Pernicious Anaemia Society
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Numbness/pins and needles comes and goes - Is this normal

I have numbnness and smetimes pins and needles in my fingers but not all the time. As it is variable does this mean it is not related to being b12 deficient please.

I also get it in one foot but only after walking some distance. When I am pottering around at home my foot is not affected.

Is this variability usual?

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The cause of the numbness in both cases is the insulating shield around a nerve becoming less effective. In the case of both the hands and the feet this can be made worse by the nerves being constricted because in both cases they pass through an area which is narrowed by surrounding tendons and bones.

In the case of the hands this is a region called the carpel tunnel. Keeping the wrist straight can ease the constriction there ease the symptoms. For me things also get slightly worse if I have any water retention (eg before period) - so a lot of the month I won't notice it unless do something that means the wrist is very bent ... like knitting.

With the feet the problem be made worse by because of going through an area constricted by tendons etc in the ankle. Using arch supports tends to provide some relief because it moves the position of the tendons etc a little and creates a bit more space.

Like you I find that if I walk a lot then my feet get sore or numb but if I use arch supports it is much better.

My experience - and the logic above - would say that what you are experiencing is normal.

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Hi I see you have B12 deficiency from your other posts and had loading doses followed by 3 monthly injections. If u have neurological symptoms then it should be 2 monthly at least.

My pins and needles are very variable and even were before treatment.

Perhaps you need more B12 if you're still getting symptoms? You could try to persuade your GP to increase to 2 monthly and also consider sublingual supplements in between injections.

I found 5mg supplements methylcobalamin really helped my finger pains/numbness and if I miss taking them I get worse again quite quickly.

Plus I only was aware of symptoms in one foot but both had no vibration sensation when I was examined.

So yes symptoms in one foot can be B12

Good luck!


I had the last of my loading injections two weeks ago. This week I have been feeling more and more tired

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Generally, I remain tired overnight after a loading injection.

That explains it. Neuro symptoms are supposed to be treated with alternate day injections until no further improvement. Try going back to your GP with BCSH guidelines. Alternatively try sublinguals.

Good luck😊

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You may be able to use the severity of the numbness and pins and needles as a scoring system to monitor your B12 levels.

Start a log book of all your symptoms and try to assess a severity score for each symptom. Also log your food, drink and meds - this is because once you start on B12, new symptoms start to show up.

The two symptoms are probably opposites. When you are low, the numbness appears and when you have higher B12 levels the pins and needles. This is because the nerves are trying to heal when the B12 is up and the signal strength to the brain. Sometimes this appears to be "pain" because the brain takes a while to adjust/recalibrate to the stronger signals. The "pain" is a good sign that the nerves are healing - it can be quite off putting initially, and lasts a day or two until the pain recalibrates. Tell your self it is good - in order to reduce your stress - and somehow it goes away. Stress is a big consumer of B12 and getting our of stressful situations allow your B12 injection to last longer.

The logbook serves some additional purposes. It can become your short term memory is that is one of your neurological symptoms.

Because the gut is involved in the recycling of B12, there is always a delayed reaction when something your eat or drink impacts the B12. Look back 3 to 48 hours to see if you are reacting to any food or drink item. Gluten, Dairy, Soya , Natuarl Flavourings (MSG - E621) are typical items that can give symptoms that are similar to B12 deficiency.

For me, although I don't have PA per se, my stomach doesn't produce enough Intrinsic Factor to recycle B12 properly.

Look at supplementing also with Folic Acid, (up to 5 mg per day), Vit B6, Vit B1 and a daily multivitamin to support the healing of the nerves.

You can also use the logbook, like I did, to provide evidence to your GP that you need more frequent B12 injections.

The GP will be tempted to test your B12 again , and because you are now on injections, the results will be normal. You want high levels to repair neurological damage.

Discuss your plans with your GP so that he/she is not taken off guard when you present your "evidence".

The logbook gives your some control back and allows you to distress.

Also to stimulate the repair of the nerves, you need to do gentle exercises to move the muscles (all the muscles you can try to move.)


Such a very useful response. Very informative. Thanks so much--Invaluable information! Best wishes.


such a useful reply - thank you

That sounds very interesting.  I'm just had my fourth B12 injection yesterday, I have one tomorrow and one more on Monday and that's my loading dose finished.  I get the pins and needles and they seem to be worse after the B12 injection.  In fact, I always have a bad day after the injection then the next day I feel better.   I thought they were supposed to make you feel better straight away...but obviousely not. :-(

Start a logbook of all your symptoms.  You will see the same ones each time the same duration after your injection.  

