Hi. I'm 34 year old female. Was told yesterday my B-12 in extremely low. Dr wanted to start shots right then I said no out of fear. I also have low vitamin D and low iron. I'm so afraid to take B-12. Will I shake or feel like I'm out of control. I have suffered with anxiety panic attacks and depression for years. I had my last 6th child a year ago. I can't be unable to help them. Any advice?

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  • Many people find that low B12 can affect them to make them more anxious and depressed, so it's quite possible that treating your low B12 may improve your state of mind.

    If you really can't bear the thought of injections then discuss it with your doctor. It may be that you can absorb enough from high-dose (1000 to 5000 ug) tablets to get your levels up where they need to be. You probably won't be able to get them from the doctor on prescription, but you can buy them yourself from Amazon and other suppliers. But, if you can force yourself, then injections really are the best bet in most cases.

    The important thing is to get your levels of B12, Vit D and iron up where they should be. Those who suffer from such deficiencies know that ordinary life can be difficult. I hate to think how I'd be able to look after kids as well.

  • I bought sublingual tablets 10,000 mcg and liquid vitamin D. My dr called in a prescription for iron. I'm just afraid of having a reaction. I'm so sensitive

  • Hi Dredre112. I'm so sorry that you're having a bit of a rough time - I expect with the B12 and other deficiencies your probably feeling quite ill. And, as Fbirder says, the symptoms of B12 deficiency can cause anxiety and depression...and lots of other symptoms too.

    It sounds like you have absorption problems (all those deficiencies) so injections would be the best way to raise your B12 levels quickly - though I can understand how worried you must feel about this.

    When you say you're sensitive - do you mean you have other proven allergies - or that you're sensitive as in concerned about having an injection?

    About the possibility of allergic reaction - there are rare occasions when this happens (very rare - anaphylactic shock) - if this did happen, it would happen very quickly after the injection, while you are still in the surgery, and the reaction could be reversed very quickly by the medical staff present.

    Vitamin B12 can cause side effects (i.e. Facial flushing, headache etc.)... but these usually wear off quite quickly - and many people don't have any side effects at all (I don't).

    Once treatment has commenced, some symptoms can feel as if they're getting worse - this is just the body repairing itself and it settles down once the body becomes accustomed to having the amount of B12 it needs to get and stay healthy.

    There are some PAS pinned posts to the right of this page (or at the bottom of using a phone) which will give you lots of information about B12 deficiency and it's treatment. Look, in particular, at the B12 deficiency symptom list (in the second pinned post, I think) - you might find that you have symptoms that you didn't even know were symptoms (many do) πŸ˜–. And if you do discover that you have lots of symptoms, it might make it easier to deal with the idea of having injections. I know it did for me - the prospect of feeling better had me rolling up my sleeve half way up the road to the surgery πŸ˜„).

    Some people do manage with sublingual B12, nose drops, or spray, patches etc. but they don't work for everyone...but worth trying if you really can't tolerate injections.

    Another way would be to have the first six injections (called loading doses) to get your B12 levels up - then go on to the lozenges to see if these keep,you symptom free (you know if you have enough B12 because the symptoms go away - if they return, it's usually because more B12 is needed).

    Please don't be afraid of having the B12 injections - B12 is perfectly safe and it will make such a difference to how you're may find that your anxiety and depression subside as your treatment commences (many here have noticed this).

    And if you're energy levels are low (or non-existent - another symptom), then the B12 will help with that too. And my goodness, with six children I expect you need every ounce of energy you can muster πŸ˜„πŸ˜„.

    B12 deficency is really quite complex so post again if you have more questions - as often as you like, because you'll probably have lots of questions. Lots of lovely people here who will pop along to support and help you.

    Good luck with whatever you decide to do...let us know how you get on πŸ‘.

    Take care x

  • Thank you. I took 1/4 of the 10,000 mcg so far so good. 1/2 tomorrow.

  • Excellent...but please do consider having the injections - much quicker recovery. And firgot to say above...if you have neurological symptoms, injections are the recommended treatment (since delay in getting enough B12 into your system can potentially cause long-term neurological problems).

