Vitamin B12 and Vitamin D deficiency - Pernicious Anaemi...

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Vitamin B12 and Vitamin D deficiency


Hello All,

I have been diagnosed with deficiency of B12 (158) and Vitamin D (20) and Dr currently prescribed me remlyn D (which has 1500 mcg B12) daily and Vitamin D (60000 IU) weekly supplement.

I am also taking A to Z multivitamin supplement which has some B12 and Vitamin D.

My symptoms - lack of energy, fatigue, dizziness, light-headness, poor concentration etc.

Now i did question my Dr on putting me on B12 injection however he insisted on oral supplementation.

Hope I am on the right prescription??

24 Replies

Hi Riseup01

Has you GP prescribed you B12 supplements or do you have to get your own. The B12 in the multi vit. is far too little and won't do much good.

I expect the 'expert' advice will be along later.

Riseup01 in reply to beginner1


My Dr prescribed the B12 supplements.

Yes so in a day I am taking 1500 mcg (remlyn D) with multivitamin (which I agree has less B12)

If you’re in the UK ask you doctor to follow these quidelines:

Riseup01 in reply to fbirder

I am in India, not sure they are getting followed here.

linkerror in reply to Riseup01

I am based in India too. My Dr asked me to undergo 10 injection course when my B12 was 206. After the injections in Feb and then 1500 mcg daily oral supplement, my B12 hovers between 1700-1800 now.

In India there is no definite guideline to treat B12 deficiency but I have seen many people around me getting 5-10 injections without them asking for one.

Most of my symptoms are gone but some crop up for a day for two and then go on their own. For e.g. Tingling little finger in both hands, burning in shoulder blades etc.

Riseup01 in reply to linkerror

Thanks !

My symptoms are improving but slowly as I am on oral B12.

It has been 6 days and I can feel marginal improvement in Dizziness and now feel some energy.

Even sometimes I think I should be on injections but i will observe for few more days.

When do you think I should do a retest for B12 (to see what difference B12 pills are doing).

linkerror in reply to Riseup01

I was absorbing around 20mcg out of 1500mcg tablet and thats the reason Dr usually start with injections first.

Once u r on supplemnts, tests become somewhat skewed like in my example, after 10 jabs, the B12 was 1700 but I still had symptoms. So essentially you treat based on symptoms than the actual count.

I would say test after 3 months post stopping supplements.

Riseup01 in reply to linkerror

Thanks !

Yes I agree that treatment should be based on symptoms than actual count.

You know I don't think I will be leaving the supplements now specially with the kind of symptoms I had and some still having, Damn scary, dont want them to haunt me again.

They got me Off-guard once, will ensure this doesn't happen in future. I am happy with a pill once in a while (as per permissible limit) rather then leaving it and again falling into the trap.

I just need to adjust the amount and frequency of these pill.

linkerror in reply to Riseup01

U usually dont overdose on B12 as extra is exreted through urine. B12 is used in RCB creation and life of a RCB is usually 90 days so your B12 only starts making difference after around 60 days on fatigue and tiredness since the new RCB starts carrying more oxygen or rather becone efficient.

EvenI was caught off guard when I started showing up symptoms in Jan. This has happened for the first time to me. B12 is dangerous when deficient as it works in so many ways in your body.

Riseup01 in reply to linkerror

Well 60 days is long time isn't, thats what make this deficiency more alarming.

Anyway I hope things to settle down early as there are lot of important task I need to complete in June'18. Now a days, I avoid any exertion.

For me it was also the first time but every experience teaches us something very important and I have learned my lesson.

Thanks for sharing your experience and input. I will keep you all posted as soon as I will start experiencing improvements.

linkerror in reply to Riseup01

Its not as simple as fever. The deficiency itself takes months and years to develop. This it like a B12 storage tank, which is in Liver. Body uses this when its not able to get B12 rich food or does not aborbe from food. When this tank is emptied, you are done.

Even whenyou supplement, body does not absorbe whole of it and then uses it for daily consumption and extra is stored in the tank.

Its a lesson learnt, well said.

Riseup01 in reply to linkerror

Yes, I agree.

Though, I do feel marginal improvement into my dizziness (may be because of supplement or because of less exertion) , at least now I can manage to go to office and do some task. I am avoiding anything which gives me exertion.

