B12 dropped to 538 two weeks after my last injection

[petal02]

I had loading doses approx 2 years ago, and have been having 12 weekly injections ever since. Around Christmas, I noticed that the ringing in my ears was starting again (which was one of the first B12 symptoms I ever had). I was due a thyroid blood test in January, so I asked the nurse to do a B12 test at the same time. The results came back at 538 even though it was only 2 weeks after my injection. The nurse practitioner thinks this is a bit low. So she's brought my next injection forward by 4 weeks, and has said she'll do another B12 test just before she gives me the injection, just to see how far its dropped. So it looks like I may need more frequent injections. My surgery are pretty good, and I don't think I'll have to argue much for this. However will I need to start the loading doses again, to give me a good boost before going back to maintenance shots every few months? And if the surgery refuse loading doses, would 5000mcg sublinguals help a bit? I'm not ready to self inject yet.

[KimberinUS]

Yes the sublingual will help due to passive absorbtion. I would take 1000mcg sublinguals 5X daily in an effort not to overwhelm the passive absorbtion mechanism, thereby possibly wasting some b12 that might get through if taken multiple times a day, but that is just me. No scientific evidence to back this up just my thoughts.

[petal02 in reply to KimberinUS]

Thanks, that's really helpful. Do you also think that 538 sounds a bit low for someone that's only had an injection a few weeks ago? I know that's technically in the middle of the normal range, but my "in between injections" results used to be 900+

[KimberinUS in reply to petal02]

Yes!!! I definitely think it is low.

Makes me wonder if your stomach's ability to produce intrensic factor has reduced recently because intrensic factor is needed in the illeum to reabsorb b12 that is circulated all day, everyday, in the properly functioning,healthy body.

What can cause this, lesser amount of intrensic factor production? Anything that is damaging stomach cell function. Specifically...h pylori.

[petal02 in reply to KimberinUS]

I wondered if 12 weekly injections had never been quite enough, and that it's taken 2 years (since the loading doses) for my levels to gradually decrease to this point (just a beginner having a guess here) !!! How do you get a test for h pylori? Is it a blood test?

[KimberinUS in reply to petal02]

It could be drop over time since loading injections but why wouldn't it have gone from 900+ to 800, to 700, to 600?

Doesnt hurt to test for h pylori, considering it is a root cause of b12 deficiency. Test can be blood, breathe or stool sample. Breathe test considered most accurate.

[petal02 in reply to KimberinUS]

Good point, although I don't have blood tests that regularly, so it may have been dropping gradually. Thank you for the advice about h pylori, I will mention this when I next see the nurse.