Pernicious Anaemia Society
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Could i have b12 deficiency ?

Hallo everyone. I am a 44 years old guy from Norway. Been seeking for some answers for a couple of years. After years of stress and high work pressure, i had what i would call, a breakdown 3 years ago.

What i experienced in the last months up to this, was increasingly the feeling of needing to breath deep, but not beeing able to get enough air into my lungs. And also yawning all day long.

After some months of this, i came to a point where i had a attack of hyperventilation. This made me very anxious, and i felt bad for some time. I was reading up on different websites, and ended up checking my testosterone levels. The tests came back and showed that i was low on testosterone. I started TRT, and felt that this gave me back some energy, libido, more focus and mental calm. But my breathing disorders remained more or less the same.

After one year on TRT, i started to look into some of the other values in my blood-panels. At the same time i was reading about PA and B12 deficiency. I had two readings showing 232 and 234 nmol/l. Vitamin D3 is 73 and 74 nmol/l. This with about 6 months in between.

Been having problems with acid, and digestion all my life, and been using a lot of acid medication. Was diagnosed with moderat gastritis in 1999, but did not follow this up.

Other symptoms : Numbness in fingertips, fatigue, sore tongue, my dentist have for several years made notice about that i am bleeding more than normal in my gums when cleaning, bad breath, .

I have made reservations with my doctor to get a check.

I know that my values are in the reference range, but in the lower range. As i understand the Yawning and the sighs are some of the more usual symptoms of low B12 and anemia.

What do you think about my symptoms ? Are there any problems with testing regarding my testosterone replacement treatment ?

I apologise for my bad English :-)

22 Replies

Hi Knut. It can definitely be about B12. Taking antacids prevents absorbing B12.

I had a bit higher levels than you did, range over here in Finland is 150-652 and my level was 342. Public health care dies not consider this low and does nothing but I had classic symptoms too like constant yawning.

Doctor at private practice confirmed that reference ranges are ridiculous and some people need higher levels of vitamin B12 to feel good. Anything under 500 can cause a lot of symptoms.

I have been supplementing B12 for 8 months now. My levels are higher now but if I take a too long break constant yawning comes back after few days.

I am happy getting rid of yawning and some of the brain fog.

Could you go to functional practice as I have heard there are some excellent places in Norway. They could also check if you have something else going on like is your thyroid gland working. Lack of B12 can cause T4 converting to rt3 instead T3 so there might something else going on too.


Thank you for answering !

Here in Norway the references from labratories (Furst), says that below 150 is clear indicator for deficiency. 150-250 is considered a greyzone, and more testing SHOULD be done (Homocystein and MCV). So i think its a fair chance that i will be getting a check up.

I am not using anti acids now, but i have used it a lot all of my life. My father had problems with Ulcers, and was a big consumer of "Balancid", this came in bottles of 1 liter. I started drinking it when i was 11-12 years old. This was removed from market for som negative effects i think. You may had this product in Finland too ?

I also mentaly feel foggy, and decreased ability to consentrate, and keep focus. When i have more than a couple of tasks, i get stressed and confused. i often forget tasks and details.

I also find it more and more difficult to focus my eyes. Very often when i am tired in the evening, i feel like blury vision, and a strange "stiffnes" in the eyes. Like the "focus-lens" is stuck. Can someone relate to this ?

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Yeah blurry vision is one of my many symptoms. I sort of see everything gray.

You should get more tests done before you get worse! You have so many symptoms already.

You might have other deficiencies too because of using anti acids for years.

Over here in Finland you either are deficient or not. If you hit the lowest number you go to endoscopy, no other tests are done.


Couple of books that are good for finding out about B12 deficiency - which is what the symptoms you are describing sound like.

Could it be B12? - sally pachalok

The b12 deficiency survival handbook - Dr aqsa ghazanfar & regev elya

The tests for B12 have a number of flaws in them and it isn't uncommon for people to be symptomatic of B12 deficicency at levels of 400. In US labs tend to put a warning on the test results - and there is this outstanding warning in the UK on the need to interpret results based on clinical presentation

PA is just one of the causes - though the gastritis does make this more likely.


