Pernicious Anaemia Society
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Feeling overwhelmed and severely depressed after two B 12 shots

Hello. Today is June 16th. My B 12 level is 119.3. I got my first B 12 shot June 1st. I started B 12 supplememts (one per day, 1000 mcg) on June 11th and got a second B 12 shot June 13. I had energy for up to three days after the shot, them then my energy levels crashed and all my symptoms of severe depression and no energy have returned. But my depression has worsened since I have received the shots. I don't have a plan to commit suicide per se, but I'm overwhelmed, withdrawing from people I love and sometimes wish I was never born because of all the numerous health problems I have to deal with (I'm on 18 diffrent kinds of medication daily). Long story short, do B 12 shots and supplements worsen pre-existing mental health conditions? Or is it simply a matter of low B 12 aggravating my mental health problems to begin with? My doctor is only giving me supplement untill my next doctors visit. I do have bipolar disorder and on medication but my depression is a lot worse now. I also don't drink, use drugs. Any advice what is happening and why?

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dianewilson1900, it would be helpful to know

a) what country you are in (protocols tend to vary from country to country

b) what type of B12 you are taking - both as injection (cyano? hydroxo? methyl?) and also in the tablet (methyl?)

Generally speaking B12 should help rather than increase mental health issues but ...

There are a number of things that could be going on and explain the deterioriation in mood

- some people don't respond well to methyl

- some people need much higher levels of B12 post loading shots - potentially much higher than the normal or even measurable range.

and there are probably other possibilities.

I start to notice my symptoms coming back within 24 hours of a shot - though I do respond well to high dose oral/nasal and can use those to stop symptoms coming back.

I also noticed that my mental health deteriorated after I started treatment, and until I found that I needed to keep and worked out how to keep my levels really high. I find that different types of B12 help with different symptoms. I don't find that methyl makes any symptoms worse but methyl also does nothing for my mood so wouldn't use it in isolation.

You may also find this post useful in relation to finding strategies for dealing with the worsening mood whilst you sort out B12.

healthunlocked.com/couchtob...

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I hope you are taking folic acid as it helps utilise b12 , it’s early days and it can takes month for symptoms to improve . Your level is very low and every other day injections would benefit you hopefully . Meanwhile you could ask your GP to get you some help with your depression . I hope you feel better soon , take care .

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Thank you for your prompt reply. Your 100% correct, low folic acid can mimic low B 12 symptoms and make a person tired, depressed and cranky, but I also read taking folic acid can mask a B 12 deficiency. I'm not sure if this is true, but I will ask my doctor about this. I was at Walgreens the other day and thought about buying folic acid actually. It plays an important role with the way B 12 works. If my doctor says it won't skew future B 12 test results, I'm all in. It's as if you read my mind when I was at that Walgreens store. Thank you. I appreciate it. 😀😀😀

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You are correct... But you need folate - and a wide range of vitamins and minerals - to make the B12 work properly, so if you are short of something the extra B12 might not be as effective.

Folate, potassium and magnesium can play a greater role in mental stability than some of the others although good, balanced levels of everything are vital.

You might benefit from a broad spectrum multivitamin and mineral supplement plus extra folate, potassium and magnesium, maybe iron.

I suggest you Google these to see what the effects of too little and too much are and what sources of them you might like.

Take heart from the fact that this is all difficult to cope with and therefore feeling fed up with it is to be expected and normal.

However I hear that you are aware that your feelings aren't within the range you sense to be acceptable and you want to work out why so you can improve your situation and that in itself is very good.

You are taking a lot of different things, some of which may be conflicting slightly or using up/locking up vitamins and minerals and producing symptoms as a result.

You are obviously bright and so I suggest you do your research with this in mind and carefully try things.

Remember to add in things in small quantities for a few days. If you feel you get a positive response you can try increasing the amount slightly. Always check that your improvement is linked by taking it out again and seeing if you worsen again.

It really helps to keep notes, set limits and review your progress.

Good luck and feel free to ask more questions.

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Thanks, I appreciate it. This is good advice and feel cofident buying folate now. I know it helps B 12 work well. I will start with a low dose and work my way up. Vitamin C and D are important vitamins to take as well, but I will add those down the line. Low vitamin D can worsen feelings of depression and anxiety too. I've been anemic in the past. So I bet the farm in deficient in other vitamins too. Thanks so much 💕💓❤💕💓😀😀🌼🇺🇸

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I didn’t want to overwhelm you with info but please consider asking your doctor to check your thyroid and ferritin , all the best .