Also I am avoiding stress. Hope everyone gets out of this quickly.

Riseup01 in reply to linkerror

Its interesting, you mentioned that body absorbs only 20 mcg out of 1500 mcg tablet. Do you know how much body absorbs from injection. Also if you can please share the tablets which you had and the injections which you had with schedule and frequency.

linkerror in reply to Riseup01

Thats my case.. I was absorbing around 20mcg from tablet.

Injection when given Intra Musclularly does not need any absorbtion in stomach as it directly goes into blood. But whatever extra is excreted from body and remaining stays in blood. In my case after 10 jabs of 1500mcg each my B12 blood count went from 206 to 1710.

Looking at your level, I am surprised why your Dr did not start injections. Oral supplement is a gamble since you never know if you have any absorbtion issues to bwgin with. To be on safer side, Dr usually give jabs as loading dose and then start pills.

My Dr prescribed me a tablet called 'B fit CD'. Its a multi vitamin tab with B12 of 1500mcg.

Riseup01 in reply to linkerror

Thanks a lot and I do have some more queries please.

When you say, you were absorbing 20mcg from tablet, you had any absorbing issue (like IF)??

I also feel I should be given Jabs first. Also did you start feeling well right after the few jabs or your symptoms also took some time to subside.

If I redo a B12 test after a week of Oral pill supplement, Can that be an indicator that pills are not working or working.

Was your Dr neuro or hematologist, mine was Neuro.

I have heard, too high level of B12 in the blood are not good (You know net is full of +- information).

linkerror in reply to Riseup01

Body does not absorb the whole lot and so Dr prefer injections which need no absorption. Even in this case, the body excretes what is extra and so even in case of injections, you dont get all of it. But its the sure shot way of loading the levels and so is preferred.

I became deficient because of my diet. I am a vegeterian and so my source of B12 is very limited. As I said, your liver acts as a storage for vitamins and usually has B12 which will last for some months. When you use this storage and dont get enough from food, you become deficient.

I was curious to know if my diet is the issue of lack of absorption but then in two months (Around 40 tabs) my B12 jumped by around 130mcg. Your body needs 2.5mcg everyday and so I am safe if I keep taking pills for longer duration. Of course, as of now I have a lot of B12 already (1830) and so its ok even if I dont continue with tabs.

Since how long have you been taking the pills? Check the strength, total dose and get the count from blood. Usually 1-2% should be absorbed at least. There is no definite formula as each of us are different. The bottomline is, your B12 should always be more than 500 at least. The lab specifies the range as 250-1100 but safe level is above 500.

I was diagnosed with the deficiency by my family Dr who is a general physician but has 40 years experience. I had burning sensation in my hands, arms and shoulder blades, tingling and numb little finger in both hands, fatigue, anxiety, breathlessness and irritability.

I am not recovered fully even after 4 months, but trust me I feel much better now. As I said, my symptoms return for a day or two and then disappear.

B12 is fortunately not toxic so its safe even though your B12 level is more than what lab range says. However, if your B12 keeps on increasing even WITHOUT any injection/supplement at alarming speeds, then its a serious issue which needs to be diagnosed. This means your Liver is now functioning well and there is some underlying issue.

Internet is a boon and bane at the same time. When I was diagnosed with the deficiency, I started googling and it took me to a point where it said, I have a cancer. I even have chest pains in between and coupled that with my already raised anxiety, I went into a depression. I am non alcoholic, non smoker, vegeterian with all blood work normal still I was convinced that I have heart failure. I got multiple ECG, color doppler, 2D echo, chest CT scan all done with all negative and still at times I wonder why I have chest pains. My cardiologist said I might have Costochondritis and Vit D deficiency for which I am taking supplements. This year so far has been terrible for me. Till now I never had fever more than 2 times in a year such was my immunity and all of a sudden all hell broke loose.

Anyways, be careful with your supplements and maintain a diary of symptoms, see if you get any better and give feedback to your Dr about your recovery. All the very best !!!!

Riseup01 in reply to linkerror

Thanks for your detail reply.

I started my Pill from 24th May'18 and I am taking Remlyn D which has below composition.

