How much should levels decrease by in 6 months?

Hi all,

Earlier this year I was diagnosed as having low b12 (114) so i had the course of 6 boosters.

I recently had another blood test and the b12 count came back at 210 which is borderline.

My question is, can anyone tell me approximately what the booster injections would’ve put my levels up to? I’m curious to know how much it’s gone down in the 6 months since. I haven’t had any boosters or OTC vitamins since.

Thanks!

[fbirder]

Impossible to say as we are all quite different.

It would mainly depend on three things - how much B12 you consume in your food, how much of the initial dose is removed by the kidney, and how efficient you are at absorbing B12 from the gut.

If you have very efficient kidneys then they will not remove as much of each IM dose. So your levels from those six injections would be higher.

If you eat a lot of foods rich in B12 then that will help maintain your levels for longer.

Unless you don't absorb B12 from the ileum (part of the small intestine). Poor absorption would also mean any B12 excreted in the bile would be lost to you.

The fact that your levels have dropped down so low after just 6 months strongly suggests that your absorption is hardly working, if it's working at all.

[Gambit62 Administrator]

immediately after a booster shot your levels will have been totally off the measurable scale and then, as fbirder says, they will reduce over time - but how quickly they reduce depends so much on the individual it is impossible to say.

For someone with an absorption problem the average would be for hydroxocobalamin to start fall into ranges where people are deficient within 2 months. With hydroxo its about a month but some people are much quicker and some are much slower.

[Nackapan]

Are you getting symptoms at 210? Surely you need maintenence b12 injections having had the loading doses. I don't understand why you were left for 6 months? Or were you trialling oral b12 tablets? I've not known of anyone just having loading doses and not at least having a maintenence injection 3 Months after.

[Hidden]

Thanks everyone. I hadn’t considered the various factors that could affect it and I’m still learning about b12. To be honest I’m no clearer as to the cause of my deficiency - the IF test came back fine but I know it’s not always accurate, and I have a fairly normal diet which includes meat.

Nackapan - I was told it isn’t pernicious anemia so the doctor doesn’t want to know. My symptoms are starting to come back which is why I went back to the doctor who sent me for another test, but as I’m within the normal range they won’t do anything.

I tried the b12 vitamin tablets but they gave me severe stomach cramp and acne, much like the booster injections did. I didn’t want to keep taking the tablets if my levels were actually fine, but due to various reasons I didn’t get round to having another blood test until recently. The fact it was 6 months since the booster injections wasn’t deliberate.

[Nackapan in reply to Hidden]

I've aso been told i haven't PA. I'm on 2 weekly injections jections at present. Only thing that's helping me recover with the extra vits and iron.

It's good you have managed that long without injections. I just don't want you to start horrible symptoms if your level dropped too far.

Stay well

[Nackapan in reply to Hidden]

I also had a very good mixed diet. Did have alot alot of stress that eats b12. Also stomach acid reducessation with age. I must've been going down in leveks over a few years as so gradual. My first ever b12 test was very low at 106. Severe neurological symptoms I wouldn't wish on anyone . I'm telling everyone to get tested !

[fbirder in reply to Hidden]

It doesn't matter if it's PA or not. You need treatment.

Ask your doctor to read the entry for hydroxocobalamin in the British National Formulary (BNF - they will have an online version).

The very first part of the entry is under 'Indications and Dose' and says -

Prophylaxis of macrocytic anaemias associated with vitamin B12 deficiency

By intramuscular injection

Adult

1 mg every 2–3 months.

So, the first entry says nothing at all about Pernicious Anaemia. It says you need injections every 2 to 3 months to prevent macrocytic anaemia. You have a B12 deficiency. You need injections to prevent anything nasty happens. Even if you're not anaemic now, you need injections to not be anaemic in the future.

[sbadd]

I too like you had loading injections in jan my b12 was 148 then went into the thousands, i had no more injections after that, my current b12 level is 600 tested few weeks ago