Pernicious Anaemia Society
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Advice on exercise

Hi all,

I am hoping some of you will be able to share your experience of starting to exercise again after a long period of mobility issues.

For 2 years I gradually lost my mobility and had been referred to an OT after being diagnosed with fibromyalgia.

I felt so ill that I was convinced this diagnosis was not correct and requested copies of my blood tests which showed my b12 getting lower over the years. 165 was the last test done and I was supplementing b12 at the time which my gp said would not effect the test! After many arguments with my gp who refused further testing I gave up and started self injecting last October with the help of the pernicious anemia society.

This really has saved my life and I would say I am now 60% better and enjoying life again. I used to be a keen runner before getting ill and I really want to get my fitness back. I have started doing the couch potato to 5k and it is killing me.

The following day my symptoms seem to return and I am totally wiped out and in quite a lot of pain. It seems to take quite a few days to recover.

My question is am I trying to do too much too soon and is this usual to feel so wiped out after exercise? Will it always be like this or will I have to learn to take things a bit easier or will I continue to recover and eventually be able to run again?

I take plenty of supplements and eat healthy?

If any of you can offer advice and share your experience it would be much appreciated.


7 Replies

I'm a 51 year old woman and have been going through this a bit over the past few years. It does get better in my experience but it takes some time.

I was never sporty as such but walked everywhere, backpacked, swam and played the odd bit of tennis, so reasonably energetic before developing PA in my forties. Gradually I just slowed to a halt - it came on gradually and at first I thought it was just middle age. I slept most of the time I wasn't working, and put on three stone.

I started three-monthly injections five or six years ago and shortly afterwards went gluten free. I now suspect I'm coeliac, as this was the turning point. Since then my weight has dropped off and I've gradually become much more active. I make sure I have a pretty good diet. But even then I found full-on exercise very difficult.

I could swim casually (that middle-aged breast-stroke chatting-to-your-friend type) and walk about the city, but if I tried running properly, or even walking fast several days in a row, I'd feel great while I did it but flat and unwell for two days or so afterwards. And I'd be scared to do too much exercise because it depleted my B12 and I'd feel terrible for the last few weeks between jabs.

Suddenly last year something changed – I wish I knew what; I'm convinced it was some malabsorption issue – and I could run again. I did couch to 5K (didn't finish it but got to the point where you run for 25 minutes) and am going to take up weights. I now feel generally better than I have in 10 years, though it does come and go a bit and I'm still pretty unfit. I do a yoga class weekly and find that very useful as it makes your muscles work and builds low-level strength without being too demanding up front.

I can only suggest taking it slowly, resting and eating well, though I know that's not much help!


Thank you so much for your reply. I am also coeliac which I guess is why I became deficient. It does feel like I have used up all my b12 after a run! So glad you are doing so well and nice to know that you can run again. I think maybe I am rushing things in my recovery but feel better knowing that you eventually improved. Thanks for giving me hope and I think I will look at yoga x

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This is part of the overall balancing act that so many of us face and it can be frustrating! Go easy on yourself for who knows how long your system has been out of balance and it can take a very long time for things to trend back to "normal."

Since you have symptoms returning and take days to recover your body is telling you something - please listen to it. Slow down and gradually work up to more exercise. Consider taking additional B12 in whatever form works best for you. Your body is still repairing damage and you just jumped off the couch. Give it some time to catch up to your mind. Extra B12 will be worked off due to the exercise and it sounds as if more might be needed to keep everything working properly. The added stress and strain of more physical activity won't help your physical and mental health and will only slow your recovery. This is from someone that has learned this the hard way as well!

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Thank you, it's just so frustrating but will have to take things a bit easier while still recovering


Well established in the sporting community that you need more B12 if you are exercising - so may be that you are getting through more - have you tried upping the frequency with which you supplement?

Also worth making sure that you are getting plenty of folate as using more B12 will mean you are also using up more folate ... and if your folate runs low you won't be able to metabolise and use B12 properly


Thank you for your reply, I am already on a frequent dose due to self injecting but maybe I still need more and probably need a bit longer to recover before pushing myself


Start with no weights and do range-of-motion exercises to stimulate nerves and get muscles and joints moving.

Muscle pain is to be expected and as nerves heal pain may increase (this is a good sign). This pain is actually sort of an illusion because the brain needs to recalibrate to the stronger signal from the healing nerves.

When muscles are warmed up, stretch to keep them from cramping. Then do exercises with light weights.

Joint pain is something else and if you have swelling you need to let joint rest and heal and start range-of-motion exercises again.

Get yourself a small pulley and eight feet of clothes line rope through the pulley. Hang the pulley on the back of a door and use it for shoulders to lift one arm by the rope with the other and vice versa.

When muscles warm up, the pain may decrease also. This is also a good sign, if you can get past the initial pain.

Gradually build up weights. Can of soup is a sort of good starting weight.


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