B12 loading dose - am I just being impatient?

Hi Impala ,

I expect you have to wait a bit, particularly as you also have just started 50mg thyroxine for only three and a half weeks. Both B12 and thyroid meds can take some time to feel effective , in your case its just a double whammy , you must be feeling exhausted! Give it a few months, look after your self now, eat well, sleep lots, and hopefully you will feel a lot better in a few months (could be weeks we all are different).

If not think then about spending money on self treating, I tried high dose of B12 tablets, lozenges etc, but they did nothing for me but empty my wallet.

So much has gone wrong over years in your body, it is most likely going to take a few months for all to get right. It took me some 3-4 months to feel the benefit of B12 injections, but then it was really good and you then start to rely on the B12 keeping you well I know little about thyroid meds but believe they also take a few months to feel the benefit. Taking a multi vitamin can help to make sure you do not get to many in-balances, all vits etc need to be in balance ideally. Giving loads of one can cause others to deplete, so a multi can help avoid deficiencies in other (B) vitamins occurring in the initial load up time that will mean a lot of new cells being produced in the body etc.

I hope you will feel a great improvement though in time,

Kind regards,

Marre.

The test for PA is notoriously hit and miss as it isn't very sensitive and it doesn't actually matter what the cause of your deficiency was the treatment is the same (unless it is down to lack in the diet) - shots of B12.

The deficiency basically happens because the delicate mechanism that absorbs B12 in the ileum goes wrong but there could be a number of reasons for this

- an autoimmune response (body creates antibodies that either destroy intrinsic factor - a binding agent necessary for the process) or the parietal cells (which do the actual absorbing). This is PA in its proper sense

- if the ileum has been removed or changed by surgery then the cells needed for absorption will no longer be there so ...

- as you get older levels of acid in the stomach decrease - and the body needs a certain layer of acidity in the gut to be able to process B12

- there are also some drug interactions eg Proton Pump inhibitors that are used to lower stomach acid and treat heart burn/acid reflux, metformin used to treat diabetes (though some research shows that although it lowers absorption it may increase the efficiency of metabolising ...), NSAIDs (eg ibuprofen) ... and a load of others.

- congenital deformations in the ileum

I think you could actually drive yourself mad trying to get to the bottom of what actually caused the deficiency - though I also think there is a case for GPs being more aware of drug interactions as in theory resolving those should correct the deficiency but as things like acid reflux can be symptoms of an underlying deficiency occuring there is also an argument that that is a bit of a mute point.

The bottom line is that whatever the cause the treatment is the same - finding another way of getting B12 into the body that doesn't involve the gut - and injections are the most efficient.

Depending on what symptoms you have a couple of weeks is probably a bit early. The first time I noticed energy levels rising from B12 was when I had a B12 shot about 9 months after my loading doses - which doesn't meant that it wasn't there just that I hadn't noticed because I was just told my B12 was low to start off with without any explanation of what that meant.

Given the other complications I would probably wait and see what happens with getting the thyroid problem sorted out before putting too much financial resource into supplementation - but do keep a record of how you are feeling as there may be symptoms that you haven't really noticed that the B12 has been helping with that you'll notice returning before the next shot.

Really hope you feel better soon

Hi Impala, I'm so sorry to hear you have to deal with both conditions at once! You must feel so exhausted. I'd been hypothyroid for some years before I discovered I'd got low B12 too. Unfortunately both of these conditions have similar symptoms, so it's really good that your GP picked them both up. It will take a while until your thyroid is optimally treated ( the 50mg of Levothyroxine is only a starter dose). Usually it will be increased gradually by 25mg at a time, with interim blood tests to check how things are going. I am rather surprised that the GP is not planning to do anymore B12 testing though. Again, they usually monitor how much B12 is being retained by testing six to eight weeks after the loading doses. Have you got any neurological symptoms from the low B12? Numbness, pins and needles, memory problems etc....? Hope you get all the help you need, people on here are great at advising and providing links to further information. Best wishes MariLiz

Hi, I've recently just gone through all this too so hopefully I can help you a bit. It took me about 6 weeks after the loading doses to feel better. I'm usually exhausted all the time and what happened was I started my Christmas holidays from uni and then went on an active long weekend holiday with friends and when I got back from that at around 9 at night I was still feeling wide awake! It just sort of happens gradually without really noticing at first that suddenly you can function again. I think what also helps is giving yourself time to properly relax after the injections. When I was getting my loading injections I had university exams and I felt absolutely awful. I think it was after spending a week relaxing at home in my holidays that gave my body some proper time to recover which really helped.

