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Pernicious Anaemia Society
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Do i need more frequent injections?

Hello all, i need help. I have read many posts and responses so this will be long in an effort to answer all questions i can upfront.

In Oct of 2014 i had blood work done.

Vit b12 169 pg/ml range 200- 1100

Vit d 20 ng/ml. Range 30 - 100

MCV 94.4. Range 80-100

HEMOGLOBIN 13.8. range 11.7 -15.5

Potassium 4.0 Range 3.5 to 5.3

RBC 4.42. Range 3.8-5.1

So no big deal per doctor. Recommended to take a mulitivitamin, a B 100 complex and 5000 IU of D with A and K2

I did that daily for 16 months

In Feb of 2016 i have same test done.

Vit b12 246

Vit D 39

MCV 95.1


Potassium 4.2

RBC 4.57

Ferritin was not measured.

B9/folate/folic acid was not measured

So i didnt increase my b12 or D as much as i thought i would but whatever, the numbers were now in range of not being deficient.

I was on an anti depressant from Sept of 13 until Aug of 16, so 4 years. Then i moved and had no health insurance, so since i knew i would be running out of the month after month prescription my doctor had written, i tapered off over last 3-4 months. So again, in Aug 2016 i ended anti depressant and since i wasnt taking the anti depressant i also stopped taking everything else. The stupid things we do.

In April 2017 a therapist said i needed to go to doctor for anxiety medication, which i had never had before, and possible depression.

I was sick of masking whatever my problem was with anti depressant so i went to a Hollistic doctor 5-2-17 I gave her copies of my previous blood tests. She said adrenal fatigue and b12 and D issues. She gave suppliments for cortisol reduction and massive doses of b.

B6 50mg

Folic acid 5000 mcg

B12 1000 mcg

I was to take 4 a day.

Plus multivitamin and im taking krill oil now for the Omega 3, hoping it might help with my joint pain.

My anxiety reduced quickly. Maybe 4 days

I stopped being so irritable. Im not depressed.

I was still tired though. Resting. Researching. I read that like 1% of oral b12 is absorbed through passive absorbtion. So like 10 mcg per 1000 mcg pill. And since i wanted to get into what the Japanese consider a healthy range for mental health, 550 or above, i thought this oral route is going to take too long. I researched b12 injections. My hollistic doctor does not offer injections. Weight loss clinics in my area do.

They offer 1000 mcg ONCE a week. I got first one on 5-22-17. 2nd one on 5-30-17. Im sure it is cyan kind since im in the US.

My brain fog and memory has improved but definitely not 100%. I used to feel i had lost 40 or 50 points of IQ i had such a hard time processing info.

My knees hurt...for no reason. I am not overweight and due to being tired i never do anything that would work them or any other muscle in my body. I had muscle weakness, it is better but not gone. My tongue has changed color from red to pink. I can drive without being tired/anxious. I can breath better. It is easier to take deep breaths. It is so weird. I no longer need a 3 hour nap every day even though i had 8-9 hours of sleep every night. I havent drank very much alcohol for last 4 years as it makes me so tired and so hungover/sore the next day, like i had been beaten. And i felt that way after only 3 drinks once a month or once every 2 months. So now i never drink.

I read that after an injection 50-98% of b12 is passed out of the body through urination. Of the 2-50% we do absorb, 75% is in the blood serum in an inactive form, making any b12 tests after injection unnecessary. The 25% of b12 that is absorbed and actively being used in cells is the only portion helping us to feel better.

So here is my question. Why are loading doses (injections every other day) needed?

If there is a bunch of b12 in the blood serum wont the cells reach for it/use what is in the blood serum to make new cells?

I ask because if i need to, i will go to a second weight loss center and get a 1X weekly injection from there also.

I want to feel better asap. Please remember, i have no health insurance so everything i am doing is self pay.


8 Replies

Hi KimberinUS I'm not a medically trained person but I'm wondering whether your really do need somehow to get both your serum B12 and Folate levels checked again as these help your iron to make healthy red blood cells. There is a complex interaction between folic acid, vitamin B12 and iron. A deficiency of one may be "masked" by excess of another so the three must always be in balance.

There are others on here who will be able to give you good advice and I wish you well.


first thing to bear in mind that stats you are talking about are just that - stats - they are averaged figures based on large populations and trying to apply them to any one individual is going to be a bit hit and miss, particularly if you are talking about something where there is large individual variation - which tends to be the situation with B12.

