Pernicious Anaemia Society

B12 deficiency and peri menopausal

Hi I'm new here I'm 45 and for the past 6 months I've went through loads with my health I have psoriatic arthritis and 6 months ago was diagnosed with b12 deficiency and peri menopausal my symptoms range from mild to excruciating firstly I get headaches like no other my bones and muscles ache I get a horrible taste and tingling in my mouth my chest feels like it's being crushed my shoulder blades are burning and sore,I feel flu like, but the thing that's bothering me is the stomach pains I get a pain on my left side just below my left rib it feels like a pressure also my breasts are so sore to the touch and burn like mad I've been for a ct on stomach had a heart trace as I was getting tingling down my arms both came back fine I've now had the six loading shots for b12 get another in a few weeks I'm on esttete duo for peri menopause I am so scared I've got something really bad wrong with the pains in my chest and boobs any help would be so appreciated thank you xx

13 Replies

Hi Kirstiet It is not uncommon for some symptoms to appear to get worse before they get better as the B12 you've been having injected starts repairing the damage done to your nervous system and your brain starts getting multiple messages from part of the body it had "forgotten about" or lost contact with.

I sometimes liken it to a badly tuned radio on which you have turned the volume up high trying to catch the programme you want when all of a sudden the signal comes in loud and clear and the blast nearly deafens you.

A lot will depend on the severity and longevity of your B12 deficiency as to how long before there is no further improvement or recovery.

Some symptoms will "disappear" quite quickly whereas others may take months or even years. There is no set timescale as we are all different.

If you can get to see a doctor please also ask him/her to check your Folate level as this and B12 help your iron to make red blood cells and to function properly.

Do you have any idea why you became B12 deficient in the first place?

Anyone at any age, can become B12 deficient. However, certain people are at an elevated risk. They include the following:

Vegetarians, vegans and people eating macrobiotic diets.

People aged sixty and over

People who’ve undergone any gastric and/or intestinal surgery, including bariatric surgery for weight loss purposes (Gastric bypass).

People who regularly use proton-pump- inhibitors. H2 blockers, antacids, Metformin, and related diabetes drugs, or other medications that can interfere with B12 absorption.

People who undergo surgeries or dental procedures involving nitrous oxide, or who use the drug recreationally.

People with a history of eating disorders (anorexia or bulimia).

People with a history of alcoholism.

People with a family history of pernicious anaemia.

People diagnosed with anaemia (including iron deficiency anaemia, sickle cell anaemia and thalassaemia).

People with Crohn’s disease, irritable bowel syndrome, gluten enteropathy (celiac disease), or any other disease that cause malabsorption of nutrients.

People with autoimmune disorders (especially thyroid disorders such as Hashimoto’s thyroiditis and Grave’s disease) Type 1 diabetes, vitiligo, lupus, Addison’s disease, ulcerative colitis, infertility, acquired agammaglobulinemia, or a family history of these disorders.

Women with a history of infertility or multiple miscarriages.

Can you see yourself among any of the above people?

I am not a medically trained person but I've had P.A. (a form of B12 deficiency) for more than 45 years.

I wish you well


Hi thank you for your reply I started feeling ill in July it took until November to find out the b12 and peri menopausal had the six loading shots but didn't see much difference the dr said my iron levels were fine but my b12 was really low I'm duey next shot the middle of February it's the burning pain in my breasts and shoulder that bothers me the most it's so sore I'm now on galabin for nerve Odin just started them had physio on my shoulder blade she says the muscles are so tight there, I had my gallbladder our 7 yrs ago so always had bother with my stomach but this pain in my rib left side lower down is very painful I was on omeorazlle high dose for a while x


The omeprazole has now stopped since finding out , I also have high bp just feel really not well, tingling in my lips and feel my mouth sore and teeth I don't know if I'll get checked to see if the loading shots have worked ? Do you know if that's what happens next ? Thank you xx


The omaprazole may have been the cause of the deficiency if you cannot rule out any of the others above.

It is important that your Folate level is monitored as this is essential to process the B12.

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.

Symptoms of a folate deficiency can include:

symptoms related to anaemia

reduced sense of taste


numbness and tingling in the feet and hands

muscle weakness


Folic acid works closely with vitamin B12 in making red blood cells and helps iron function properly in the body.

Make a list of your symptoms and present this to your doctor and ask him to treat you according to your symptoms and (perhaps) even re-start you on loading doses "until there is no further improvement" according to the N.I.C.E guidelines below. Click on the link, then on "Scenario: Management" and scroll down to "Treatment for B12 deficiency"

If possible take someone with you who can validate your neurological symptoms as the doctor is less likely to pooh pooh you in front of a witness.

I am not saying that this is an easy thing to do but try to stay calm, write out what you want to say and keep to the script and be confident that you are "in the right" and your facts are correct.

I'll bid you goodnight in the hope that your doctor has some understanding about Vitamin B12 deficierncy.