Did your nurse tell you you would have them for life? I found that a lot of nurses and even some GP's get confused about this as they tend to think PA and b12 deficiency are the same thing but they're not. What generally happens is that you will get your b12 injections for around 2 years then they will retest and see whether you should continue them. They will not give you life long injections if you haven't even been tested for PA. Folate is usually measured with b12, is it possible that they tested it without you knowing? Either way its a good idea to take your B complex while receiving the injections.

Hope you feel better soon!

My doctor was skeptical about my complaints that B12 was running out early. I also noticed that some symptoms repeated after each jab that were similar to the symptoms before the jab.

I kept a daily log of my symptoms, the food I ate and drank, my meds and the physical exercise and other stressful events in my daily routine.

I was sorting through a gluten and dairy intolerance along with issues with drinking wine or any alcohol of any amount. I also was developing photo sensitivity. All the symptoms from food and meds were delayed between 6 and 24 hours because the gut was involved. Stress just accelerated my consumption of B12.

The log / diary / journal / excel spreadsheet - what ever you want to call it - provided a memory jogger because I was also having short term memory issues at the time. It helped me also sort through the symptoms from the jab that repeated regularly after each jab. This also helped me to de-stress, calm down and take control of my situation.

The symptoms right after the jab were worse when I was low on B12 before the jab. PAS also helped me indentify these symptoms as detox issues. The lower I was on B12 before the jab, the larger the symptom after the jab.

The log became evidence for the dr that I was monitoring my conditions very closely. I invited him to keep a copy in his records but he declined. After about the third time he agreed to increase to 8 weeks and finally to 4 weeks for hydroxocobalamin.

When I moved to the USA and switched to cyanocobalamin, I used the same technique to convince my new dr that I needed more frequent injections.

I moved from 30 days to 14 and then to 7 and I finally started self injecting and my dr has basically said I can use what I need but the pharmacy now is the choke point because the dr can only write a prescription for 1 jab a week. They issue me 4x 1 ml per month and won't let me refill any sooner. I ended up splitting the jab into two 0.5 ml on Sunday and Wednesday evenings.

I switched to the evening to be able to sleep off a headache symptom following the jab. Now with my current regime, as well as supplementing with folic acid, a multivitamin, Vit B6, and biotin, and the occasional methyl-B12 sublingual before a stressful meeting, the roller coaster ride of symptoms has leveled off.

Folic acid in particular is needed for B12 to work. Look up methylation loop. You may feel tired because you have used up any existing stock of folate in your body when your loading doses started.

Neurological symptoms are very slow to correct. I think I have suffered some permanent nerve damage in my right hip which may never go away and I now have tinnitus pretty much all the time.

The main thing f orme is that with this fairly complex maintenance regime, the nerve damage is not getting worse.

My energy still goes up and down and I find just getting started is the hardest. Regular physical exercise helps get the injection out of the muscle and into the blood stream. Once I get going, and I pace myself, I'm pretty much good to go and feel better.

I was diagnosed with pernicious anaemia 10 years ago so b12 supplements won't help me. But if you have a b12 deficiency they will . Make sure your diagnosis is correct as their is many forms of b12 problems that come under many names mega blastic for example . I was given 6 injection to be taken every other day as a starter and it took a good 6 weeks to feel better my levels were 56 should have been around 350-400 . They told me the damage had already been done to my lower intestine so only injections won't work as low b12 over a long period of time cause irreversible damage. I also have irreversible nerve damage in both feet and other issues. It's very important to get correct help and advise as some health officials just pass it on as it's easily treated without making a proper diagnosis good luck

Hi All,

Recently i diagoned with Low B12 , that is 168 and go the first B12 injection this week. Started the feeling the pin and needle in feet, going to have few more injections in consecutive month. I read in lot of forums like low B12 can also cause hypothyroidism. DO i need to check for thyroid issues as well now itself or i can wait? In blood test i can see folate is normal but low B12, how much quantity of folate i need to take during few months of injection?

Thanks