Anyone else have low B12 in pregnancy?

[Cynicalunicorn]

I'm in the last few weeks of pregnancy and i have just had my second b12 loading injection after blood tests revealed both low b12 and folate levels.

My levels are really low (60) and I've had various symptoms like fatigue, dizziness, sparkles in vision, sores in mouth and tingling hands (Blood tests were only ordered because my symptoms didn't respond to iron and my blood pressure is excellent).

I'm just wondering if anyone else discovered their deficiency during pregnancy and whether your levels righted themselves afterwards or if you were left with permanent deficiency and damage. So far the doctors are quite vague and I think they are inclined to believe the pregnancy is to blame and I won't need any injections after birth but I'm not so sure because: 1. I was taking prenatal vitamins including folic acid and b12 and 2. My levels seem very low indeed.

Any input is very welcome.

Thank you

(I'm in the uk if it helps at all).

[clivealive Forum Support]

Hi Cynicalunicorn I can't help you much about pregnancy and B12 Deficiency being a 75 year old male but please do "bump up" your Folate level as this is essential to process the B12 you are having injected.

I am not a medically qualified person but there are others on here who will be able to give you good advice.

Take care now and I wish you a "nappy" new year.

[Cynicalunicorn in reply to clivealive]

Thank you Clivealive, I have also been prescribed high dose Folic Acid but I forgot to mention it.

[Penni]

My b12 levels crashed after I had my daughter 7 years ago. It was only picked up after I became very ill and went green! My hb count was less than 4 (it should be between 12-13). I was admitted to hospital twice and had 3 units of blood transfused.

[Cynicalunicorn in reply to Penni]

That sounds very scary Penni.

I have never felt right since having my eldest daughter three years ago, so I am wondering if this is when things started going wrong for my blood.

[Allyson1]

Sally Pacholok is probably a good source on this- she says pregnancy and breastfeeding will require b12, and if you are already low, that's not good! She says low b12 is a risk factor for postpartum depression, and having experienced the psych symptoms of low b12, I believe it!

Your baby is getting b12 from you, so they are at risk too. Low folate during pregnancy is also not good, because it's a risk for neural tube defects.

Do whatever you can to take care of nutrient deficiencies during this time.

You should also watch your child for b12 deficiency after birth. We're all born with a store of b12 in the liver, but if mom is deficient, then baby may not have enough store.

Did the doctors determine the cause of the deficiencies, since you were supplementing?

I don't mean to scare you. The tingling and all should pretty well right itself with enough b12, although it may take some time.

[Cynicalunicorn in reply to Allyson1]

Thank you for replying Allyson, I am actually being induced early due to baby being smaller than expected (SGA) so I am somewhat worried that my low levels have damaged her. But doctors are keen to state that she will have taken what she needed from me. I'm not sure I 100% trust this attitude so will be vigilant to any symptoms.

They don't seem too keen to determine the cause of the deficiency at all, it's just attributed to the pregnancy, but would that alone cause such love levels? In addition to a b12 level of 60 I believe my folate level is 2.

I can't believe this isn't tested for more regularly. I'm not sure if it's partly placebo but I genuinely seem to feel better after my second loading injection.

[Allyson1 in reply to Cynicalunicorn]

With a level of 60, I'm not surprised you feel better after an injection.

I'm not a doctor, but it just seems logical that while the baby gets b12 from the mother, if the mother is very low in b12 to the point of serious deficiency, then the baby risks not getting enough either.

It just makes sense to me to be vigilant for that, particularly since b12 deficiency can interfere with development, and it's treatable.

As for the causes of low b12, sometimes it's not entirely clear. There is a blood test for pernicious anemia. If your diet is rich in b12, then a malabsorption syndrome might be a culprit. Conditions that affect digestion, like hypothyroidism, can inhibit b12 absorption. I think it's good to try and find the cause, but at the very least the deficiency can be treated.

[Cynicalunicorn in reply to Allyson1]

I don't believe my diet is restrictive in anyway and I have taken Pregnacare prenatal vitamins (containing b12, folic acid and iron) throughout pregnancy. I think this is the main reason I'm finding it hard to believe that the pregnancy has so majorly depleted my b12.

That and the fact the baby is small for gestational age.

[Allyson1 in reply to Cynicalunicorn]

I see what you mean. Ideally an attentive doctor would be able to screen you for absorption problems.

[Cynicalunicorn]

Meant to say i'd also be interested to know more about the negative relationship between low b12 and gas & air / entenox / nitrous oxide. No healthcare professional I've mentioned it to has heard of a link whatsoever. But it's even mentioned on the trade sites of Entenox suppliers so I'm guessing it is an established contraindication.

[fbirder in reply to Cynicalunicorn]

Here's an abstract that doesn't sugarcoat the potential nastiness - ncbi.nlm.nih.gov/pubmed/825...

Patients with vitamin B12 deficiency are exceedingly sensitive to neurologic deterioration following nitrous oxide anesthesia. If unrecognized, the neurologic deterioration becomes irreversible and may result in death.

[Cynicalunicorn in reply to fbirder]

Thank you! That is exactly what I wanted.

[Allyson1 in reply to Cynicalunicorn]

Speaking of not sugarcoating potential nastiness, there is a video by Sally Pacholok and others about the effects of untreated b12 deficiency. It's on YouTube.

They interview several patients, including a mother who was low in b12 during pregnancy, and her little boy was deficient, too. She talks about the signs of his b12 deficiency and the impacts on his development.

Now I will say that I don't think this video is fearmongering, but it is scary, so whether or not it is helpful is up to you. It's scary because it shows *untreated* serious b12 deficiency. These things can be pretty well avoided with awareness and treatment.

