For life?: Hi guys, Just wanted an... - Pernicious Anaemi...

Pernicious Anaemia Society
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For life?


Hi guys,

Just wanted an opinion please. So my b12 reading was 121 and my follate levels are 9.3 ug/L. I have just finished all my injections and introduced more meat into my diet. My symptoms have improved, i have fatigue and anxiety but other than that seem to be fine.

My next blood test is in May and i have no more scheduled injectikns and will not be taking any supplements. If my levels show to be much improved would you suggest maybe that this low was a one off? What would you say is a good healthy level?

Any help will be appreciated thanks 😊

5 Replies

BCSH guidelines say to continue treatment if there is a symptomatic improvement and not to retest after starting treatment. Treatment should only be stopped if a reversible cause has been identified and corrected.

But if my symptoms go and levels go up then surely theres no problem?

If both these things happen, I suppose so but if there is an absorption problem then symptoms will eventually come back and levels go down. Personally, I would not risk that after my experience if no reversible cause was found. It is up to every individual though. Fatigue and anxiety are also possible symptoms for some people. Good luck with whatever you decide, but please do make sure you go back sooner if symptoms start to recur.


Although a B12 deficiency can be caused by lack of B12 in the diet this tends to happen if you are a vegan and eat no meat, dairy fish or egg.

Do you really have any justification for believing that your deficiency was down to diet?

The amount of B12 you need is very small so if you have B12 in your diet then it would unlikely that you have a dietary deficiency if you were eating meat ...

More normal for a B12 deficiency to be caused by an absorption problem - PA an autoimmune response that attacks the mechanisms that enable absorption of B12 in the ileum, is one possibility. Others include low stomach acidity, drug interactions, gastric surgery affecting the ileum, general absorption problems like Crohn's disease, h pylori infection.

The ileum is where 99% of your B12 is absorbed. B12 is stored in the liver in good quantities and then released in bile back into the ileum for reaborption as it is needed but if you have an absorption problem in the ileum this just becomes a leaky bucket.

Its unlikely that adding more meat to your diet is going to do any good because you would need to be eating 100x+ the amount of meat you were eating before.

The amount of B12 you need a day is about 2.4mcg - a 1000mcg injection is 400x that amount - and that is swimming around in your blood but it will be removed by the kidneys - generally you lose about 1/2 in the first 48 hours but the rate gets lower as you the level in your blood gets lower.

Right now your blood levels are going to be sky high. People vary in the rates at which they excrete B12 but by next May the chances are you will be back to being very deficient and very unwell, but ...

A good healthy level is the level that makes you feel better! Take the injections and as you feel better ease off them.. as far as I know you can't overdose on them and everyone feels better at different levels..

Peace ✌️:)

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