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Thank you. I will talk to my psych doctor and ask if what I'm feeling is normal and cause for concern. It probably isn't. I have had my thyroid checked and on medication for it. (Low thyroid). It was just checked and within normal range. My ferritin and a CBC was also just done. Those are also within normal range too. But your right, the numerous meds I'm on could siphoning out crucial vitamins and minerals my body needs. I didn't even think about that as being the root cause behind of all this. Thank you for pointing this out..

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Thank you. I'm in the United States. My doctor said 145 or less is considered deficient, 145 to 180 grey area and 180 or higher is an optimal range. As for what type of injection they gave me, I have no idea. The nurse gave it to me. I'm also not sure about my vitamins. It doesnt say on my prescription bottle. I can email my doctor and find out. I will tell him about my depressive symptoms and ask him if this is normal. Maybe the shot wasn't potent enough. I think I need a shot three times a week quite frankly. Thank you for your help!

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likely treatment was cyanocobalamin if you are in the states - and the normal protocol is weekly for loading - though that isn't always enough.

People vary a lot with B12 so I'd be a bit more skeptical about the use of the word 'optimal'. It's the normal range where most people are okay but there are logical problems with applying an averaged range to an individual - particularly one that is as large as the range for serum B12.

Hope your doctor isn't one of the many that isn't aware that injections can significantly alter the serum B12 levels an individual needs and the impact B12 can have on mental health

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Thank you again. All of the replies on this site have been very helpful and In actually feeling better. It's now Monday, June 18th. Like I mentioned before, I received my last B 12 shot June 13 and not as depressed as i was two days ago. Maybe something is taking hold here....However, I'm going to do independent lab testing for B 12 and Folate in about three months and see where I'm at if my doctor won't retest me. It will cost about $54 out of pocket. You can order any test you want here in most US states through independent lab testing, but have to have lab results read to you by your doctor. I know lab tests don't tell the whole story and can be misleading sometimes, but it's better than taking a wild guess. You cannot just ASSUME the B 12 shots are working and not test your blood levels! I'll also know simply by weather or not I'm feeling better too, thats the most important part. Thanks again

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unfortunately further serum B12 testing after loading doses can be really difficult to interpret - 3 months may be long enough - particularly if you were given cyanocobalamin but there is no guarantee that you won't still be seeing B12 left over from the shot and it isn't going to tell you how well your cells are using the B12 - homocysteine and MMA likely to be better tests but even they can be skewed for months after an injection.

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What type of B 12 shot do you think is best? What is considered the gold standard? Or is that highly unique to the individual receiving it?

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'gold standard': back to there being a lot of individual variation and the the dangers of applying generalisations back to a given individual. There is no way of being sure what works best for you without actually trying them to see.

You wouldn't decide the size of your shoes from national averages.

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Your right. In completely clueless when it comes to what kind of shot the nurse gave me. Wish I new. I could ask my doctor I suppose. Thank you

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Thank you for the link. I read it ! 😀😀🌼🌈🌈⛪😀❤❤💓

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Hi Diane, my depression worsened after my first shot of b12 (hydroxocobalamin). I self inject, so I remedied this by building up the shots slowly. I took 0.3ml on alternative days (so two shots at 0.3ml), then 0.4ml, and so on until I reached 1ml. I'm completely fine with it now. I don't think it's a very common effect but the b12 definitely caused my mood to drop initially. I saw it as proof that it does have an effect on your mood.

I'm not sure if you'll be able to get lower shots but it might be worth asking? I hope you can persevere and get through it, because it does help your mood eventually xx

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Thank you. Its June 18th and I got the B 12 shot on June 13th and feeling a lot better now. Maybe its because the shot was a new thing and I just needed time to get used to it maybe? Maybe my brain went into a minor adjustment phase where it screamed "What the hell is this"? Because it was something new. I had nothing to be depressed about. It wasn't raining or cloudy out. I have a lot more energy though and thinking clearer now though... I think the shot is taking hold now but yes, it could have been too strong intially at first. Maybe I'm better because my body has absorbed it maybe? Your probably right. Because. I feel a lot better now thats few days have gone by simce I got it. Thank you for some very valuable advice. I will let my doctor know.

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