Pain is an interesting one.   As the nerves heal, the signal to the brain is stronger.  The brain interprets this as pain for about 3 days until it recalibrates.  Tooth ache is one for me that drives me nuts but I try to tell myself it is an illusion.  I still have oregel (baby teething cure) around and I brush with sensodine toothpaste.

I think that the more severe the symptom after your injection, the lower your B12 was before the injection.  I found it to be a real roller coaster ride of ups and downs each injection cycle.

I finally started to self inject cyano weekly and take my folic acid twice daily and things have leveled out.

The symptoms after injection, I think arise from the flood of metabolism activities that have been suspended waiting for a B12 molecule to show up.  Getting the injection releases whatever each cell is going to produce from that B12 (I've called it byproducts and been criticized for it).  The flood from this dam breaking overwhelms other parts of the body and it takes a while (3 to 48 hours) for the cells to process off or filter out the excess.  This causes the symptoms.

Once you understand your particular set of symptoms and the timeframe in which they occur, you gain control back and can start to relax and reduce your stress and anxiety, both of which consume B12.

Are you taking a folic acid supplement along with B6 and a daily multivitamin to support the B12?

No, I don't take folic acid...what is it for?  Neither do I take a multivitamin...maybe I should.

Folate and B12 work together in a partnership in some important biochemical processes. So it's a good idea to take a supplement so that you know your B12 is working properly,

Can I buy it over the counter fbirder or will I need a prescription?

You can get it in most supermarkets and chemists. Some people would recommend you take methylfolate. For the majority of people there's no point (and it costs more). 

A good B12 multivitamin will include folic acid along with the others.

Thank you...I'll get some. :)

I used to fet pins & needles in my right leg. Feeling the pins & needles over an area of 4 inches bt 3 inches. This usually happened wgen the duration of my B12 injection was ending.

Hi I've been told that the folic acid is a man made version of folate and the the folate is a much better supplement to take and having looked on the internet it seems that most medical sites agree, when I've asked in chemists for the folate and they don't have it they say we have folic acid and it's the same.... It's not! I have ordered mine from the Solgar on line site (folate 400mcg)

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For the vast majority of the population, folic acid is easily converted to tetrahydrofolate which is then converted to tetrahydro methylfolate (the thing that most non-scientific web sites call folate). So there's no real point in paying more for methyl folate. While they're not the same it makes no difference.

But don't believe me - believe the Professor (thanks to Allyson1).


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I'm only going by advice given to me from the PAS Society and my body seems to have trouble converting certain things so going to give the folate a try


Hmmm, I find it surprising that the PAS tell you that methylfolate is a much better supplement than folic acid. And I can't seem to find anything like that on their web site.

However, methylfolate isn't going to be worse than folic acid apart from being more expensive. Still, à chacun son goût .

It was Martyn at the PAS who told me to get the folate

It's worth noting that some people react badly to methylfolate. Put "methylfolate side effects" into your favourite internet search engine.


Oh goodness, yes.

My pins and needles and numbness comes and goes but do feel now it may be getting less. I had my loading doses in October last year and am now on two monthly.

So I do think it's pretty normal. Take care.

I went back to my GP today. She is firmly in the 3 month only camp. I don't think it is helped that I was diagnosed with ME and under active thyroid in 2007 and shee seems to want to play my symptoms down and told me not to expect too much from my B12 injections.

Her comments do not explain the gradual worsening of my ME in the last year. I was hurting too much with back pain to debate it with her today.

She told me the Intrinistic factor test was negative, my folate level was right in the middle at 9 and I was not anemic as my iron plasma was 19.3 and my total iron was 5.5.

I did start to feel slightly better during and immediatley after my loading injections, I was less achey and less tired but 2 weeks after the last injection I am as tired and generally achey as I was before I started them.

She should be testing iron saturation. Ferritin can be off if there is inflammation in the body (very common with us lot!)  Read up on BMJ recommendation for iron level in women.  She should take note of BMJ stuff!!

My pins and needles would come and go sometimes, like my nerves were being turned on and off. Other times it was constant. Several months of weekly doses and my sensation feels about 85-90% to me, and pretty stable.

You may need to get your iron levels up as well as your b12 levels . If you have had a low b12 level for long enough , you will also have a low iron level because you need b12 to form blood cells . Blackstrap molasses contains iron and is a gentle way to get it . You could buy Spa Tone iron sachets with apple . The vit C in the apple helps you to absorb the iron . Buy some methylcobalamin active vitamin b12 yourself as it is not available on the NHS .

More nonsense.

No. Low B12 does not cause low iron.

Low B12 can interrupt the formation of red blood cells, which can mean lower levels of haemaglobin (the iron-containing compound that carries oxygen in the blood). But there can still be plenty of iron in the body - there's just nowhere for it to go.