Loading doses are about getting serum B12 levels raised quickly in response to a deficiency so that healing can occur.

Serum B12 is only one part of the picture. Metabolising B12 means getting it from your food into your blood, having your blood transport it to cells and then being able to use it in cells for all the various processes involved - making healthy red blood cells is only one processes - others are maintaining the lining around red blood cells, recycling MMA and homocysteine into useful building blocks, resetting neuro-transmitters. So basically it is a lot more complicated than just getting B12 into your cells and solving a problem at one point can start or make obvious a problem at another point in the process.

How long it takes to recover depends on what processes have been damaged and how significant the damage is so again, just working on raising levels in blood isn't going to give the whole picture. B12 is also used with other vitamins and minerals so if you aren't looking at those - particularly folate - then they can become deficient and cause problems.

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Thank you so much for tthe gr reply.

I found info concerning "inactive" b12, which i thought was just, as of yet, floating around in the blood, unattached to a cell to be used. That is not the case. It is attached to haptocorrin. Therefore, only additional absorbtion, of new b12, will have a chance to attach to the "active" binder of transcobalamin. It is b12s attachment to tanscobalamin that allows us to feel better.

I have ordered sublingual hodroxocolabamin, hoping i will have better absorbtion from sublinguals over the oral suppliments i am taking. And that it will help in removing the cyanide (although everything i have read says the amount is minute) from my cyan form injections. I will get my 3rd injection tomorrow and if i dont notice any marked improvement by Friday, i will get an additional injection from a diffrrent source at that time.

This forum has been a lifesaver as there is really very little valuable information from other sources for those of us that arent willing to let the vastly uninformed medical doctors try this or that for the next 30 or 60 days.

I find it a shame that in 2017, it takes a "specialist in nutrition" to get any knowledable care from a medical professional about a vitamin.

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haptocorrin bound B12 is stored in the liver. In people without absorption problems in the ileum it will be released into the ileum in bile where it is separated from the haptocorrin and back into the blood where it can either be bound to transcobalamin or haptocorrin for storing again. If there is a problem with absorption in the ileum however, very little of the stored B12 will actually get back into the blood.

Some people find that it takes months for them to start to feel better - it really does depend on what was causing the effect in the first place. If you have anaemia - macrocytosis - that will take a couple of months to clear because red blood cells are only replaced as they come to the end of their life - which averages about 4 months.

cyanide from cyanocobalamin is really a red-herring - its only an issue in a very few people who have a rare condition that makes them particularly sensitive to the cyanide molecule. Some people do find that cyano actually works better for them than hydroxo.


did you ever come down with neuropathy? Have your thyroid checked? I copied this from another post:

With my Thyroid UK hat on - I would suggest you also have your Thyroid anti-bodies tested to rule out Hashimotos. The tests are Anti- TPO & Tg. I had all in range Thyroid Function tests back in 2005 - but the anti-bodies were high and so treatment commenced. When you have Hashimotos it trashes you B12 - Folate - Ferritin - VitD - due to absorption issues.


This post was from beginning of June 2017. I had only had 2 injections at time. I also had not had my ferritin level checked yet. I wasnt taking any suppliments except a mulitvitamin.

At this time i hurt all over, crushing fatigue, was getting 11 hours of sleep daily and was still brutally tired, memory issues, brain fog.ect. you name it, i probably had it. I commenced supplimenting magnesium, omega 3, vitamin c, ect.

Turned out i had h pylori. Found out and was treated end of August 2017.

I kept supplimenting and getting weekly injections. I still felt bad in mid October. Thats when i Started supplimenting iron and felt better. Less joint pain, less brain fog, less fatigue, less irritability, less racing heart, less cold hands and feet.


oh wow! you and I have some things in common! I never was tested for H pylori but suspected it and did a natural at home cure for it and leaky gut. I also had a deep acid stomach, I could not even drink coffee for a good year or better. I learned that it is a symptom of low stomach acid which can cause absorption problem. The ice cold hand pain thing could be Rauynalds which is often a side of Lupus. Something my twin was diagnosed with.


If you have a blood test that shows your white blood cell level, if it is above 7, I would suspect an infection. My white blood cell level was above 7 but yet under the total above range of 10 point something and I had H pylori.

I have nausea and lack of appetite and basically was only eating because I knew I had to but even then I was not eating nearly enough. Nothing sounded good, nothing tasted good.


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