Low b12...help!

[Sammiiiii]

Hi! This is my first post on here, please be nice

So a bit of back ground, I went to the doctors a while back due to feeling completely exhausted all the time, and had some blood tests to find my b12 levels were only 45! I had the six injections (the ones that are all together in around 2 weeks) and then nothing after that.

Around a year after that (whilst pregnant) I asked them to check it again as I was feeling the same way and felt that it wasn't just my pregnancy. My levels this time were 75 so again had the six injections and now have them every 3 months.

My real question is, what could be causing them to be this low? I do have coeliac disease which can contribute but is that really the main cause of them being so low?

Sorry for the long post and thank you for taking the time to read and advise

[clivealive Forum Support]

Hi Sammiiiii You are very welcome and yes we are all very nice people on here

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.

Infants born to and/or breast fed by women who are symptomatic or are at risk for B12 deficiency.

Apart from the celiac disease connection do you see yourself among any others of the people above?

Have you been tested for Intrinsic Factor Antibodies (I.F.A.) and do you know what your Folate level is?

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

I wish you well.

[Gambit62 Administrator]

the mechanism that allows you absorb B12 from your food is extremely delicate (and complex) and things can go wrong at a number of points ... and when it does go wrong the impact on absorption is extremely significant (99% reduction).

Under normal circumstances (ie no absorption problem) your body is able to use some significant stores in your liver to regulate B12 levels but releasing the stores uses the same mechanism that you use to absorb B12 from your food so if it goes wrong it goes wrong big time.

The injections put a lot of B12 into your blood - it then gets removed over time - mainly by the kidneys. Eventually it will be depleted again - on average this takes a few months but that is an average and there are some things that can make it much slower.

Coeliacs is certainly a condition that can affect B12 absorption but it could also be that you have another absorption problem going on. Unfortunately getting a positive diagnosis for the most common cause - PA is extremely difficult because the current tests to diagnose B12 aren't very accurate.

Glad that you have been placed on regular maintenance doses now.