 monthly shots. How important is it to have loading doses? asked the Dr and he said as I was borderline I didn't need them, asked if I could have them now but he said as my levels are normal I dont need them. Would you agree? Any advice would be greatly appreciated

5 Replies

You should have had loading doses. Bad dr!


What are your symptoms? If you are still symptomatic, then you likely need more frequent injections. If you have neuro symptoms, then these should be alternate day injections (BNF 9.1.2).



Same thing happened to me. However, I did manage to persuade my doctor to give me the loading doses eventually because my symptoms hadn't improved much. She was reluctant but as I argued that it only costs around 50p a shot and it's impossible to overdose, what's the harm?! Now I don't have b12 tests as there is a danger that I will be refused my shots if levels are ok. There is still so much ignorance about this condition amongst health professionals.


I didnt get loading doses either although the nurses said it was usual practice. One of them spoke to my GP and was told I was borderline so would not need them. After 3 x 3 monthly injections I asked to be put on 2monthly ones. This was agreed. If you are feeling well and have no symptons you are not likely to benefit but if you feel unwell maybe you could ask to go on 2 monthly doses. I also use patches if I feel a down turn before my injections.


Sorry that you are having problems with your GP - can empathise.

I had standard loading doses for non-neuro symptoms after being told I had low levels on B12 when I was in hospital. Won't bore you with the details of my struggles (which come against a background of not having much faith in GPs) but on reflection I had neuro symptoms and had done for some time but couldn't get GP to listen so in desperation started using a nasal spray at 3x the dosage suggested and the change has been dramatic - gone from struggling with being unsteady to being able to go up ladders no-problem ... and all my GP wanted to do was give me anti-depressants.

In an ideal world GPs would listen to us and be open to learning about this condition but ...

As others have said, particularly if you have neurological symptoms - which would include the tiredness and problems remembering names then you should have received loading doses as hampster indicates.

I believe that the new guidance in the latest BNF indicates that people should be responding the symptoms rather than test results and recognises that you can be symptomatic even if standard blood tests show your B12 levels are normal.

I really hope that you do manage to persuade your GP to listen to you.


You may also like...