I see you are concerned about your breathing problem Knutt666,

If your breathing problems are 'breathlessness', consider Low iron or low ferritin (stored iron)

I was told by a Health Unlocked member that:-

Low iron = low oxygen= breathlessness.

My husband's Doctor could not get to the bottom of my husband's 'breathlessness', he also had Asthma so Doctor just doubled his Asthma dose to help cure the breathlessness, (it did not help cure his asthma, but made him have chronic cramps and hurting muscles and muscle weakness instead,) a member on Health Unlocked questioned my Husbands MCV, saying it was LOW 'in range' and would love to know the level of my Husbands iron bloods.

(I noticed you mentioned the 'MCV blood test')

We noticed Doctor had not done any iron tests, so recently we did our own home, (finger prick) blood test kit and results came back 'online' a few days later saying my Husband was low in iron. (which we are self treating and immediately his breathing improved, though might take 6 months to get iron/ferritin up to a good level.)

Doctor said that Hubby's Hemoglobin blood test was 'NORMAL', so Hubby should not have had low (below range) iron bloods, but he did, the home tests proved it.

That's what happens when Doctors rely on unreliable blood tests instead of concentrating on a patients actual 'symptoms' like Doctors did years ago before blood tests came about.

Hubby came off his inhaler, the cramps and muscle problems stopped immediately, he no longer uses any inhalers, oddly he feels his Asthma has gone, but he is also on a good safe dose of vitamins, D3+K2 and A

Not saying Your breathing problems are down to 'breathlessness' Knutt666,but just another angle to look at if you come to a blank.

Just another thought, B12 Deficiency and Hypothyroidism mimic each other or you can have both.

* what were your Thyroid results?

(do not accept NORMAL results for both thyroid or B12 Deficiency as having LOW 'in range' Thyroid or B12 Deficiency can still cause chronic 'symptoms', that many Doctors will ignore.)


I do not fell like bring out of breath when exersising . But more a hunger for air when at rest.


Stiffness in eyes and vision problems I can relate to, I do eye exercises to help.

B12 Deficiency mimics Low Thyroid (Hypothyroidism,) I have Hypothyroidism.

Justina mentioned Thyroid earlier to you.

Also tiredness, brain fog and lack of concentration goes with Hypothyroidism, or you can have both B12 Deficiency and Hypo together. (I had both hypo and low in range vitamin B12)

Google:- 'Air Hunger and Low Thyroid' I believe it is connected, but check for yourself.

Have you had any thyroid bloods done ? (TSH, FT4 and FT3)

If so Can you get a printout of your thyroid bloods and their ranges ?

If thyroid FT4 and FT3 bloods are LOW in range, Doctors often do not accept you have a problem. Yet you can still have thyroid symptoms presenting, but Doctors will say your Thyroid bloods are NORMAL ???

Many people with B12D and Low Thyroid (Hypothyroidism) get 'missed' Knut666


This is kind of exactly what I'm going through right now.

I try and go swimming every second night in my building. I'm generally able to breath without issues - BUT when I start sitting idle - I am hungry for air! Yawning almost non-stop.



Do you eat a lot of fish?

One possible cause of B12 deficiency is infection with the fish tape worm. I read that one sign of infection with fish tape worm is a high level of eosinophils. I also read that eating raw or undercooked fish increases the chance of infection.

Eosinophils is one of the types of blood cell that is tested in the Full Blood Count (also known as Complete Blood Count).

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Hi Knut666 - the hyperventilation may be a stand-alone symptom. But the pins and needles, numbness, sore tongue, fatigue certainly could be caused by a low B12. The total serum B12 test misses up to 90% of B12 deficiency, compared to a newer test that is not widely available. [1] So you need either to get a better test [your doctor can test for methylmalonic acid, or homocysteine in addition to the B12 level. Whether the ActiveB12 test is available in Norway I don't know. OR, if your symptoms disappear [or greatly reduce] after 2-3 months of treatment, that is diagnostic too. If they do disappear, you would have to keep using b12 for the rest of your life.

If you have no joy with the medical profession, you can buy your own tablets - if you take, for instance, 5000 mcg of methylcobalamin [brands like Swanson, Jarrow, Superior Source are available via Amazon] one of those every day should help. Of an oral dose, about 1% is absorbed EVEN if you do not have the intrinsic factor which is normally needed to absorb much smaller amounts. 50 mcg daily should more than supply your need.