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Clivealive,suspect that the gallbladder removal is probably more of a factor than the omeprazole - as it is an operation that can damage the ileum.

The stomach issues that led to the prescription for omeprazole were probably treating the symptoms of low stomach acidity (pretty much the same symptoms as low stomach acidity).

Kirstiet, if you are now on injections omeprazole isn't going to be an issue with your B12 as you are getting the B12 through the injection rather than your stomach.

How did you go about stopping the omeprazole - going cold turkey isn't recommended and can have side effects - though couldn't say if those would fit the below rib pains that you describe - a pharmacist might be able to tell you though

couldn't find anything in 'esttete duo' when I did a search but if it contains progesterone then there have been reports of progesterone interferring with the metabolism of B12 - I've had it a few times for exceptional bleeds whilst peri-menopausal and found that I only needed a fraction of the amount prescribed but the amount prescribed left me feeling like a zombie.

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Hi yes I went cold turkey as the doctor recommended that I'm now on ranitidine the pain in my ribs is on the left side under my breast it feels like a pressure and when it's at it's worst the pain goes into my shoulder blades and breast like a burning tingling pain really sore,the doctor only just gave me the galabin on Monday so don't know if that's working yet and Ben on esttete for two months,, this all started so suddenly I got up one morning in July with aching calf muscles then I got the tingling in my left arm and a few weeks later the fatigue sore jaw and mouth then gradually each day a new symptom headaches pain but the main ones just now are the jaw mouth pain and horrid taste breast and shoulder blade pain and nausea sorry for the big rambling messages but it's so nice to actually speak to someone who knows what I'm talking about sometimes I feel my dr thinks I'm nuts,, I did go through a horrible month in December not wanting my partner to go out and leave me as I was convinced with the breast and chest pains I was going up have a heart attack and he'd find me dead, I'm not that type of person at all xxx


B12 tends to come on slowly over time though symptoms can snowball when the deficiency tries to bite. folate deficiency tends to come on quite quickly.

suggest that you speak to the pharmacist about the chest pains and if they could be due to coming off omeprazole too quickly.

I find that I can get really bad heart burn at times though that's in the centre of the chest rather than just below the rib cage - but taking a little lime or lemon juice in water helps to stop it - but I'm not saying that that would be a good idea in your case.

Please also bear in mind that one of the symptoms of B12 and folate deficiency is actually being more susceptible to stress - hence the anxiety attacks.


Hi I'm going to make an appointment to get folate checked as I'm not sure what mines was yes I've been really stressed and scared so guess that won't help either this pain is there constant and varies in degrees of pain starts off just a gnawing then gets really sore and goes in my back and shoulder blade and my breasts are so heavy and sore feeling xx


Thank you so much for all your information I'll make an appointment next week to get my folate levels checked thank you xx

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Hello Kirstie. Your post rang bells with me. I am 51, and perimenopausal. I was also B12 deficient when perimenopause began in earnest at 47. I think a B12 deficiency makes the whole hormone thing much, much worse. I also have the left-side pain, which I think is related to the spleen. In my experience, falling oestrogen somehow prompts an immune response, especially if you have MCAD / mast cell / allergy issues. I can also feel that my spleen is swollen at times. Digestive issues as well - I finally lost my gallbladder late last year after years of digestive complaints. Hate to say that I now have post-cholcystectomy syndrome, so struggling with that too. Tingling arms - yep. Sore breasts = lack of progesterone. If I could give any advice to a B12 deficient, undermethylated perimenopausal woman, it would be to make sure your progesterone doesn't go too low, because oestrogen dominance can cause so many problems (including gallbladder), and it also blocks thyroid and B12. Keep your progesterone up, and keep up with your B12, folate, iron. I am having a truly horrendous time, and I think if I had done this from the get-go, it needn't have been. Work with a hormone doctor if you can.


Thank you so much for your reply, I'm sorry to hear you have been having such a hard time, it really has been horrific these past 6 months going from a reasonably healthy person to this constantly in pain and moaning about this being sore and that being sore I think it's more the fact I got into my head as it wasn't getting any better it must be something really serious and that caused me to get really stressed out my partner says I've been a joy to live with lol I'm going to make another appointment and get checked again I've not had any other bloods taken for three months so surely they would want to check and see if the medications having any effect anyway xx


Kirstie - I relate. I have also gone from being reasonably functioning to be basically sick, with new symptoms every day. It's not in your head! I try not to talk about it with other people, because they don't get it, and it becomes boring for everyone after a while. I am bored of myself! If you wonder whether other people are having a hard time, go to the menopause matters forum. You will have company with new symptoms every day, and horrendous health anxiety, although they don't go into treatments too much. Btw I also have burning mouth - another B12 deficiency symptom.


I'm the same now I don't mention it sick everyone's eyes rolling lol I can't believe how quickly it all came on and how bad a thing I'd never heard of before can make you feel xx


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