B12 injection and anaesthesia - Pernicious Anaemi...

Pernicious Anaemia Society
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B12 injection and anaesthesia


Hi all. I have diagnosed PA, am a member of PAS and have been hanging around this forum for a little while but this is my first question.

I am due for my next needle towards the end of next week and a week after that am going in for a gastroscopy/endoscopy procedure so will be under anaesthetic. I've read a few of the previous posts here about the affect anaesthetic has on B12 levels so I'm wondering if anyone has any thoughts/experience on whether it is worth having my shot when it's due or if it would be better to push it back until after the procedure?

If I've read previous posts correctly would I be essentially wasting the B12 in the shot if I go beforehand? If I don't, is it likely to make the effect of the anaesthetic worse? I take forever to come out from under at the best of times.

I will be discussing the issue with the anaesthetist but that won't be until the day of the procedures so any thoughts anyone might have would be appreciated.


10 Replies

Write to the gastroenterologist and ask if nitrous oxide is part of the anaesthetic. If so mention your worries about your B12.

Suzibelle in reply to fbirder

Thanks, fbirder. I've got to ring the anaesthetist's office tomorrow anyway so I might see if I can get anything out of them first and if not try the gastro.

I would certainly have the B12 before the op. I did for my second op in 2015. I have referred to this in my previous posts.

Suzibelle in reply to Dulaigh

Hi Dulaigh. Thanks for sharing your thoughts/experience. I am leaning that way anyway on the assumption that if the NOx depletes the B12 one way or the other then I'm better off starting from a higher concentration of it in the blood rather than a lower.

Hi Suzibelle, I had a gastroscopy/endoscopy a couple of years ago and was given the option of a general anaesthetic or a spray to numb my throat. I chose the throat spray and, while it wasn't a pleasant experience, I managed I got through it without the worry of having to worry about the effect of an anaesthetic on my B12.

I hope the procedure goes well!

Suzibelle in reply to Callo56

Hi Callo56, thanks for that. It's something else I can ask when I ring the anaesthetist - see if they even offer the option. last time I had these done (5 years ago) it wasn't even mentioned!

fbirder in reply to Suzibelle

For a gastroscopy I am offered Horst spar or a sedative. No nitrous oxide at all.

For the colonoscopy I was offered a general or gas and air. I opted for the latter. I believe that I was slightly deficienct in B12 before. I’d been suffering from increasing symptoms that I’d put down to age.

After the colonoscopy I hit rock bottom. I could hardly walk 10 m. Luckily the registrar that did the procedure thought that B12 might be the problem so ordered a test. It was 85 ng/L - no wonder I felt unwell,.

Dvpk24 in reply to fbirder

If B12 was depleted by NOX if you get shots how long will it take to feel the difference. Is the NOx damage permanent. I once had a dental procedure with NOX for an hourlong and all my problems started.

fbirder in reply to Dvpk24

The problem with N2O is that it binds irreversibly to any B12 it encounters, rendering it inactive.

In normal people there’s enough B12 stored in the liver that can be recycled via enterohepatic recirculation that this isn’t much of a problem. But if you’ve already got low levels and you don’t absorb from the gut then it can be a big problem.

If treated early levels should soon (couple of weeks to months) recover.

The N2O damage isn’t permanent. As soon as it clears the system (hours) the effect stops.

For people with an absorption problem B12 levels gradually decline. A dose of nitrous puts a big step in that slow decline.

Suzibelle in reply to fbirder

Hi again fbirder. Just spoke to the anaesthetist and he's assured me he won't be using N2O and that he's aware of the issue in relation to PA. So I'll take him at his word and have booked in for my injection this week. I guess I'll see what happens! Thanks for your responses above, they're appreciated.

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