    The key here is symptom relief. Check your symptoms against the checklist and monitor which ones - if any - are going away. If symptoms remain, it's likely that you are not absorbing enough B12 and will need injections (absorption rate from tablets or lozenges 1-2% at best. Absorption rate from injections 100%) πŸ˜„.

    Very best of luck - hope you feel better soon πŸ‘X

  • If you have simple B12 deficiency, the sublinguals will work for you, but 10,000 mcg will probably make you feel jittery like you just drank a whole 10 cup pot of coffee..! You should experiment with something lower first; I tried 1,000mcg sublinguals with little benefit then my doctor told me that with pernicious anemia, no amount of ingested B12 will work; so, if you have pernicious anemia, you have to bypass the digestive system, which means you have to inject IM or SQ.

    By the way, I also discovered that the Nexium I have been taking for many years for my GERD is what caused me to develop B12 deficiency and eventually pernicious anaemia. If you are on any kind of PIP for gastro problems; I would suggest you talk to your doctor about getting off that !

  • Hi UDEE. Just a quick comment...PPI's do impede the absorption of B12 but if having injections then this is not a problem (since the B12 is being delivered via a different route than the usual absorption mechanism). added problem...people with PA have low stomach acid, and PPI's reduce this further...this compounds the problem and perhaps increases absorption problems for other vitamins (some vitamins required stomach acid for proper absorption so as a consequence, other deficiencies can occur (iron absorption will also be affected).

    And too little stomach acid has the same symptoms as too much stomach PPI's might actually cause the symptoms, rather than 'cure' what can appear (but not actually be) high stomach acid.

    I stopped PPI's (following discussion with GP) with no discernible effect, either way.

    PPI's are only recommended for short term use (though many GP's leave patients on them for years - I was one of them).

    And some do find that they have to take them long-term, regardless (think clivealive may...but might be mis-remembering - apologies clivealive if wrong. πŸ˜–πŸ™ƒ. Pretty sure you do take folate though πŸ˜„πŸ˜„πŸ˜„πŸ˜„).

    Hmm...a tricky one...


  • Foggyme,

    I concur with your comments.

    I took PPIs for GERD, mostly Nexium (esomeprazole), for 14 years before discovering it was most likely the original cause of my pernicious anemia. At which point I stopped Nexium abruptly. Unfortunately, that "cold turkey" approach caused severe "rebound" of GERD and other horrible side effects. So, I went back on Nexium. Now, recently, I started weening myself off Nexium very, very slowly, and I am not experiencing any repercussions.

    I believe that pernicious anemia may be reversible because "intrinsic factor", destroyed by long-term PPIs will return in the gastro system to extract B12 from food in normal fashion. But only after I eliminate PPIs from my medication regimen.

    My ultimate goal is therefore to return gastro & immune systems back to normal before I got hooked on Nexium prior to the FDA obliging manufacturers to start warning people NOT to take their product more than a few months..!

  • UDEE. Pernicious anaemia (and the B12 deficency it causes) is not reversible.

    In PA, two mechanisms are potentially involved: an autoimmune response - the presence of IgG antibodies prevent the bonding of intrinsic factor to vitamin B12 and/or the progressive destruction and eventual loss of pariatel cells leading to diminished production of IF. Here's more information on that: (B12 and Intrinsic Factor)

    If your B12 deficency is caused by PA, then stopping PPI's will not act as a 'cure' - unfortunately πŸ˜–. PA is for life.

    B12 deficency can have causes other than PA (i.e. long-term use of PPI's): if this is the cause of your B12 deficency and that cause is removed, then the B12 deficency will 'right' itself as the mechanisms at play which impede the absorption of B12 are removed, and B12 absorption returns to 'normal'.


  • Wouldn't have thought it could be described as 'a simple B12 deficiency' Surely not knowing the cause of B12 deficiency can become quite a complicated issue if not PA?

  • My intention in describing possible "simple deficiency" was to separate B12 deficiency that can be repaired by dietary changes and vitamin supplements from "pernicious anemia".

    PA means deadly! and involves a suppression of "intrinsic factor" that extracts B12 from food (and pills) in the digestive system.

