Returning symptoms

[Tehmeena]

I've been having b12 injections every 6 weeks since sept last year, I also started taking vit D . It took around 4 months to feel a little better, but since yesterday I've been having pins and needles in my hands and feet again with aching muscles and fatigue. Is this normal? Thank you

[Tehmeena]

I took folic acid last year for 6 weeks only

[clivealive Forum Support]

Are you in the UK?

The guidelines here say that if you have neurological symptoms injections should be given every other day until there is no further improvement. Your interval of "every six weeks" is puzzling.

Are you having cyanocobamalin or hydroxocobamalin B12 injected?

It would be an idea to get you Folate retested as you may need to continue to supplement with folic acid which with B12 helps iron to make red blood cells.

Do you know your Vitamin D level?

[Foggyme Administrator]

Hi Tehmeena. The symptoms you describe can also be symptoms of iron deficiency anaemia.

Might be a good idea to get your ferritin levels checked (one of the markers for iron deficency anaemia. GP's often say these are okay when they're near the bottom of the reference range. I find that if mine are below 80 I start to feel very unwell - my GP is happier if my ferritin levels are around 100ug/L.

Also a good idea to ask for a FBC (in addition to folate and ferritin levels) - may help clarify the position.

Good luck 👍

[Tehmeena in reply to Foggyme]

I just called my GP and asked for ferritin levels from my last blood test which was 2 months ago. The level was 42....is this low? I remember at the time my GP said they were normal

[Foggyme Administrator in reply to Tehmeena]

Hi Tehmeena. Do dear, that's not an easy question to answer - because we're all different and what's okay for one person might not be for another 😖.

GP's often assume that when a result is within the reference range then it must be okay. But that's not always the case - sometimes it's where the result is in the reference range that counts. Personally, I always feel better when my ferritin levels are higher than that.

With ferritin, the lower the level goes, the more likelihood of suffering the symptoms of iron deficency anaemia. So, the real question is...are you suffering the symptoms of iron deficency anaemia (lots of information on the internet if you want to check).

If your B12 deficency was previously well controlled but you are now suddenly getting new symptoms (which you appear to be), then it's likely that you may have another deficiency emerging (the common ones are iron, vitamin D and folate).

Has your GP checked folate and vitamin D too - if not, good idea to ask for them to be done (as others have suggested).

About the ferritin levels - if you suspect that you do have the symptoms of iron deficency anaemia, it would be best to discuss this with your GP and ask her/him to help,you get your levels up.

I'm always reluctant to suggest that people self-supplement with iron on a 'just-in-case' basis because too much iron can be as dangerous as too little iron. So I would always advise a symptom based approach - and discussion with a GP so that appropriate levels of iron supplements can be prescribed (if necessary).

GP should also want to repeat blood tests (ferritin and perhaps a fir on panel) at three months and six months to assess the efficacy of treatment and prevent potential over supplementation with iron.

Sorry for not being able to provide an engraved in stone answer - supplementation (with anything) is sometimes quite tricky to get right on an individual basis.

Good luck.

👍