Feeling ill after first injection

[ruth1988]

Hi all,

I just want to find out if these feelings I'm having post injection are normal.

The GP told me last week that my B12 level is really low (I don't know what the level was) and today I had my first injection, which he said is a one off injection then I can top it up with supplements.

I had my injection 3 hours ago. Within the first ten minutes I felt really hot and dizzy but I went home and had a lie down, which seemed to ease it slightly. Since then I've not felt well at all. My chest feels tight/painful, I feel sick, headache, weird feeling in legs and whole body hurts.

I was going to go back to the surgery but I've been waiting to see if I feel any better. The surgery is now closed and I still feel ill.

Is it normal to feel like this straight after the injection? I do suffer from anxiety at times so I'm not sure if it's linked to that.

Thanks in advance.

[clivealive Forum Support]

Hi ruth1988 it is not uncommon for there to be some "side effects" after having an injection but if you really are still concerned (It's 2 hours since you posted and 5 since the injection) ring 111 and see what they say.

Do you have any idea what your 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

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.

What supplements has the doctor prescribed?

Hopefully by the time you read this things will have settled down, if so, please try not to worry.

I am not a medically trained person but I've had Pernicious Anaemia (a form of B12 deficiency) for more than 46 years.

I wish you well.

[ruth1988 in reply to clivealive]

Thankyou Clive.

I decided to go to bed and hope for the best! I managed to sleep well and I've woken up feeling much better, not great but not terrible.

I'm not sure what my folate levels were but I have a GP appointment on Tuesday so I will ask her then. At the time she said that B12 was the only level that was low. I have been given Cyanocobalamin. I was given these to take before my injection as she said it's worth trying them first but I was suffering with bad indigestion and stopped taking them, which resulted in me having the injection earlier.

I'm not sure when I should start taking these and I'm also confused because I've read that most people have 6 shots over two weeks but I'm only have one.

Thanks,

Ruth

[clivealive Forum Support in reply to ruth1988]

Glad to read that you are not feeling too bad after a night's sleep.

A lot will depend on what your doctor thinks is the cause for your low B12.

If for instance it is dietary giving you supplements would have soon raised your levels but as it seems you didn't get on very well with them your doctor has given you an injection to boost your level.

However if the cause is an absorption problem with your digestion or are diagnosed with Pernicious Anaemia, oral supplements will be no help which is why other patients you have read about are given six or more "loading doses" to "flood the bloodstream in the hope that some at least will get into the cells and then go on to having "maintenance" injections every two or three months for life.

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?

Please remember I am not a medically trained person.

[ruth1988 in reply to clivealive]

The only category I fit into is that I have IBS. I'm a 30 year old female who has a healthy diet including meat on most days. I probably only have one meat free day a week and I eat dairy.

The doctor didn't explain why I might have a deficiency and didn't go into a lot of detail about other supplements that I might need. This forum has been really helpful and I'm going to be asking a lot of questions on Tuesday.

My symptoms (which I've been having for years) are:

Fatigue

Aching muscles

Excessive sweating

Cold feet and hands

Shortness of breath (although I am asthmatic)

Anxiety

Headaches

I've had a few blood tests over the last 10 years regarding my fatigue but apparently everything was fine. One doctor told me I'm probably just a 'tired' person!

[clivealive Forum Support in reply to ruth1988]

It's quite possible that your B12 level was never tested as it is not routinely included in an FBC.

You could just ask your doctor "politely" whether he/she thinks that having IBS may be the cause and see what is said. It's possible that he/she is not well acquainted with B12 deficiency

If you are feeling brave make a list of your symptoms and present this to your doctor and ask him/her to treat you according to your symptoms and (perhaps) even start you 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 take someone with you who can validate your neurological symptoms as the doctor is less likely to pooh pooh you in front of a witness.

[ruth1988 in reply to clivealive]

Thanks Clive. I'll have a look at the link. I've made a list of my symptoms so I will take these with me.

I just hope I feel better soon.

[ruth1988 in reply to clivealive]

I saw the doctor today and she gave me a print out of my test results.

B12 level is 143ng/L

Folate is 5.3ng/L

I still don't feel well since my injection. The doctor has recommended to take folic acid and come back in three months to see if my B12 levels have increased. She thinks I had a bad reaction to the first injection as I also came out in a rash on my torso.

[clivealive Forum Support in reply to ruth1988]

Did you mention the N.I.C.E Guidelines for treatment of B12/Folate deficiency?

Personally I don't think one injection is going to be enough and coming out in a rash is one of the known side effects of hydroxocobamalin.

You can buy B12 Sublingual tablets and folic acid over the counter at your local pharmacy or supermarket. Have a word with the pharmacist for advice.

I am not a medically trained person but I've had Pernicious Anaemia (a form of B12 deficiency) for more than 46 years.

I wish you well.