    PA requires injections of B12 to by-pass the digestive system, whereas what I called "simple deficiency" does not.

    The only way to know for sure which one you've got is via a specific B12 serum blood lab test as well as the standard multiple test.

  • Well mine is a 'simple deficiency' and I also need injections of B12! Treatment of PA and B12 deficiency is the same. As the intrinsic factor test is only 50% accurate, most of us on here struggle to get a diagnosis! So not really simple.....

  • Please be assured Dredre112 that the B12 injections are not very painful. I've had more than 600 over a period of 45 years and I can count on the fingers of one hand how many have "stung" a little and as Foggyme says it's best to get your levels up quickly.

    You might also ask your doctor whether your "Folate" was checked as this works together with Iron and B12 to make healthy red blood cells.

  • Derdre112, No worries! I was diagnosed with pernicious anemia 17 years ago and have been injecting myself subcutaneously with cyanocobolamin (b12) 1,000 mcg/ml ever since. What seems to work for me best is a shot every 3 weeks and I do it by pinching the skin in the fattest part of my abdomen & injecting with a thin needle, i.e. the kind diabetics use, at a 45 degree angle. I have never felt any scary after effects; sometimes I start feeling more energetic almost immediately, sometimes it takes a few days; after 3 weeks I can feel the low-energy anaemic condition of my body so I switched from monthly prescription to 3 weeks & my doctor approved.

    Good luck and dont worry about it; it will become a simple part of your life.

  • Thinking positive will help, if you have a phobia about the injections themselves or the effects, your practice nurse should put you at ease. You wouldn't be the first to feel anxious, so relax and try not to worry. (Easier said than done!) As stated earlier your anxiety could possibly ease with the injections. Looking after six children can't be easy with vitamin deficiency, the tiredness in its self is enough without not being able to think straight too! Bite the bullet, so to speak, think of them as something that will help you, like having an inoculation.

  • Thank you everyone. I don't know why but I am still awake and keep having anxiety attacks. I'm telling myself it's not from the B12. But my mind is racing. I don't know how long I have felt like this. It should be ok to take the SL tablets everyday right?

  • What form of B12 are you taking? I do get very anxious and uncomfortable with methylcobalamin. It will not last forever, it does get better. Try to remember that. I had a rough time getting my levels up. I was on oral only and would skip days when I could not bear the symptoms of the healing. After several weeks I was feeling wonderful. The only issue I have now is if I take very much methyl I get palpitations, anxiety, etc. There is a small amount of methyl in my B complex but most of my B12 is adenosyl/hydroxy and it works very well for me. I also get some cyanocobalamin in multivitamins occasionally.

  • Oops, methyl isn't the *only* issue! I do get low level symptoms if I am sick or stressed or very active physically. I've learned to catch on quickly and increase the dosage. And when symptoms poke through, its always something different. Maybe numbness in my arm or brain lapses one time and another time my leg will get pins and needles and my face will start getting pigment spots. It eases quickly once I get some B12 in me.

  • I have injected cyano for 17 years with good results. Never tried the methyl but I did read in the manufacturer's declaration pamphlet that although it performs better it is not recommended for anyone with cardiovascular conditions, which happens to be another "problem" of mine...

  • link to a post that might help you understand the anxiety and find a way of coping with it.

    suspect that anxiety probably is down to the B12 deficiency ... and methyl B12 may not be the best form for you if that is in the tablets you have been given.

  • I was worried about my first injection too as I tend to be very reactive to lots of things, but I was fine. I felt unusually calm after it and much less anxious than usual.

    For your first one, as the others have said, you will be monitored for a little while afterwards to make sure you don't have a reaction at the surgery.

    Instead of every other day, you could have the injections once weekly to see how you get on.

    I didn't find it particularly painful. If you tense up it will sting a little, but if you breathe slowly for a minute or so and relax your arm, it's only a momentary slight discomfort.

    I think I read somewhere that it's possible to have the injections at half the usual adult dose, but you'd have to ask at your surgery about that.

    Can you arrange for someone to help with your children on the day of the injection and maybe a couple of days afterwards? That might help to stop you worrying that you won't be able to cope if you do feel a bit off after the injection.

