B12

Hi had blood test done b12 came back 100,folate and ferritin ok IF was negative,I have had gut problems for years ibs,diverticoltus,and other symptoms, had loading doses about 8 weeks ago symptons all went and felt great,but this last week gone back to normal wind rolling round gut ibs symptoms tired feeling low again tingling in right arm and hand,not due next jab until end of September,is this due to needing more frequent injections,thank you,

2 Replies

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  • Hi Ozzie,

    It is worth telling your GP that your symptoms have returned well before your next B12 injection, and that tingling means neuro involvement and if he she could please look at the BNF (If in UK) and hopefully he she will decide to give you more frequent B12 jabs, and do further blood tests testing serum folate and ferritin (all needed in good supply with B12 for good blood production and other B vitamins), and thyroid function as all these can go wrong when B12 treatment has started.

    You can help your self (after you have been top GP/ had bloods taken) by taking a good multi (B) vitamin, besides eating well and looking after yourself.

    This may help you (same guidance as in the BNF) see:

    patient.co.uk/doctor/pernic...

    Management[2]

    •For patients with no neurological involvement, treatment is with six injections of hydroxocobalamin, 1 mg in 1 mL at intervals of between 2-4 days.

    •Subsequently, 1 mg is usually given at intervals of three months. There is as yet no evidence-based guidance as to the optimum regime but the National Institute for Health and Care Excellence (NICE) is considering releasing guidance in due course. It should be remembered that serum B12 is not always an accurate reflection of deficiency at a cellular level.[4] It is perhaps for this reason that some patients become symptomatic if the frequency of their injections is reduced, despite having normal serum B12 levels.

    •For patients with neurological involvement, referral to a haematologist is recommended. Initial treatment is with hydroxocobalamin 1 mg on alternate days until there is no further improvement, after which 1 mg should be given every two months for life.[2]

    •Care should be taken not to give folic acid (instead of B12) to any patient who is B12-deprived, as this may result in fulminant neurological deficit.

    •Oral iron therapy should be given before B12 if iron deficiency is diagnosed by an absence of stainable Fe in the bone marrow or other parameters (eg, serum ferritin <449 pmol/mL).

    I have years of IBS diagnosis, its only last year that I have seen a gastro, full investigations, resulting in diagnosis of bile acid mal absorption and medication given that finally helps me, so please persevere in pestering your GP/Dr, go back tell him her, or any gastro specialist you have seen.

    Be very careful with alcohol and what you eat, it all can help to get a better quality of life.

    I hope this helps,

    Kind regards,

    Marre.

    PS I see you have another post like this one see: healthunlocked.com/pasoc/po...

    I see you say doc not interested, perhaps try to see an other doc or ask for referral to haematologist )

  • Thank you

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