Hello, I have been receiving b12 injections from my GP for the last year and my last one was at the begining of this month. I was feeling a lot more fatigued than normal a few weeks before this was due. Blood tests received and need to be repeated in a month because of the following, sorry if its unrealted to b12 but I don't know what it means. Please can someone help me or point me in the right direction, thanks.
When it appears that a B12 injection has not worked when it usually does it's always useful to ask the question 'what's changed'?
In your case, your blood test results show that you have both calcium and phosphate deficiency, both of which can give rise to unpleasant signs and symptoms, some of which are the same or similar to those of B12 deficiency (pins and needles, muscle cramps, weakness, bone pain, muscle pain, dizziness, confusion, etc).
Vitamin D deficiency can cause calcium deficiency and in turn, low calcium can cause low phosphate levels, so,it may be that the calcium and phosphate deficiencies are interconnected.
Some of the most common causes of low calcium hothead. It’s likely culprits) are:
Vitamin deficiencies (vitamin D, magnesium)
Low calcium intake from diet
Malnutrition
Malabsorption (those with B12 deficiency often have absorption problems - this impacts on the absorption of,other vitamins too)
Alcoholism
Parathyroid disorders
Some drugs also cause issues with calcium absorption (i.e. steroids, immunosuppressant...and many others).
I note that you've posted on the Rheumatoid Arthritis forum so am wondering if you're taking any drugs that might have caused vitamin D deficiency...and hence calcium and phosphate deficiency. (I take steroids and immunosuppressants and have to take Adcal/D3 to maintain Vitamin D and calcium levels).
As vitamin D can be a causative factor, just wondering if you GP has tested your vitamin D levels?
There are other causes of calcium / phosphate deficiency, but the usual causes are the most common ones (as above). Here's a couple of links that will give more information about some of the more complex (and less likely) causes:
The calcium and phosphate (and likely vitamin D deficiency) may be related to B12 deficiency because of the potential related absorption issues that may impact on the body’s ability to absorp other vitamins. Because you're likely to have absorption issues, it's less likely that the deficiencies are due to poor diet. And vitamin D deficiency is very common during the winter months...so,this may have an impact to (since D deficiency can cause calcium and hence phosphate deficiency).
Or as already mentioned, it could be related to certain medications..if you're taking medication that are known to deplete vitamin D and calcium, there's no point in waiting a month and re-testing. It's usual to start treatment when a deficiency is diagnosed...or start supplements when the medications are commenced, to prevent the deficiencies occurring in the first place.
Should also be noted that GP should always want to investigate the cause of low calcium - especially if none of the most likely causes are thought to be the problem
Have to say, I'm wondering why your GP is not treating your proven deficiencies.
The usual treatment is with vitamin D and calcium supplements (Adcal/D3 being one option, though the vitamin D in it is quite a low dose - if higher vitamin D doses are needed, calcium and D are usually prescribed as individual items).
When I was diagnosed with calcium deficiency, I was sent for a Dexoscan to test bone density / calcium loss in the bones. A good idea, especially if you have other 'bone' or arthritic issues (think I recall you may have).
So....the fact that your B12 injection appears not to have worked is more likely to be due to the symptoms of what the lab calls 'modest' calcium (Hypocalcemia) and phosphate (hypophosphateaemia) deficiencies, which in turn may have been caused by vitamin D deficiency (though there are other causes too).
It's likely that one the calcium and possible vitamin D deficiencies are addressed, you'll feel a lot better....and more like the B12 is working.
Thank you so much for your detailed reply. I have just looked at the foods which contain the most calcium and I eat most of them daily, so I am having a good intake from my diet.
I thought at one point I had RA but turned out to be fibromyalgia and osteoarthritis.
I am indeed suffering the same symptoms I had before the b12 diagnosis with additional nausea which is very bad at the moment and a spacey feeling, I have to stop and lay down fairly often.
My vitamin D was tested at the same time, after reading the links you kindly provided I am even more confused as it seems my vitamin D is adequate. I do not supplement anything only the prescribed b12.
VITAMIN D
25 OH VITAMIN D (TOTAL) 78.0 nmol/L
COMMENTS Result interpretation: Adequate vitamin D status
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