  • Everyone talks about getting B12 injections into the muscles, which can be painful. Yet the manufacturer's declaration pamphlet, which is allegedly monitored by the U.S. FDA for my cyanocobolamin states unequivocally that it can alternately be injected subcutaneously. I have been shooting 1,000mcg/ml into my fatty layer (just under skin) for 17 years with good results and zero injection pain.

  • In UK at a medical practice it will usually be hydroxocobalamin, although I think cyano is available, and will usually be injected into a muscle in the upper arm as far as I'm aware.

  • Dredre112 , can totally understand how anxious you feel.

    I could not understand why I was feeling so anxious and nervous about everything. I didn't realise B12 deficiency did that much harm.

    I am sensitive / allergic to dozens of things --- as diverse as chocolate, pineapple, ginger, coffee, alcohol and bizarrely wallpaper paste! The tiniest amount on my skin will irritate for hours. 2 years ago decided to strip old wallpaper in my house, red wheals appeared in minutes--- from dry paste that was years old.

    First, print a list of B12 def symptoms, mark the ones you have. B12 cannot harm you, any excess is just excreted. Your dr is willing to help so go with that. Having your injections there will ensure you have medical help and supervision on hand.

    It might help to write the steps down and go over them. You have a lot of emotional weight on your shoulders, 6 children must bring a lot of joy but need a lot of energy.

    I've found sublinguals and patches helped just a tiny amount-----but the B12 injections got me back on my feet, restored my balance and took away the brain fog, hand tremors and anxiety.

    You will feel better, trust your doctor to help you and you and your children will benefit.

  • Go back to your GP you can die from low b12. My father did.

    I'm sure your children need you so please swallow your fear and have the injections for there sake.

    I'm b12 deficient low iron and bit D. Never felt so good till I had jabs.

  • Catherine,

    Hear! Hear!

    That's why extreme B12 deficiency is called "pernicious anemia." The word pernicious means "deadly." If untreated, PA leads to total mal-absorption of vitamins that the human body needs to keep functioning. In due course, the lack of these essential vitamins causes all systems to close down with deadly results...get those shots!

    Ironically, U.S. Medicare does not recognize the deadly aspects of PA and Part D (medications) Insurers will not cover the serum, although I believe part B will cover the clinic office injection procedure itself with a small co-payment.

    As a self-injector, I have to pay full retail for my cyano serum and its price is going up there an epidemic of PA going on out there?

    My condolences on your father's demise...

  • Yesterday I took 1/4 and then a few hours later another 1/4 so a total of 5,000mcg for the day and up to 3,000IU of vitamin D. When I get nervous or stressed I get blisters in my mouth. So I'm dealing with that right now too. I feel like I am feeling my body again. Like I can feel my skin is not numb. I feel less zombie like. I've spent the last year in therapy and trying to treat my anxiety and depression and postpartum depression. I had even thought of killing myself. Yesterday was one of the best days I've had in a long long time. Thank you everyone for listening and talking to me and sharing your journey.

  • Dredre112 , reading your latest post, I'd say you definitely need the B12 injections. I felt very much like you describe after my children were born ( a long time ago) I think you've depleted your B12 reserves and although sublinguals and Vitamin D will help, I really think you need the injections.

    I now realise I had signs of B12 deficiency for a long time before it came to a crisis where I literally couldn't get out of bed, felt constantly dizzy, spaced out, anxious and shaky and so, so tired.

    The injections don't hurt. I do my own and I'd never injected anything in my life. I've now been self injecting since last August. Had no side effects whatsoever and have got my life back. Last August I was spending just a few hours out of bed each day, had to hold the walls to get around my house. It was the most horrible feeling. Not 100% right yet ( but I'm a lot older than you)

    Do give it a try as any extra stress or energy expenditure seems to use up B12.

  • Dr said taking the 5,000mcg SL for 6 months along with the D would be ok. Now I felt more like myself I was even able to take my kids to the park yesterday however last night I had horrible shaking and sweating. Did I over do it? Do I still need to "rest"? Maybe menopause? I feel so disappointed I thought I was getting better. πŸ˜”

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