It's like if a baker runs out of flour, so he can't make any more scones. He still has plenty of raisins, but no scones to put them into. Your suggestion is exactly the same as saying that a lack of flour causes a lack of raisins. It's nonsensical.

It's possible that the baker runs out of flour because he doesn't have enough money - a situation that can cause him to run out of raisins as well. Just as it's possible for gut problems to hinder the absorption of B12 and iron. They can have a common cause, but one does not cause the other.

If you cannot form blood cells quickly enough or they die off to quickly , you will get a relative iron deficiency . Blood cells need iron to form but if there is not enough b12 , they cannot do so properly . The cells will die off too quickly , be the wrong size or take too long to form . A patient can have a haemoglobin level in the normal range and still have PA . When there is an iron deficiency for long enough , your body will start using other metals to form blood cells such as lead or aluminum . There is plenty of peer reviewed evidence to show that children diagnosed with autism have higher than normal levels of the wrong metals in their blood and more than enough scientific peer reviewed evidence to show that children diagnosed with autism , respond very well to methylcobalamin active vitamin b12 . If people , including doctors chose to ignore the scientists that is their problem .  

Other metals! Really! Other metals. You really think that aluminium or lead can substitute for iron in haemaglobin?!

That's the biggest, stupidest, load of shullbit that you've managed to come up with! Ever! In a whole mire of unbelievable garbage this is the biggest, stinkiest pile of wombat droppings of the lot!

Yes, some people think that there may be some connection between autism and heavy metals in the blood. But these heavy metals aren't in the haemaglobin molecule.

Molasses, molasses, molasses. Sorry but my scepticism is rising!

I quote from one site:

100 grams of blackstrap molasses has about:

4.7 milligrams iron (26 percent DV)

My view:

They do contain iron. But in order to get enough iron to make a sizeable contribution, you need to consume an awful lot of molasses. They are still about 55% sugar so, from the 100 grams mentioned above, you get 55 grams of sugar. To get a full DV of iron, you'd take in about 220 grams of sugar. Perhaps not such a wonderful addition to our diets?

If molasses are such a wonderful source of iron, why are there so many products based on molasses but with added iron?

Molasses is a waste product, near enough, of the sugar industry. Funny how other substances which are, or are made from, waste products are decried on that basis alone. Given how many times I see blackstrap molasses mentioned, I suspect that the sugar industry is manipulating the media.

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Ah, but don't forget, it also contains trimethylglycine, which is good for mopping up homocysteine.

What a shame it contains just 1 mg per 100g. Which means that you'd need to eat 50 kg to get the same amount of TMG as in one of my little capsules.

I don't think it's the sugar industry. I think it's some people who operate clickbait websites that are hoodwinking the people who are susceptible to such cons.

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what actually makes blackstrap different is that it has been boiled three times and releases lots of useful nutrients and minerals . It ciontains trimethylglycine ( known as betaine ) which binds to homocysteine and helps the body get rid of it . 





Does the boiling increase the amount of iron? Or reduce the amount of sugar you'd consume?

Please, if you think that you can get a significant proportion of your daily requirement of iron from molasses, without also consuming a hefty amount of sugar, explain how. I certainly don't understand and would welcome being educated in this.

Do bear in mind that people trying to recover from iron-deficiency anaemia will have to consume more than a daily requirement in order to build up their retained iron.

fbirder has already commented on the trimethylglycine content.


If TRIMETHYLGLYCINE is such an important part of the use of molasses to get iron, I am surprised that you didn't make any reference to it in your earlier reponse. You just said "Blackstrap molasses contains iron and is a gentle way to get it . "

Hah! I was just searching Amazon for iron supplements and found that you can get capsules of Blackcrap Molasses. But it's so poor in iron that they had to add it artificially.

I laughed.

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Quite... :-)

Trimethylglycine is an important methyl donor . It is found in this type of molasses and in beetroot . I have mentioned this many times on the site . The sugars are burned off in blackstrap . If a person has a b12 deficiency /PA they actually need brain sugar . The goverment seems to be saying that sugar causes many diseases . I wonder if this is a euphamism for nitrous oxide gas .

Brain sugar! This just gets more and more ridiculous. What on Earth is brain sugar? 

Trimethylglycine is important. That's why your body can make all it needs from the oxidation of choline. Which is lucky, because if you relied on Blachshite Molasses for a reasonable amount you'd die.

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What on earth does it mean that "The sugars are burned off in blackstrap ." ????

I quoted one source (there are many) which was about the amount of sugar in blackstrap molasses as sold.

Why is there any need for a euphemism for nitrous oxide? There are around 180 papers on PubMed which in some way, sometimes very obviously, link nitrous oxide and B12.

For example, from 1993:

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