I have been diagnosed with b12 deficiency as I have been feeling like I have no energy and I have to sleep all the time I even feel tired when I wake in the morning.
My b12 level is 165ng/l so I have been started on loading doses and thereafter every 3 months I am in the UK.
I am worried about Neuro symptoms as I have a tremor which Gp noticed and I have cold hands and feet.
After loading doses I am thinking about self injecting once per month and would like to know if the self injection has to be IM.
Any advice is greatly appreciated
Thank you x
Written by
Ningy13
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Thanks for replying. No I don't know folate levels to be honest this is all new to me and GP has provided little information. Gp did not offer the injections at first I had to ask for them.
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
Anyone at any age, can become B12 deficient. However, certain people are at an elevated risk. They include the following:
Vegetarians, vegans and people eating macrobiotic diets.
People aged sixty and over
People who’ve undergone any gastric and/or intestinal surgery, including bariatric surgery for weight loss purposes (Gastric bypass).
People who regularly use proton-pump- inhibitors. H2 blockers, antacids, Metformin, and related diabetes drugs, or other medications, or infections such as h-pylori that can interfere with B12 absorption.
People who undergo surgeries or dental procedures involving nitrous oxide, or who use the drug recreationally.
People with a history of eating disorders (anorexia or bulimia).
People with a history of alcoholism.
People with a family history of pernicious anaemia.
People diagnosed with anaemia (including iron deficiency anaemia, sickle cell anaemia and thalassaemia).
People with Crohn’s disease, irritable bowel syndrome, gluten enteropathy (celiac disease), Pancreatic insufficiency, or any other disease that cause malabsorption of nutrients.
People with autoimmune disorders (especially thyroid disorders such as Hashimoto’s thyroiditis and Grave’s disease) Type 1 diabetes, vitiligo, lupus, Addison’s disease, ulcerative colitis, infertility, acquired agammaglobulinemia, or a family history of these disorders.
Women with a history of infertility or multiple miscarriages.
Can you see yourself among any of the above people?
It is also important that your Folate level is monitored as this is essential to process the B12.
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 and your B12 levels are "bumping along the bottom of the range.
Initially, replacing B12 will lead to a huge increase in the production of blood cells and platelets (which occurs in the bone marrow) and can lead to rapid depletion of folate and iron stores; this can then limit the expected recovery of Haemoglobin.
Both iron and folate may be needed so please have these levels checked by your doctor.
How many loading doses have you had so far? To see what the N.I.C.E guidelines say should happen, click on the link, then on "Scenario: Management" and scroll down to "Treatment for B12 deficiency"
particularly about those with neurological involvement/
Before thinking about self-injecting I would give the three-monthly regimen a chance. Many people find it satisfactory.
The neuropathy caused by a B12 deficiency tends to be more of a sensory type. Numbness and tingling are the common symptoms. But if you’re worried ask for a referral to a neurologist. They can do some proper tests.
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