Pernicious Anaemia Society
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New to B12, do I need a GP appointment?

In June this year I went to the doctors because I hurt my knee running and without any info to why he decided to do some blood tests, thyroid, B12, liver function etc.

He phoned me with the results and said everything was normal except my B12 was low and told me to see the nurse twice a week over 3 weeks for 6 B12 injections. He also got me to take folic acid tablets for two weeks I think it was.

The nurse told me that I will have to have an injection every three months for ever more, and I am having the first of these next week.

I am feeling a bit in the dark here, surely I should have further tests so the doctor can check that I am low again or to discuss why this is affecting me. I also now have no idea if I should take more folic acid?

Also I now have the numbness in my fingers sometimes which I had thought was related to a problem I had with my neck/shoulder and saw physio for it but having read about the symptoms of PA I think it may have more to do with PA and that is why physio did not completely cure it. Should I see the doctor to let him know that I have this issue, as I did not see him about this.

Thinking about it I am not sure if the doctor has actually diagnosed me with PA, he really did not say much other than to see the nurse.

Any advice, thoughts would be appreciated.



11 Replies

You must have been diagnosed with PA as you are to have b12.injections " for evermore " . You mention your shoulder pain. I had bursitis, which physiotherapy didn't help at all . B12 injections worked straightaway ! If you look on US sites , you will see that B12 injections are an acknowledged treatment for burstis . But GP s here would be very sceptical .

You must ask your doc if he has diagnosed PA . Best wishes to youn.


That's interesting, thanks


For a definitive diagnosis of PA you really need a test for anti-IF (Intrinsic Factor) antibodies. The problem is that the test gives a negative result for half of people who ho do have PA. So if the test came back negative you still wouldn't know if you had it or not. Then you would have to hope that your doctor would carry on the treatment.

There's no point retesting for B12 as your levels will be artificially high after getting the jabs.

Your numb finger could well be because of peripheral neuropathy caused by low B12.

As long as you don't mind the injections it's probably a good idea to keep them up. If you do have PA then they will do you some good. If you don't have PA then they won't do any harm.

I'd also stick with the folic acid at 400 ug a day (Tesco is cheaper than prescription).

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Thanks, I will get the folic acid, after I put the prescription in for it I did wonder why I had not just bought some from the supermarket

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Your B12 levels can be low because you don't have any B12 in your diet because you don't eat any animal products or use cereals fortified with B12. However, this is rare and it is much more likely that low B12 is caused by an absorption process.

Normally the body is very good at storing and recycling B12. The body stores B12 in the liver and then releases it into the ileum (where most B12 is absorbed) for reabsorption - but if there is an absorption problem here then it is just like trying to keep water in a system when there is a leak - it doesn't work. So if you have an absorption problems then you can't replace your stores - which is why you need the injections to top up levels on a regular basis.

Measuring B12 in the blood is one way of trying to gauge if you have enough but the levels in your blood don't tell the whole story - as what counts is the amount that is available for your cells to use and the chemistry is quite complicated. Whilst you are receiving shots a serum B12 test doesn't mean an awful lot unless it is low.

As fbirder says - you could go for getting tests for PA - but a) the tests are notoriously prone to giving false negatives and b) PA isn't the only absorption problem - but what ever the problem is the treatment is the same. The guidelines do say that GP should investigate the reason for deficiency - but don't give any idea why - personally I think you could drive yourself mad trying to get to a specific cause though the treatment doesn't change - and the really important thing is treatment - but that is my personal position - not knowing exactly what the cause of my B12 deficiency is myself.


I was told I had B12 had the jags and was told I would be on them for ever every 3 month. Had a jag yesterday only to be told I don't any more even though had no more blood tests and was feeling bad before getting the jag

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Hi suzywong71,

If it were me, I'd definitely want to talk to the GP about this change in B12 injections!

You are entitled to know what is going on as regards your health!

Good luck! :-)

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A lot of GP's seem to be going back on their original decisions over B12 injections. If you need it forever, what has changed? If they repeat a blood test once you are on injections, of course the level will be higher. I have a friend at Art Group whose husband is currently fighting for his injections. He also has another blood condition, and has felt so much better on more frequent B12.

Hope you get your injections re-instated Suzy?


Thanks.... this is all new to me


My gp has now decided 3 injections is enough as my b12 had gone up on its own before first one. Beginning to lose faith in him .I'm seeing locum next week so I'll discuss it with him.


I don't know yet if I have PA but GP has taken blood to check. My story goes like this.... go to GP reporting numbness in right hand and fingers on waking and when cycling. After prodding about a bit he diagnoses carpal tunnel syndrome and tells me to buy a Futuro wrist splint, and to get blood taken by nurse to test for B12 deficiency, thyroid deficiency and rheumatoid arthritis. Two days later am phoned by receptionist who tells me that I am B12 deficient and am to start injections. I ask for an appointment to discuss with GP as I am already on enough interventions. Different GP shows me the results and I can see that B12 is low. She agrees that I can try to increase B12 by diet and will retest in 3 months, but also explains the absorption issues associated with PA and so warns me if this is the case then it's injections as dietary method will make no difference. So classic case of testing and finding something, a short hop from numb hand to auto-immune life threatening condition yay!


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