Pernicious Anaemia Society
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Symptoms worsening when tired/stressed?

I'm about 6 weeks into daily subQ injections and have seen great improvement. Two of the worrying neuro symptoms - balance and muscle strength - were among the first to improve and even completely resolved. But now the last 2 days i've been stressed at work, working very late, and having some issues with hormone meds leading to physical stress... And possibly as a result of these stressors, my balance seems to have gotten worse - swaying again when walking in the dark to the bathroom, knocking into doors, dropping or knocking over things, etc.

Is it normal to revert like that in the beginning stages? Something to do with stress depleting b12? I do notice that the few times i tried to skip an injection, by evening time i was again losing my balance and getting clumsy.

Maybe those are my 'markers' indicating sufficient therapy?

Eventually i hope i dont have to inject daily, but until i get to the "symptoms stop improving " phase and start injecting less frequently, i guess it's normal for even small things to cause symptoms to come back? (Should add clarity of writing to thst list LOL!).

I hope this isn't a stupid question.

Part of my concern is that if these issues (reappearance of symptoms) aren't b12 related , i shouldn't wait too long to see a neurologist (which i haven't so far)!


6 Replies

What you describe seems similar to the experiences of me and many others.

I have used 1.5 mg in 1 ml hydroxocobalamin every day for over a year with great success but can't envisage a time with less jabs.

Please make sure you are getting enough of the supporting supplements needed to make the B12 work - a broad spectrum multivitamin and mineral supplement, plus extra folate, potassium and magnesium, maybe iron.

I have had to have constantly very high amounts of these to prevent all my symptoms returning but in the last couple of months I have become slightly less dependant and can sometimes go 3 or 4 hours without "top-ups" without crashing so I would think that in time (lots of it!) you may find your requirements may lessen.

In the meantime remember your body is needing extra to repair damage sustained while you were deficient so keep up good levels of B12 and supplements.

Well done and keep going!


Hi jade_s are you supplementing Folate as this gets used up processing the B12?


I certainly find that stress affects my B12 symptoms and they get worse if I am stressed but don't up my supplementation


Definitely not a stupid question!

I found the same thing. I'd got to weekly injections then felt awful again. I had a cold and also had some stress over a property problem so I reckoned those combined were enough to use up not just the B12 but probably other vitamins too. I slotted in an extra injection and picked up again pretty quickly.


Another one here who finds B12 lasts shorter time if ill with flu or under a lot of stress


Thanks for the responses deniseinmilden Gambit62 06hollyberry Secondchance ! Things seem to have gotten back to normal i.e. how I was before the cold / work stress. The nerve issues have gone back to 'socks and gloves' so that's good news!

clivealive Yes I'm taking 400 to 800mcg folate so should be fine there. :) I'm also covered on other vitamins and minerals including potassium.

I guess I was just a bit worried since I'm injecting daily yet was still got issues with just a little bit of stress. I did debate doing 2 x 1mg ampoules in one day, but didn't, since things seemed to stabilize.

@deniseinmilden I would try 1.5mg but I now have a whole cabinet of 1mg in 1mL ampoules LOL! Although Maybe I'll try one and a half ampoules once "just for fun." ;)


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