Alpha Lipoic Acid - 100 MG

Pyridoxine Hydrochloride - 3 MG

Methylcobalamin B12 - 1500 MCG

Folic Acid - 1.5 MG

Vitamin D3 - 1000 IU

With this I am also taking A to Z multivitamin tablet however that has very less B12 and has mostly all vitamins.

I am also Vitamin D deficient ( mine reading was 20) , so with this I am also taking weekly 60000 IU Vitamin D supplement.

Now its been one week with B12 oral supplement and I am thinking of doing a blood test on coming Sat. If I see its increasing I will carry on otherwise I will also plan for a shot.

As far as my symptoms are concerned, I see marginal improvement into my Dizziness however I feel extremely tired even with some amount of exertion.

I am happy I got the diagnosis early because generally dr under estimates B12 deficiency and often ignore this test.

Can you please share the composition of B12 Injections you had and the schedule you followed for it. Though I have no plan to copy it however it will be good for my knowledge.

Interestingly, I also suffer from mild autoimmunity which has never been diagnosed correctly. Sometimes, I do get red bumps on my both legs which resolves on their own (Dr says they could be autoimmune).

I also have anxiety and chest pain and did the ECG and Echo and likewise all my test were normal.

But anyway, While I believe all these sufferings and difficult times are really painful, sad and hurting but they do test our will, give a very different perspective and in the end make use more strong. I mean not trying to be philosophical but just sharing thoughts.

Thanks again for your valuable advise. In India, where do you put on?

linkerror in reply to Riseup01

The tab is a multiVitamin and has B12 in Methylcobalamin form with 1500mcg strenth.

I'm based in Pune MH. Where are you from?

Can u describe ir chest pain? I usually have on my sturnum and left part of left on ribs. It could very well be Vit D deficiency. I'm on Vit D supplement as of now, I hope I would stop having the chest pain soon.

Riseup01 in reply to linkerror

I am from Delhi.

My chest pain is more linked to anxiety, I don't have it all the time.

It could be because of Vitamin D deficiency as well however it doesn't exist all the time and whenever it happens its very dull.

Overall I see a lot of improvement in my condition (though still far from perfect well), may be lot of my symptoms were from Vitamin D as well.

I will give one more week to B12 oral supplement and will go for blood test on 9th June'18.

Riseup01 in reply to linkerror

Hi Today, I got my B12 results and it has increased to 232 (from 156)

... I am taking oral supplement from past 18 days.. do you think it's fair increase or with injection I would have got more then 232..

Please also could you share which b12 injections you were taking .. we're you taking 1000 mcg B12 .. every alternate day .. and were taking oral pills all the time ... Pls if you can share your initial schedule... I am also aiming to self inject.

linkerror in reply to Riseup01

Good thing is, you dont seem to have absorption problem. However if the rate is good enough or not that only you can tell depending on your symptoms.

I was prescribed "Nervigen" injections and "B fit Cd" tablets post 10 injection course. My B12 jumped from 206 to 1710 in 5 weeks post 10 injections and then from 1710 to 1830 post 40 days of tablets. Injections are effective way of loading the level and then you can be on tablets to maintain it.

If your symptoms are slowly improving, you can ask for injections to your Dr. Some symptoms improve quickly while few take months. My fatigue took 2 months to correct while the burning sensation was gone in 2 weeks. I still get numb/tingling in my little finger on both hands once in a month. Everyone is different so there is no fixed pattern on improvement.

Riseup01 in reply to linkerror

Thanks for your reply.

My symptoms are improving (but its a slow improvement) also I still feel little dizziness and trouble walking every now and then.

I am planning to fix a meet with my GP this week and will request for injections. Hopefully with injection, my improvement will expedite.

When I feel alright, I think I should pursue oral medicine, though whenever I get symptoms I think I better take injections.

Having said that, I will keep all posted on my recovery. In parallel, I am also Vitamin D deficient and taking supplement for Vitamin D as well.

Many thanks fbirder.

After meeting with Dr on last Friday, he finally prescribed me 500 MCG Methylcobalamin shots every alternate day (8 shots). In parallel, he advised me to take 1500 MCG B12 orally daily.

After taking two, I am feeling little improvement with Dizziness.

On another note, I am experiencing more sneezing, sinus related issue post injection (I don't know that's a side effect or something else).

Also at times, I get shortness of breath. Overall hope things will improve faster from here.

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