Log in
Pernicious Anaemia Society
16,730 members11,584 posts

Anxiety & Depression due to B12 deficiency?


I'm new here,

from a month now I suffer from anxiety and depression(life is meaningless and much other stupid **** I don't actually believe...) I also have headaches from time to time, cold sweating hands and feet, loss of apetite, weakness, tiredness, heartbeat (90-115) and also a body temperature (37.3-4) from time to time. I don't feel like myself.

So two weeks ago I made a B12 deficiency test and my B12 was less than 50 pg/ml and my Iron was 3.5 µmol/l but my hemaglobin level was fairly normal 122 g/L. So could B12 be the reason for my depression & anxiety?

I use Miravital CureSupport Nasal Spray (5000mcg Methylcobalamin) for two weeks now...still no improval I am so scared.

Thanks in advance!

40 Replies

Hi ttonev are you in the UK? With B12 level so low you really need to find the cause of it.

Are you vegan/vegetarian?

What other medications are you on?

Have you had gastric surgery or do you have "tummy troubles" with your digestion?

Was your Folate level tested?

Have you seen a doctor about how you are feeling as your symptoms may well be due to the B12 and Iron deficiencies.

I am not a medically trained person but there are others on here who will be able to give you good advice.


No i am not vegetarian/vegan, but i eat a lot of fast food. I am from Bulgaria.


The only natural source of B12 from food is by eating red meats, fish, seafood, eggs, poultry and dairy produce.

With the above you need to eat plenty of leafy green vegetables, sprouts, cabbage, broccoli, asparagus, spinach, peas, beans etc for Folate which works with B12 to help your Iron function properly and make red blood cells. The three work together and need to be always in balance.

Symptoms of B12 deficiency tend to develop slowly and may not be recognised immediately. As the condition worsens, common symptoms include:

Weakness and fatigue

Light-headedness and dizziness

Palpitations and rapid heartbeat

Shortness of breath

A sore tongue that has a red, beefy appearance

Nausea or poor appetite

Weight loss


Yellowish tinge to the skin and eyes

If low levels of B12 remain for a long time, the condition also can lead to irreversible damage to nerve cells, which can cause the following symptoms:

Numbness and tingling in the hands and feet

Difficulty walking

Muscle weakness


Memory loss




Sadly it is possible that the "fast food" you are eating is lacking in enough nutrients including B12 and Folate and although the nasal spray you are using is of a high amount it may be that only a very small percentage is getting into the blood cells where it is needed.

Do you have a doctor? Who carried out the tests?

I really think you should be having a course of B12 injections but you would need to make an appointment with a doctor to get the treatment you need.


Yes, my doctor said that I have piles, but i doubt that they caused this deficiency. He prescribed me b12 1000mcg sublingual tabs. But I thought that they are not enough for my deficiency and bought a nasal spray.


"irreversible damage to nerve cells" does that mean thag it is possible for me to have permanent brain damage?


Short answer - nerve damage YES - which is why you need to get treated as soon as possible.

I've had P.A. (a form of B12 deficiency) for more than 45 years and I'm still "clivealive" and over 75.


1 like

Go back and ask for "loading doses" of Vitamin B12 injections to treat your neurological symptoms in accordance with the N.I.C.E and B.N.F Guidelines.


Click on the link above, then on "Scenario Management" and scroll down to "Treatment for B12 deficiency"

I wish you well


Unfortunately, I can't open the site(It Is restricted from outside the UK). BTW...Here In Bulgaria the doctors overlook the symptoms of B1w deficiency, which Is pretty bad. I mean my personal GP was like you just have depressive episode so get over it and move on. :D But I was pretty sure that there was something wrong with me, and decided to make a test and get an appointment to another Doctor, which finally said that B12 Is very low and I was like YES....and then he prescribes me only 1000mcg sublingual.

Btw I am 20 years old (if it matters.)

I really hope that depression and anxiety will lift as soon as I treat the deficiencies in my body.


what was the range associated with the B12 test? If it was active B12/holo-T test then your result is well into the normal range - and the result sounds much more likely to be for active B12 rather than serum B12

1 like

It says that reference values are 197 - 771 pg/ml on the test.(It was a blood test.) But it doesn't says if its active or serum.

