Pernicious Anaemia Society
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b12 240 after loading doses

hi everyone my b12 levels where 145 and vitamin d was 18 i was put on folic acid had 6 b12 injections over 2 weeks and put on vitamin d capsules when blood results came back my b12 was only 240 doctor has said it will be every 3 months for b12 injections but i am feeling very low my family are finding it hard to live with me,does any one know if every 3 months is enough to get those b12 levels back up thanks

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How long is a piece of string elainelxx1976xx ? That is not meant to be a flippant answer but the answer to "how long" is almost impossible to give as we are all different and a lot will depend on how long you have been deficient and how much damage has been done to your body.

Ironically it is not uncommon for some neurological symptoms to appear to get worse before they get better but this can be taken as a sign that the B12 is actually working and doing the repair work necessary.

It's an idea to make a list of your symptoms and monitor this on a daily basis noting which improve or otherwise and which disappear altogether. Then, if you have need to go back to your doctor for an increase in frequency of injections you will have written evidence.

It is good that you are also supplementing with folic acid and Vitamin d as low levels of these can produce similar symptoms and folic acid and B12 help your iron to make red blood cells.

I really do hope that you start to feel better soon but in the meanwhile try to be a "patient patient".

I am not a medically trained person but I have had P.A. for over 45 years so I do know a little of what you are going through - I'm due my next injection in an hour's time at nine o'clock.


thanks i had b12 injection last tuesday nurse has said if i still feel rotten i have to wait 10 days and have more blood work done

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when exactly, in relation to injections, was the blood test that showed 240.

Its actually quite a low result for someone on injections. If your GP is using blood tests after injections to determine treatment then they need to be aware that most people have much higher levels and need to maintain much higher levels after treatment with injections - even being off the top of the scale is no guarantee that enough B12 is actually getting through to cells where it is needed.

Follow up blood tests on B12 that can be used to see if there is enough at the cell level are homocysteine and MMA - MMA probably more likely to be available through GP.


hi the blood tests where done 3 months after the loading doses thanks for reply

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thanks for clarifying - definitely on the low side for someone on injections.

on the three months - there's no solid scientific evidence that I am aware of to support 3 months - when hydroxo was introduced originally it was monthly. It changed to 2 monthly after a study in the 60s showed that on average people retain hydroxo twice as long as cyano - but the same study also made it clear that this was far from being the case for everyone - the move to 3 months (where no neurological involvement) happened in the 1980s for reasons that were probably penny pinching rather than scientifically based.

You could try talking to your GP and request more frequently given that your levels are now quite low - ask for MMA to show that there isn't enough B12 at your cell level ... and keeping a diary of symptoms and showing when they return would be a good idea.

It can be extremely difficult getting a GP to budge but you won't know what your GP is like until you try.

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thank you very much for the great information i will ask GP if he can do the injections more frequently and have also started a diary for the past 3 days i am having pins and needles/tingling fingertips

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