Active B12 levels

[pepperpot99]

I’m currently loading IM fortnightly and have done so since November. My original total b12 level was 93... had loading doses and sent on my way.. someone at surgery tested my B12 a month after loading and it came back 1100- surprise surprise.. injections stopped.. hence self injecting.

I’ve been treated for h pylori and was put on a PPI which I’ve since weaned myself off of.

I sent off for a private active B12 test last week and it’s come back with an active level of 150.

Do the recommend levels cover total or active?

Should my active levels be higher since I’ve been injecting fortnightly?

I’m still achey and exhausted. Should I be feeling the benefit by now? Would the PPI interrupted by absorption?

My iron was tested and since supplementing has come up so I’m probably not anemic anymore.

Hope someone can help

[Gambit62 Administrator]

at 150 your active B12 is high, but the test is pretty meaningless after loading doses.

The PPI was given because your stomach needed to be protected from acidity to allow it to heal after the h pylori infection - which is a condition that can lead to B12 deficiency.

Recommend that you speak to a pharmacist or GP (preferably GP if you can) about the fact that you are no longer taking PPIs given that the prescription was part of the process of treating the h pylori infection.

There are different types of anaemia including

microcytic anaemia in which red blood cells are smaller than normal - typically associated with iron based anaemia

macrocytic anaemia in which red blood cells are larger and rounder than normal - typically associated with B12 and folate deficiencies.

If you had anaemia it is likely to take a few months for the anaemic cells to be replaced with healthy new red blood cells, so the fact that you are still tired and achey one month on may not mean much.

If the h pylori infection was the reason that you hadn't been absorbing B12 then treating the infection should resolve the B12 deficiency without the need for life-long injections.

That is the theory - there are some people who need to maintain very high levels of serum B12/active B12 after loading shots but to be honest I think it is a bit early to tell if you are one of those.