My first post

[HonorElizabeth]

Hi, I had my last of 6 initial B12 injections last Saturday & although I feel much better I'm still getting tired easily and my concentration seems variable. Am I being unrealistic to expect to be symptom free? Six months ago I was energetic, fit and healthy, albeit middle aged.

[clivealive Forum Support]

Hi HonorElizabeth it is still very early days yet and it is not uncommon for some symptoms to vary in intensity as the B12 starts to get to work repairing the damage done to your nervous system. In fact some may even appear to get worse but hopefully not in your case.

A good idea is to list all your symptoms and grade them from 1 to 10 on a daily basis crossing out those that do disappear and adding any new ones.

Do you know what your Folate level is? It is essential to keep this at a healthy level as it gets "used up" by the B12.

I wish you well for the future

[HonorElizabeth in reply to clivealive]

Many Thanks for your prompt reply clivealive. I don't know what my folate levels are, but I will ask my GP. My B12 was 138 & Vit D was 46. I'm waiting on the intrinsic factor result. Due to dizziness I slumped down onto a glass vase and lost 1.5 litres of blood. (2 months ago) I was given a couple of units of blood and was started on ferrous fumarate. Although my wound healed nicely I was not getting better and returned to the doctor requesting to be tested for PA (both my grandmothers suffered from it) I realise that I am fortunate to have been diagnosed & started on treatment early but was naive in thinking I'd be 'back to normal' with the injections. I'm returning to work at the weekend, fortunately part time, but I'm concerned as to how I'll cope.

[clivealive Forum Support in reply to HonorElizabeth]

Well your low Vitamin D will drag you down - I trust you are being given treatment for that too.

So sorry to read about your accident - that can't have helped but it was good that you knew about your grandmothers having it as P.A. can be inherited.

If you are still having neurological symptoms your B12 injections should really be continued in accordance with the below - especially the highlighted paragraph:

Treatment of cobalamin deficiency

"Current clinical practice within the U.K is to treat cobalamin deficiency with hydroxocobalamin in the intramuscular form outlined in the British National Formulary, BNF,

Standard initial therapy for patients without neurological involvement is 1000 μg intramuscularly (i.m.) three times a week for two weeks, then every three months.

The BNF advises that for Pernicious anaemia and other macrocytic anaemias patients presenting with neurological symptoms should receive 1000 μg i.m. on alternative days until there is no further improvement, then 1 mg every 2 months.

However, the GWG recommends a pragmatic approach in patients with neurological symptoms by reviewing the need for continuation of alternative day therapy after three weeks of treatment ".

Your doctor should be aware of this but then again he may not so it's as well to be prepared.

I hope all goes well at work and that you feel better each day.

Take care now.