B12 318 ,while supplementing??

[Lispuhiza]

Hi everyone my mum is 74 her results: tsh:2,78 (levothyroxine 100) ferritin 13, VIT D3:58.0, b12:318,she's taking 1000mg of b12 supplements,also d3 supplements,she also is diabetic even though she takes drugs for diabetes sometimes glicemia in the morning goes higher than 8,also high cholesterol and triglyceride also using drugs for that,foot neuropathy aches,and edema on the legs,any advice plesae??

[clivealive Forum Support]

Hi Lispuhiza is your Mum "taking 1000mg of b12 supplements" every day or should that read 1000µg or 1000mcg?

I am not medically trained so cannot comment on the other teat results but B12 at 318 is not particularly high and your Mum may benefit from increasing the amount she is supplementing. She cannot "overdose" on B12 as any excess is excreted via her urine.

[Lispuhiza in reply to clivealive]

Thank you clivealive ,1000mcg,two kind of supplements ,500 mcg of b12 along,and 500 mcg of b12 together with acid folate,she also has cold hands especially her fingers,Iron level:13 still not supplementing with iron,because doctor says doesn't need it,really confused.

[clivealive Forum Support in reply to Lispuhiza]

Do you know whether your Mum was supplementing with B12 before the test was done?

Was it her doctor that suggested/prescribed the supplements she's now taking?

Symptoms of B12 deficiency tend to develop slowly and may not be recognised immediately. As the condition worsens, common symptoms include:

Weakness and fatigue

Light-headedness and dizziness

Palpitations and rapid heartbeat

Shortness of breath

A sore tongue that has a red, beefy appearance

Nausea or poor appetite

Weight loss

Diarrhoea

Yellowish tinge to the skin and eyes

If low levels of B12 remain for a long time, the condition also can lead to irreversible damage to nerve cells, which can cause the following symptoms:

Numbness and tingling in the hands and feet

Difficulty walking

Muscle weakness

Irritability

Memory loss

Dementia

Depression

Psychosis

The British Society for Haematology guidelines say on the Diagnosis of B12 and Folate Deficiency "In the presence of discordance between the test result and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment".

google.co.uk/url?sa=t&rct=j...

As your Mum's B12 level is within "NORMAL" (I hate that word) range many doctors will say treatment is not necessary but they should not ignore her neurological symptoms or any medications she is on or the other autoimmune illnesses, as well as her age (i'm 77, am diabetic and have had P.A. for 46 years) that affect absorption. The serum B12 test is not a good indicator of how much is actually getting into the cells.

Make a list of your Mum's symptoms and present this to her doctor and ask him to treat her according to her symptoms and (perhaps) even start her on loading doses "until there is no further improvement" according to the N.I.C.E guidelines below. Click on the link, then on "Scenario: Management" and scroll down to "Treatment for B12 deficiency"

google.co.uk/url?sa=t&rct=j...

If possible be with your Mum as you can validate her neurological symptoms and the doctor is less likely to pooh pooh her in front of a witness.

I'm sorry I cannot be of any real help and wish you both well for the future.

[Lispuhiza in reply to clivealive]

Thank you clivealive. Yes she was supplementing before the test whith b12 capsules 500 mcg daily,yes she has symptoms of sore and dry tounge,she couldn't eat many things,because she experience aches of tounge,also sweating on head and face while standing on sofa like hot flashes,sweating at night,cold hands especially on fingers ,she's now on b12 injections,every three days one injection 500 mcg (IM),she feels better her toes are more relaxed,and some improvement in tounge,her iron test 13:I'm not sure starting supplementing with iron too,but I'm not sure if she will absorb it,how to take in liquid form or capsules?? Any advice??

[clivealive Forum Support in reply to Lispuhiza]

I'm sorry I assumed you were in the U.K but looking back over your previous posts it appears you may be in Canada? If so treatment protocols are different which would explain why your Mum is getting only 500mcg injections of B12 instead of 1mg on alternate days over here.

I cannot comment on iron supplements as I'm not medically trained but suggest you speak to your pharmacist.

Goodnight from the U.K.

[Lispuhiza in reply to clivealive]

Hhmm you are saying to take 1 mg instead of 500 mcg?? Every three day or everyday?? No I'm not from Canada,I'm from Kosovo,but here the doctor says that my mum needs capsules not injections,because they're old techniques (ridiculous) and the only one supplement that he gave to my mum is Acid alfa lipoic,because all the time he thinks that my mum has feet neuropathy caused from diabet,not from any deficiency,but i insisted without his permission i started with injections(I'm a nurse) i do it at home,she feels better but not shure if it's sufficient doze 500mcg,i would really appreciate if someone tell me if i have to raise the doze or not? Thank you again.

[Marz in reply to Lispuhiza]

I think you need more thorough thyroid testing too. The TSH is of little value once taking Levo. You need to know the FT4 & FT3 levels and both should be in the upper part of the range. TSH is better around 1 when taking levo - it is possible she needs a dose increase.

Have the anti-bodies been tested to rule out Hashimotos ? TPO & Tg are the ones that need testing. I have read on Thyroid UK here on HU that Ferritin is good around 70 for good conversion of T4 into T3. Supplement a good 4 hours away from the Levo and take with VitC to aid absorption. There are many types of Iron ...

Rased cholesterol can be a Hypo symptom and taking a statin could be causing some of her symptoms - how long has she been taking them ? There is no research indicating they benefit women.

I am not a medic - I have Hashimotos and a B12 issue due to surgery ... 😊

[Lispuhiza in reply to Marz]

Thank you Marz,In our country doesn't exit ferritin tests,only Iron my mum's iron is 13,yes she is diagnosed with hashimoto disease,not sure starting supplementing with iron,because she on too much medication (diabet,infart of miocard,hypothyroid,high triglyceride and cholesterol,edemas) she's takes 13 medication every day,every 5 or 6 month she suffers from some discomforts such as nause headaches,dizziness,tiredness i and google all the time to find out what's going on and lately i find out something that is called Lactic acidosis,caused as intolerance of Metformin in the body,which are related with my mum's symptoms my uses it twice daily,but doctors never diagnosed why this is happening so frequent,all the time they just guess on something else but nevet proper diagnoze thank you again!

[clivealive Forum Support in reply to Lispuhiza]

I apologize for "placing" you in Canada.

If your Mum is benefiting from the 500mcg B12 injections every three days she may be even better if you follow the U.K. Guidelines which say that:

For people with neurological involvement:

Initially administer hydroxocobalamin 1 mg intramuscularly on alternate days until there is no further improvement, then administer hydroxocobalamin 1 mg intramuscularly every 2 months.

You are probably injecting with either cyano or methylcobamalin but the amount of B12 in each is the same.

Do you know what your Mum's Folate level is?

There is a complex interaction between folic acid, vitamin B12 and iron. A deficiency of one may be "masked" by excess of another so the three must always be in balance.

Symptoms of a folate deficiency can include:

symptoms related to anaemia

reduced sense of taste

diarrhoea

numbness and tingling in the feet and hands

muscle weakness

depression

Folic acid works closely with vitamin B12 in making red blood cells and helps iron function properly in the body.

Please remember that I'm not medically trained.