Pernicious Anaemia Society
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Vit B12 level of 135. Is this low and should I be concerned?

hello, I'm new here and looking for a little advice, I have recently had a blood test for Vit B12, my GP has just called with the result, He said it should be 197 and mine is just below at 135, He has suggested I have an injection for it.

he said I am only just below the required level. Seems quite a lot to me (- but what do I know).

what symptoms should I expect at this level? I have noticed thinning hair but this seems to be it, I am a female, age 43.

Thanks for any advice offered :-)

3 Replies


Your Vitamin B12 is very low and needs to be treated as ASAP. As far as the desired level is concerned 197 is still very deficient and should be around 1000 for optimal levels. Do you know your Folate iron/ iron ferritin and vitamin D levels. If you have had a full blood count taken you need to ask for a copy as you are entitled. Symptoms can be varied including fatigue,nerve pain,numbness and tinnitus to name a few but you need to know if you have a b12 deficiency or Pernicious Anemia. Your GP should commence b12 injections and monitor. There are a lot of people on the site who know lots about b12 but if you want info take a look at the pernicious anemia society website. Don't be fobbed off by your gp keep at it until you get a resolution



For people here to assess what needs doing to help you they need your test results posted here. As holehead said you are entitled to have a print out of them.

Post them with the ranges eg. vit B12 103 < (180 - 1000) also folate and ferritin and any other bloods you had done all with their ranges.


Hi kateredpants Welcome!

Yes your B12 is very low and you will need injections to raise your levels as your GP has mentioned.

Now for the info avalanche - sorry! :-)

Symptoms: Can be many and very varied - some you may have and not realise they were anything to do with low B12 - I did! See here for some lists... pernicious-anaemia-society.... and

Causes: Most common is pernicious anaemia (an autoimmune condition where the body can't absorb B12 properly) but there are various others reasons too: h pylori, eating a diet with not enough B12 (B12 is found in animal products so vegans and others who eat low meat/fish/dairy/eggs/fortified foods can become deficient), some kinds of parasites, malabsorbtion (can be caused by crohns, coeliacs, stomach or intestinal surgery, low stomach acid and others), medication (metformin, PPIs and others) and others too. See here for more: pernicious-anaemia-society.... and pernicious-anaemia-society....

Treatment: Unless it is due to something reversible like not eating enough B12, h pylori or medications that can be altered, injections will be necessary - for life. Are you in the UK? If so the treatment plan is injections every 2nd day for 2 weeks (6 "loading doses" - this is to raise your levels quickly) then an injection every 3 months. If you have neurological symptoms then this should be even more frequent - injections every 2nd day until no further improvement (with a review at 3 weeks) then injections every 2 months.

These are the UK treatment guidelines (BSH guidelines for treating B12 and folate deficiency): pernicious-anaemia-society....

Have you been tested for anti-intrinsic factor antibodies? This is the test for pernicious anaemia. Its is not a great test as it gives 40-60% false negatives (so you can still have PA even if you test negative) but if you test positive you almost certainly have PA.

Have a look at the pinned posts on the right or at the bottom on a phone, (not sure where they are on the app - shout if you can't find them!) for some more info and links.

Other things: You may have had other things tested to - particularly folate. Is is important this is within range as it is needed along with B12 for some reactions in the body. Absorption problems may also lead to low iron (GPs usually check ferritin, an iron binding protein) and low Vit D which can also cause some similar symptoms to low B12 so may be worth checking too, if they've not been done already.

Ask away if you've got more questions. :-)

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