1 like


from the range it is serum B12 and your result is a severe deficiency. Given your comments on diet you have an absorption problem. This means that you will only be absorbing a small fraction of the B12 you are taking orally - and it will take a very long time to raise B12 levels using oral supplements. With levels that low you really do need injections to raise your B12 levels.

Any chance of talking about this to the doctor who ran the tests? or speaking to a pharmacist about whether you could get injections - in some countries you canactually get injections from pharmacists - really donn't know what the situation actually is in Bulgaria.


Active B12? I am going to be having blood work done next week as I have never had my B levels checked requested only serum folate and serum B 12 as have to pay full price and money is an issue. Is it necessary for me to test for active B 12 also?


I think you should check your Serum B12, Folate and Ferritin, also it is good to check Iron. But i am pretty new here, and still learning about P.A. and B12 deficiency so i am not quite sure. Best wishes!


active B12 measures just the amount of B12 in your blood that is bound to the protein that allows it get from blood to cells - whereas serum B12 measures all B12. Generally speaking the 'active' B12 accounts for around 20% of the B12 in serum so no need to get both tests done. If results come back in grey range then tests that can help to clarify are MMA and homocysteine but both need to be done in a wider context. They are measuring the levels of some harmful waste products that build up if your body doesn't have enough B12 to recycle them into building blocks. However, they can also be raised by other factors - so need to check for those. Homocysteine will be raised if your folate levels are low - so if your folate comes back low it won't be a useful additional test but MMA could be.


I will talk to her as soon as possible! Does that mean that i will need b12 injections for the rest of my life? Thanks for the support, awesome community!

1 like

it would be good to try and understand what the problem is - but the most likely outcome is that you will need injections for life.

Possible absorption problems: PA, Coeliacs, crohn's, low stomach acidity, drug interactions, h pylori infection ...

h pylori is treatable but its possible that the injections could trigger a different reaction that would leave you needing to keep your serum levels much higher than normal - so injections for life may still be needed.

Testing for PA specifically (unless you still have schilling test in Bulgaria) is really problematic - and a negative on IFA test is a long way from being conclusive proof that you don't have PA


Is it possible that I will have to take antidepressants because of this or the b12 therapy will be enough (I don't want to take them.)? BTW I have made pylori infection test and it is negative.

And have you experienced depression & anxiety due to b12 deficiency?


Hi ttonev I would avoid taking the anti depressants if you can. Very low B12 does cause mood changes. Once your levels go up I think you will feel more cheerful. When my B12 is low I cry - when it is high I am cheerful.

Hope you feel better soon.


had 40+ years of anxiety and depression before being told I was B12 deficient and then took me another 15-18 months to work out what that meant and what treatment I personally needed. anti-depressants never really helped.


Hi I'm fairly new here but the reason I originally went to the doctors was because I was feeling very anxious, even sitting on sofa or being in shower etc but although felt like I was anxious felt chemically unbalanced luckily had bloods done told was low in folate , given tablets and low in b12 given injections and now feel much like normal self . Just waiting on injection in next four weeks and using spray when feel foggy .

1 like

Must add still occasionally get heart palpitations but now don't panic that I'm anxious just feel it's part of the ride and ride it out . My b12 levels were much higher than yours though so may take you longer but good luck sorting it out .



Symptoms of B12 deficiency



Risk factors for PA and B12 deficiency




B12 Deficiency and Mental Health



PAS (Pernicious Anaemia Society)


PAS tel no +44 (0)1656 769 717 answerphone

PAS is based in UK but has members from around the world. Some people on this forum join the PAS.

B12 books I found useful.

"What You Need to Know About Pernicious Anaemia and Vitamin B12 Deficiency" by Martyn Hooper

Martyn Hooper is the chair of PAs (Pernicious Anaemia Society). Book is up to date with UK B12 guidelines.

"Living with Pernicious Anaemia and Vitamin B12 Deficiency" by Martyn Hooper

Has several case studies.

"Could it Be B12; An Epidemic of Misdiagnoses" by Sally Pacholok and JJ. Stuart (USA authors)

Very comprehensive book about B12 deficiency with lots of case studies.