[1] Ward MG, Kariyawasam VCM, Sathis B. , Patel KV, et al. Prevalence and Risk Factors for Functional Vitamin B12 Deficiency in Patients with Crohn's Disease. Inflamm Bowel Dis. 2015.

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I have now been at my doctor. Tested for methylmalonic acid and homocysteine in addition to the B12 level. I think the lab form said "free B12".

We also tested for H-pylori, as i have been diagnosed with moderat gastritis in 1999.

I am waiting for my results, and i will post them when they are ready.


I have now been at my doctor. Tested for methylmalonic acid and homocysteine in addition to the B12 level. I think the lab form said "free B12".

We also tested for H-pylori, as i have been diagnosed with moderat gastritis in 1999.

I am waiting for my results, and i will post them when they are ready.

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Thanh you for answering. Just want to make clear that my "hyperventilation attack", was after a long period of sighs and yawning.

The problem with sighs, yawning and "airhunger", have been there or less constant for 15 years.

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I have now been at my doctor. Tested for methylmalonic acid and homocysteine in addition to the B12 level. I think the lab form said "free B12".

We also tested for H-pylori, as i have been diagnosed with moderat gastritis in 1999.

I am waiting for my results, and i will post them when they are ready.


Got my results back today.

MMA 0,15 umol/l (ref <0,26)

Homocystein 19 umol/l (ref 5,0-17,0)

Active B12 58 (ref 32-207)

Total B12 266 nmol/l

Homocystein is just above the reference. Can someone comment ?


Did you also get tested for folate levels? High homocysteine can be caused by folate deficiency as well as B12 deficiency.

Homocysteine is converted to the amino acid methionine by methylation. To methylate the homocysteine requires methylcobalamin. Methylcobalamin is produced by methylation of hydroxocobalamin by methyltetrahydrofolate, which is formed from folic acid.

So, a lack of folic acid means you can't make enough methionine.

And a lack of B12 means you can't make methionine.

And an inability to transform folic acid into methyltetrahydrofolate means you can't make methionine.

In all three cases the inability to make methionine means that homocysteine levels build up.

It's important to get your homocysteine levels down. As well as your B12 jabs I would start taking 400ug of methyl folate (or metafolin) each day. That bypasses the conversion from folic acid, fixing the first and third cases above.

You could also ask to get tested for mutations in the MTHFR gene to see if you do have problems with methylation.


Thank you for a thorough answer. I will have my folate levels checked 22.01.

I will be back with numbers :-)


Does anyone know what will raise first in first stages of B12 deficiency. Methyl melonate acid(MMA) or homocystein.

And is there many of same symptoms between low B12, and B9 folic acid?


Wow is all I can say! Just saw your B-12 post and the constant yawning. This is me 100% of the time. The crazy thing is I also have low T and started TRT and also terrible acid reflux(had surgery for it 2-20-2017). Have you found a solution to the yawning?

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My b-12 is noe higher. Around 400. And the yawning problem is much better. I still have it in periods. I also fins It vert important to keep myself hydrated. Seems to be a connection.

For how long have you had thid problem ?


It has been going on since Jan 2016. I was on Nexium for a long time so I think that might be the cause of it.


I have started to notice this yawning problem begin on Thursday or Friday of last week. (It's currently wednesday).

It started with yawning for about an hour in the afternoon for the first few days - but now it's progressively getting more and more. Today I've been almost yawning since I've got up and it's about noon.

I have sleep apnea, so last night wearing the CPAP machine - I was also requiring to yawn slightly and was almost having a difficulty getting to sleep as a result. I finally tried a different sleeping position - which I think helped me enough to finally get to sleep.

As I know yawning is usually a symptom of body trying to get oxygen in the body, I was told before I had a low b12 number - but I've started taking the 5000 mcg dosage of B12(sublingual) yesterday.

I know people have also said that protein intake can be related to a b12 deficiency(not sure if this is accurate) - so I also started having a protein bar yesterday and am going to continue.

I've noticed over the last hour or so today - the yawning is less frequent, but still more frequent than normal.

I'm hoping to get back to normal where I'm yawning mostly when I'm tired and about to go to bed - or shortly after I wake up in the morning.


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