I'm seeing GP tmrw, but I already suspect he will not prescribe more frequent jabs for me. Finished loading doses on 16 April and not due next one til mid July. But symptoms are back worse than before. I'm hoping that when he actually sees the state of me he will agree, but if not I want to SI. I've read that the large amounts of B12 will use up vitamins and minerals much more quickly. So what would I need to replace? I understand that folate and vit D are to be taken, but what doses? I'm worried about overdoing other things and creating even more problems 😒
Which vitamins alongside SI? - Pernicious Anaemi...
Pernicious Anaemia Society
The repair of damage when you start B12 can lead to a drop in other vitamins and minerals as the processes that aren't running and using the other vitamins and minerals start running again.
A B12 absorption problem may also affect the absorption of vitamins and minerals.
However, it is difficult to say if this is going to be the case with any one individual
The best sources of vitamins and minerals are from food.
Whilst B12 isn't toxic - other vitamins and minerals can be toxic, so please consult a medical professional - eg GP or pharmacist, before embarking on supplementation.
If you have macrocytosis then initial stages of B12 treatment can see drops in folate and potassium.
Avoid B6 as you can overdose and the symptoms of an overdose include neurological problems.
To my knowledge B12 won't impact on vitamin D. Most of us in Northern lattitudes don't get enough vitamin D but at the same time too much vitamin D can cause problems.
Thanks for replying. I think it's microcytosis I have - small red blood cells? I haven't really been told much about that by GP - something else to ask tmrw
microcytosis is characteristic of iron based anaemia - cells being small.
macrocytosis (characteristic of B12 and folate deficiencies - but also not present in 25% of people when they first present) is larger rounder red blood cells which makes them less efficient at picking up and depositing oxygen where it is needed.
It is possible to have both going on at the same time due to absorption problems.
Below is one of my favourite websites with sound advice on nutrition and health generally. I had Microcytic anaemia and it was this link where I discovered a connection between this and a deficiency in B6. Although you can overdose on B6 and iron, it is believed that B vitamins generally work synergistically.
"EFFECTS OF B6 DEFICIENCY
Because vitamin B6 plays several important roles in the body, a suboptimal intake or status will have many detrimental effects on health. The classically recognized effects of a vitamin B6 deficiency are microcytic hypochromic anemia (small red blood cells with low levels of hemoglobin), dermatitis, glossitis (sore, inflamed tongue), depression, confusion, and convulsions. Hyperhomocysteinemia, or elevated levels of homocysteine in the blood, can also be due to marginal B6 status, often seen in conjunction with low folate and/or vitamin B12 intake.5,9 Hyperhomocysteinemia is thought to be a risk factor for cardiovascular disease and stroke. Yet studies have produced conflicting findings as to whether using supplements to lower homocysteine levels provides protection against these diseases. Blood vitamin B6 levels are significantly decreased in diabetics and B6 supplements have been shown to help with problems related to glucose intolerance.18 A recent population study showed that lower blood levels of B6 are associated with higher levels of inflammation, oxidative stress, and poor blood sugar control.30"
Thankyou 👍 This would make sense, as I have ulcerative colitis (diagnosed at the same time as B12d) and the main symptom I have is inflammation.
If you have had macrocytic anaemia caused by a lack of B12 then your body will start a burst of red cell production when you start getting your B12 levels up. This can use up a lot of the body’s stores of potassium. But that will be over in a couple of months, so it should have finished already.
If you have PA then the lack of stomach acid will hinder the absorption of iron, so taking a low dose iron supplement (not iron sulfate) May be a good idea.
Blood results were:
Haemoglobin estimation 116
Well! I saw GP today and he gave me an injection!! I've got to call him back next wk to make sure my symptoms have improved and he will prescribe more frequent jabs! Trouble is, I was so gobsmacked that I forgot to ask him the other questions I had 😂 Never mind, next week. Thanks for all your help everyone
Very interesting, I have found that my body has been responding better to iron Supplements than the iron that the doctors prescribed to me. Makes sense now with my PA. Thank you.
Your low MCV suggests iron-deficiency anaemia.
PA means that you don’t produce stomach acid and that’s required to get iron into solution - which is where it needs to be to be absorbed. Iron sulfate is particularly difficult to absorb. You can improve it by taking it with something that contains Vitamin C and citric acid. Effervescent Vitamin C tablets often contain both.
Otherwise you can take iron in a more soluble form - fumarate and bisglycinate being the most common.
Ok sorry if this sounds a stupid question, but I've been drinking smoothies to try to calm my stomach down. I always include spinach. Will this be easier to absorb?
I’m afraid not. Spinach contains oxalic acid which binds to iron forming an insoluble complex. So spinach inhibits the absorption of iron.
Wow really?? This is so hard to work out ☹️ I wish I'd studied Nutrition 😂 so what are good absorbable (if that's a word) sources of iron?
In food, the most easily absorbed iron is haem iron, found in meat and fish. Non-haem iron isn’t so easily absorbed, but eating it along with citric and ascorbic acids (ascorbic acid is vitamin C) can help a lot. So have a glass of orange juice with your nuts, seeds and pulses (all good sources of iron).
You need to cook spinach! The raw form in smoothies & salads does the opposite you'd expect! As fbirder explains below.
You need to take Iron Supplements with Vitamin C to absorb properly. (The original NHS Iron Supplements used to contain Vit' C, but for some reason it was removed & no advice given to supplement the Vit' C as well.)
hi there, seeing as you have an iron and b12 deficiency, i wanted to pose the question of whether or not you have been tested for h pylori.
h pylori is a root cause of b12 and iron deficiency.
additionally, i agree with fbirder about (raw) spinach containing oxalic acid and that the most absorbable form of iron being heme. however, i have read that cooked spinach releases the oxalic acid and increases the amount of iron in spinach up to 6X the amount of raw spinach.
fyi, if you are taking vitamin D, please consider taking magnesium, as it is a cofactor. without magnesium, some people can get a vitamin D induced magnesium deficiency that can cause fatigue.
best of luck and health.
I know that this is an old post, but if you're having B12 injections then you really ought to have a good Vitamin B-Complex supplement to balance out the other Bs - all water soluble so can easily go out of balance.
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