More b12 info

Lots more B12 info in pinned posts on this forum.

Blood tests

Have you had tests for folate, ferritin and full blood count as well as B12?

If your B12 is low has your doctor ordered an Intrinsic Factor Antibody test? This test can help to diagnose PA (Pernicious Anaemia ) but is sometimes not reliable.

I am not medically trained.


ibb.co/cB61Yk This is a screenshot from my tests. Sorry its not entirely in english.


One can buy B12 ampoules for injections, in Bulgaria, from a firm called Wicked Bulgarian Liquid (and there may be other sites as well) if you needed to self inject. I found them on the Internet.

If you did decide that was what you needed to do you must have the first one from a doctor as there is a rare risk that you may be allergic to it.

If you need help with what else you need for self injecting just ask here again

1 like

beginner1are you from Bulgaria?


ttonev no I am in the UK but as a granny I worry when young people are ill, you could be my granddaughter who needed help.

1 like

AMAZING COMMUNITY, AMAZING PEOPLE <3! I am afraid to inject them alone, I have phobia from needles...:D I will go to a hematologist and will urge them to prescribe injections and find the problem. Thanks again for the support people!


Let us know how you get on at the doctors. Hope everything goes well.

PS Don't be a chicken about needles -if you need them. xxx

1 like

beginner1 I will keep all of you in touch! Thanks again!

1 like

Gambit62 What was your depression like? I am curious, because I have never before felt this way and It Is **** scary. I am not even sure if it's depression.

And also is it possible for the depression to become permanent?


untreated it is untreated and will persist.

At its worst my mood was very low - doing anything was an effort - I didn't want to be with people and I was haunted by constant intrusive thoughts about death.

Before I finally got the treatment I needed I was also having problems with being in crowded spaces where there was a lot of noise or activity because I just had no ability to filter out what was the important conversations etc.

These symptoms actually got a lot worse in the year after my loading shots and before figuring out what treatment was right for me. I think this is because I reacted to the loading shots by becoming functionally B12 deficient so I now have to keep my B12 levels very high.

Having had issues with depression and anxiety for many years I didn't believe there was a link for me until I managed to find a treatment regime (little often) that worked and noticed a few months after significant balance problems resolved that depression had gone as well.

1 like

Same story here, I am happy because at least I can walk straight. I really hope to improve after starting B12 shots. And i will continue to use my nasal spray after the shots. Monday i am planning to make Intristic Factor AB test, also, Folate, and Ferritin.

Thanks again guys. My hope is restored. :D

1 like

BTW Is it possible the test for b12 to be false normal(in the normal range, because of the nasal spray i am using) if now i test b12 serum?


Hi ttonev -Yes, yes and yes! this could be the cause. This was one of the main symptoms that my husband suffered, and was the reason I made him go the doctors because it was so bad, his memory was shot to pieces and I was concerned it could be some form of early dementia. He had never had this before. When he was diagnosed it was a huge relief and once he started his injections this was one of the first things that improved. He was a bit up and down at first but he is now back to his cheerful self and looks and feels so much better. It seems like it took about a year from starting treatment to really stabilise and be completely gone. He still has the numbness and pins and needles in his hands and we're trying to get him a jab every 2 months at the moment as this is when he goes downhill a bit. For that last month he has a 5000 sublingual each day and that seems to keep him going until the next jab. He also takes a general multivitamin and mineral tablet every day. The mental effect of being B12 deficient can be pretty devastating as I've seen first hand and for my husband (and me) this was worse than the physical symptoms. I hope you can get some treatment soon.

1 like

Hi christina my mum has the exact same problem. She has awful short term memory problems, depression, anxiety and she also acts very nastily to us all. It is so hard to deal with. She started the injections 2 1/2 months ago, every other day. Physically she improved very well but mentally there has been a small improvement. The guidelines say to give the B12 injections on alternate days until symptoms stop improving. Her GP has reduced them to weekly as we are unsure if she will improve any further. It's hard to say whether she will improve any more and her memory is so poor that she doesn't know whether she is still getting any better because she can't remember how bad she actually was!

My question is what dose and frequency did your husband have and how long was it before his memory symptoms improved ? Has his memory returned to normal?