[Gambit62 Administrator]

Sorry that the medics who are treating you seem to be so unaware of B12 deficiency.

Unfortunately the NICE guidelines do make mention of the fact that B12 levels during pregnancy can be lowered during pregnancy without providing any further guidance or clarification. So if your GP is one of those that thinks that you can do everything through test results there is a tendency to leap to assuming that low B12 is due to pregnancy rather than actually carrying out a full clinical evaluation (looking at symptoms). Your levels do seem a little on the low side and your symptoms a bit too prevalent for pregnancy to be all that is going on.

It is good that you are receiving some loading shots.

You may want to consider using a formula to supplement breast feeding after the baby is born to ensure that the baby does actually get enough B12, folate and other nutrients. I would also strongly recommend joining the PAS itself

pernicious-anaemia-society....

as, depending on what level of membership you select, this could give you access to a specialist nurse that you could talk through any potential issues with - someone who is aware of B12 - and someone who can advise and support you in a way that members of this forum can't.

[Cynicalunicorn in reply to Gambit62]

Thank you, I will definitely consider joining.

I am definitely going to be supplementing with formula.

One thing I am concerned with is that my GP made no mention of any further doses after the two weeks of loading, only that they will retest my levels when my baby is about 5 months old. But having looked through lots of guidelines in the past few days it seems to suggest that I should expect further injections every third month.

Have I massively misunderstood?

Also a lot of guidelines state that if b12 deficiency is found during pregnancy then the patient should be referred to a haematologist, again this has not happened.

[Gambit62 Administrator in reply to Cynicalunicorn]

try drawing your GPs attention to what you have found in the guidelines to try and think realistically about the possibility that your deficiency isn't just gestational (to do with the higher demands in pregnancy) and therefore only temporary (so wouldn't need on-going maintenance shots) but that you may well have an underlying absorption problem (not temporary so would require regular maintenance shots) which has become critical due to the extra demands of your pregnancy.

Often GPs aren't aware of guidelines and sometimes local guidelines are out of date with national guidelines. Whilst guidelines may be looked at in relation to establishing your GPs duty of care they are also just guidelines and they are supposed to use their professional judgement - part of that shoul involve making sure they have critically evaluated all of the evidence and not just made broad assumptions.

Really hope that you can work with your GP but if it is an uphill struggle, more weighty support available from the PAS to a member may be what you need to tip the balance.

[Cynicalunicorn in reply to Gambit62]

Thank you so much for your input. I'm speaking to my doctor tomorrow to try to clarify the points I'm concerned about.

I've felt so much better since the loading injections started (my complexion has even become 'pinker'), and I keep discovering things that I believe could be related, I had recently started forgetting net passwords etc and bowel problems that I have supposedly had for years (accredited to mild IBS) have magically cleared up and I'm starting to believe I was in denial about how bad I felt before. But I'm rather terrified of finding myself with my previous symptoms whilst looking after a newborn.

[Allyson1 in reply to Cynicalunicorn]

You mentioned above that haven't felt well since having your daughter. Please do mention this part to your doctors.

[Cynicalunicorn in reply to Allyson1]

Yes, I'm definitely going to . I've certainly deteriorated in many ways in the past few years.

[Allyson1 in reply to Cynicalunicorn]

It's true that b12 deficiency can take years to develop a the liver store is depleted. I know I got a little worse each year until I was really in trouble.

[Cynicalunicorn]

Thank you that is useful to know.

[Cynicalunicorn]

One of the most frustrating things I am hearing from my health care providers is that there is no way my deficiencies (which seems very low to me!) could effect my baby, because she will have taken it all away from me.

However almost every article about b12 and folate mention neural tube defects and low birthweight/small for gestational age which is why I am being induced in two weeks!

[Cynicalunicorn in reply to Cynicalunicorn]

My baby has also been much more active since I started loading injections whereas before I was having regular checks for reduced/low movement .

[Cynicalunicorn]

Just thought I'd say baby is a month old now and we're both doing well. However the last couple of weeks I've started getting b12 symptoms back - eye problems and mouth sores - so I await next month's tests with anticipation!

[SarahBear224 in reply to Cynicalunicorn]

I was wondering on how baby is doing. I was just diagnosed with b12 deficiency at 35 weeks. Baby is measuring small and I scared myself with everything I was reading on the internet. You’re story is the only first hand account that resembles mine.

[Cynicalunicorn in reply to SarahBear224]

Hi, im happy to help with an update.

I completely my course of loading shots and Baby was induced soon after at 38 weeks because of small size. Baby is now 15 months old and perfectly healthy although still very small (bottom centile). She did have several bouts of tachycardia before and during labour which I believe can be B12 symptoms but has been fine since birth.

You may want to research the relationship between gas and air and b12 before labour because I was repeatedly offered it and when I said about B12 etc (it was on birth plan) absolutely everyone including the assistant anaesthetist was clueless. The other members of this board are far more knowledgeable about this correlation than I.

My blood has been checked a couple of times since giving birth and my B12 level has been just above the level that the GP treats.

best wishes to you and the little person.

[Domimira]

My hematacrit levels immediately began to drop each time i became pregnant. I gave up the first baby at 5 months because my red blood cell count was down to 17. The doctors did not know about B12. They drilled into my hip and also took some bone marrow thinking it was due to iron deficiency. During my 2nd pregnancy i glanced over all of my previous blood tests and saw a small note on one of 5he test results that suggested B12 injections. The doctors had missed this result and when i mentioned it they gave me an injection and my hematacrit began to rise.

I was given B12 injections weekly. I would not have survived 9 months without them.