B 12 injections; Slow Recovery. blood test?

[Nytsom]

Hi all, sorry for the long drawn out post; but Hope you can help?

Had my 6th, loading B12 injection yesterday. I'm not getting any real improvement from having the B12 injections?? or maybe I am?? After the first injection there were signs of improvement ! But joints still swollen etc... began some Magnesium supplements; in hope they may improve my strength and energy (one a day) over the last few days. Sent for some Solgar Folate 800mcg and some Jarrows Sublingual 5000mcg tabs. A few friends and family say my colouring has improved (not looking so pale) recently; but the joints and nerve ends in my feet are still giving me problems when trying to walk any distance. Hip and pelvic (lower back) pain comes and goes; although there is something each day causing mobility problems.. Have another Blood test in 6, weeks and my 7th injection in 10 weeks ..

I have a question to ask about blood test readings? Hope you don't mind if I post just one or two at a time. My Serum Vit, B12 was 136 ng/L ( 180 - 900) "LOW" I'm getting injections of the B12 Deficiency But that is all I'm getting treated for; and a hospital appointment at Rheumatology Dept.

Here are two blood test results I'd like some help with; and some advise on maybe taking some form of supplement?

1, - Serum Folate 6.4 ug/L (> 4.5 ) not considered very low?

2, - Serum Ferritin 10 ug/L ( 15 - 300 ) LOW do I need to take these : Ferrous Sulphate Tablets 200mg? or not?

Haemoglobin - 110 g/L ( 130 - 180 ) LOW

I have the the results of FBC etc... post other results for advise later..

Thank You for any advise and guidance ..

[Galixie]

Well the low hemoglobin and ferritin would indicate iron deficiency anemia. Combining that with the low B12 result means you might be experiencing two forms of anemia at once: microcytic anemia due to iron deficiency and macrocytic anemia due to B12 deficiency.

The tricky part about having both of those at once is that some of your test results, such as the MCV, might give a false normal result and a doctor may not realize how anemic you actually are.

The fact that you are showing multiple vitamin deficiencies means that the cause(s) should be investigated. You could be tested for celiac disease, pernicious anemia, or ulcers, etc. Unless you've been living off of unfortified bread and water, multiple nutrient deficiencies are probably not due to diet alone, so don't let them fob you off with "you just need to eat healthier".

I know we focus mainly on how serious B12 deficiency is, but iron deficiency is just as serious and the cause for that really should be established. Good luck getting some definitive answers.

[Nytsom in reply to Galixie]

Thanks Galixie,

I've had the 6, loading injections; and the next injection of B12 is in ten weeks on the 10th of August. Going to take some Iron, Magnesium and Folate supplements to aid the take up of B12 vitamin.

[Gambit62 Administrator]

Your folate levels are't great - bit on the low side. Body needs folate to absorb and use B12 so you won't be getting the full benefit of of the shots.

On the problems with the feet - there's a condition called tarsal tunnel which is where the nerves in the feet get constrained as they run through the bones in the ankle. This can be a sign of B12 deficiency - very often using an arch support can help as it shifts the position of the nerve so might improve things a little whilst you are waiting for the B12 to start working properly.

Unfortunately it is also possible that the pains may get worse before they get better.

One of the things the body uses B12 for is maintaining the insulating layer around nerve cells. Eventually it gets to a point where nerve signals don't get through so well but ... and the reverse is true as the B12 starts to work so you can get nerve signals coming through again at levels that are higher than they were when your brain has got used to signals being much lower - bit like volume on the radio suddenly getting painfully loud when the signal improves.

Stiffness in joints is also very common with B12D and unfortunately B12D is often associated with other autoimmune conditions - which would include rheumatoid arthritis. B12 plays an important part in cell reproduction, which includes bone tissue so it can lead to osteo-arthritis.

As Galixie says you are obviously anaemic in the true sense, so like many B12 sufferers your situation is far from simple. Really hope that you can work with your GP to get things resolved. B12D can result in anaemia - hence the name pernicious anaemia associated with B12D caused by an autoimmune reaction and sometimes used as a shorthand for B12 Deficiency though it isn't the only reason for malabsorption and because of folate supplementation eg in breakfast cereals, significant numbers of people wit B12D don't show signs of anaemia.

[Nytsom in reply to Gambit62]

Thank you Gambit62,

You certainly described my symptoms and the effects of the 6, B12 Injections; sometimes the pain and discomfort seems as though the condition is worsening as time passes .. Iron - Folate and Magnesium supplements on the way..

I really do appreciate the replies; they are extremely helpful; and give me a better understanding of the Vitamin Deficiencies.

[MariLiz]

Hi Nytsom, you are in the very early stages, so it will take some time for everything to settle. If you think about it, your body has been starved of B12 for some time, suddenly it has a supply! All those nerve endings are going to be more sensitive for a while. I hope you get the iron levels and folate increased, which will help the B12 to be used at cell level. I wish you well MariLiz

[Nytsom]

Thanks MarLiz,

I hope so..

[Secondchance]

You have neurological symptoms so the guidelines and BNF recommend alternate day injections until no further improvement. Go back to your GP with a copy of these and a companion. Good luck! Things will get better. You just need to load up on B12. If your GP refuses there is always the option to self- treat which many choose here. I supplement my GP treatment with Jarrow 5mg sublingual and B12 boost spray. I have found the methylcobalamin helpful for some points and needles/decreased finger sensation/pain.

[Nytsom]

Got the Jarrows 5000mcg Methylcobalamin tabs. may also give the Holland & Barrett - BOOST Spray a try..