It's so hard seeing my lovely mum like this when she was an active intelligent woman before all of this.

I hope your husband is still doing well


Hi Kerry - yes it is very hard to see. My husband had a bit of a roller coaster getting the treatment. He is a lovely, happy go lucky person, runs a company, but he was unrecognisable from the confident person he was. It was a horrible time for him especially and he went downhill over about 3 years. He was diagnosed and given the loading doses for a week and then went on to have them every 3 months for a few times, then they said no more as his blood level was high. From improving very dramatically initially which was such a relief as it was obvious this was what was causing his symptoms, I had to watch him go rapidly downhill again when they stopped his treatment. In the end I wrote to his doctor at length and made an appointment to see her. He was in a really bad way and she immediately put him back on it, but would not move from 3 monthly! The consultant at the hospital also confirmed he had B12 deficiency.

Anyway, he has his injections every 3 months but goes downhill after 2 but they still won't budge. I can say that it seemed to take a year for him to be much more settled and the downhill slide is not so acute, but I know he needs it more frequently. My husband's memory problems come and go depending on when he is not getting enough B12 and he is much worse before he has the jab. His depression and anxiety also start to return and he has never been like that prior to becoming deficient. Your doctor seems very good in giving your mum plenty of doses. Don't give up as it's early days and your mum may take longer to show any improvement in her memory, but if she's feeling better physically that's a good sign. Possibly if she is still having depression and anxiety this may need to addressed separately if the B12 does not help. I really wish you and your poor mum well. She sound like she's still feeling pretty crap mentally hence her behaviour towards you. Might be worth talking about this to her doctor.


Monday i am planning to make Intristic Factor AB test

The Intrinsic Factor Antibody test may give a false positive result if blood is taken soon after having a B12 injection.


see bottom of page in above link

Intrinsic Factor Antibody test is a test that can help diagnose PA (Pernicious Anaemia) but the test is not always reliable. It is still possible to have PA even if Intrinsic Factor Antibody test result is negative/normal range.

In UK, it is recognised in the BSH Cobalamin and Folate Guidelines (a UK B12 document) that it is possible to have Antibody Negative Pernicious Anaemia.

I'm not sure if Antibody Negative PA is recognised in Bulgaria.

BSH Cobalamin and Folate Guidelines


Flowchart from BSH Cobalamin and Folate Guidelines


"Is it possible the test for b12 to be false normal(in the normal range, because of the nasal spray i am using) if now i test b12 serum?"

I have read that results of b12 blood test can be affected if you are taking B12.



Gambit62 can you describe your intrusive thoughts and feelings while in depression, are they completely gone now? I am soooo scared. Sorry for the spam.


take a look at this post on another forum



Recently diagonossed with B12 deficiency. I am 36 and my B12 is at 206. I had burning sensation which started in my left arm one fine day and spread over to left leg, hand and shoulder blade. Then next day it started with muscle pain in both hands and shoulders.

I was shit scared as I thought it to be a Heart issue. My GP who has 35 years experience asked me to do B12 test along with other blood tests. He examined me and took an ECG which was normal. My Lipid, Cholesterol, sugar tests are all NORMAL. but B12 was at 206 which he said is deficiency. He said I need to be at around 600 at least. He has started course of 10 injections - twice a week 1500 mcg dose.

My burning sensation is gone. Also the muscle pain has reduced a lot but then at times the rib case bone near my breastbone has dull pain. Since last 3 weeks, he checked my BP twice a week which was always in the 120/70 range even when I am anxious.

The lasting impact of this left side burning and muscle pain is that I am under constant fear of being a heart patient. I do not smoke, do not drink, am I vegeterian and walk 30 mins a day without any sweat. I dont know but I get depressed about if I am a heart patient. He has counselled me many times that had it been the case, he would have noticed it while physically examining me (Even ECG was normal) but somehow every 2-3 days I get this feeling of doom. He says its all in my brain and I should let go this thought.

I wonder if this feeling of depression or anxiety is also because of B12 deficiency. I have had 7 jabs already and now 3 more to go before he starts with tablets. How much is usually absorbed by body out of this 1500 mcg jab?

Also ttonev : Have you recovered from your symptoms yet?


You may also like...