B12 deficiency

Hi

Not sure if this is the correct forum but I’ve been told today that I have a B12 deficiency (level 150). I’d been getting symptoms like tiredness, weak legs, tinnitus, upset tummy and assumed it was a gastro based problem.

I take 100mg Thyroxine so before I head to the pharmacy for a supplement tomorrow, I wondered if anyone can offer any further advice?

I eat really healthily, green veg, salmon etc etc so baffled why I’m deficient.

Thanks in advance

[Nackapan]

You may not be absorbing it.

Especially if you have stomach problems. Csn be caused by not producing g enligh stomach.acid. Try vinegar on food or or lemon or lime juice at ebd of meal.

Did you have the intrinsic factor antybody test. ?

You could have Pernicious aneamia as an autoimmune disorder.

Can somrines come with thyroid problems.

If tiy eat plenty of b12 food. Eat meT and fish diary ect tiu cant be absorbing it well.

I was shocked too as diet really good. In my case the menopause (a known factor ) had its role to play.

Are you having b12 injections?

You will find plenty of good advice on here.

I hope tour symptoms improve with treatment.

[Hidden]

Thank you. No mention of injections, just been told to take supplements.

[Sleepybunny]

Hi,

"so baffled why I’m deficient"

There's lots of causes of B12 deficiency including ...

diet

PA (Pernicious Anaemia)

Coeliac disease

H pylori infection

exposure to nitrous oxide

Crohn's disease

damage to terminal ileum (part of gut where B12 is absorbed)

some drugs/medicines

internal parasites eg fish tapeworm

plus other causes

Risk Factors for PA and B12 Deficiency

pernicious-anaemia-society....

b12deficiency.info/what-are...

b12deficiency.info/who-is-a...

"so before I head to the pharmacy for a supplement tomorrow"

I've assumed you're in UK.

What treatment has GP offered you?

If your serum b12 level is 150 ng/L and you have symptoms of b12 deficiency, the GP should be treating you.

Symptoms of B12 Deficiency

pernicious-anaemia-society....

b12deficiency.info/signs-an...

b12d.org/admin/healthcheck/...

Peripheral Neuropathy is often associated with B12 deficiency

nhs.uk/conditions/periphera...

Letters to GPs about B12 deficiency

b12deficiency.info/b12-writ...

If PA is a possibility then worth joining PAS who can pass on useful info and offer support.

PAS (Pernicious Anaemia Society)

Based in Wales, UK.

pernicious-anaemia-society....

There is a helpline number that PAS members can ring.

A UK B12 document

BSH Cobalamin and Folate Guidelines

b-s-h.org.uk/guidelines/gui...

Flowchart from BSH Cobalamin and Folate Guidelines

stichtingb12tekort.nl/weten...

Flowchart outlines process for diagnosing PA and Antibody Negative PA in UK

Useful B12 book

"What You Need to Know About Pernicious Anaemia and B12 Deficiency" by Martyn Hooper

Martyn Hooper is the chair of PAS (Pernicious Anaemia Society). BNF treatment info in the book is out of date. See BNF link below for up to date info.

BNF

bnf.nice.org.uk/drug/hydrox...

BNF guidance on treating b12 deficiency changed about a year ago.

pernicious-anaemia-society....

Many UK forum members have reported difficulty in getting adequate B12 treatment at the moment due to impact of pandemic; forum members from UK have reported B12 injections being cancelled/delayed/ frequency reduced or swapped for oral tablets. There are lots of forum threads about this.

If you think the treatment GP has (or has not) offered is affected by pandemic then see this next link where I left a reply about impact of pandemic on treatment in UK.

healthunlocked.com/pasoc/po.....

"No mention of injections, just been told to take supplements"

Don't let the GP fob you off with oral B12 tablets if you need B12 injections.

You already mention symptoms such as tinnitus and weak legs that are usually considered as neurological.

It's vital to get right level of treatment or there is a risk of permanent neurological damage.

Neurological Consequences of B12 Deficiency

PAS news item

pernicious-anaemia-society....

I wrote very detailed replies on another forum thread with links to B12 deficiency symptoms lists, causes of b12 deficiency, info about tests for PA, list of B12 books, list of B12 websites, more UK B12 documents, letters to GP about B12 deficiency and other B12 info which you might find helpful.

healthunlocked.com/pasoc/po...

If you're not in UK, it's helpful to know which country you are in, as treatment and guidelines vary between countries, even the type of b12 used can vary.

I am not medically trained.

[fbirder]

How often do you eat salmon? Other fish? Meat? You need to eat about 100g of salmon a day, every day, to get enough B12. So you could be deficient because you're not eating enough.

However, your mention of a suspected gastro problem brings the possibility of Pernicious Anaemia into play. This is, at heart, an autoimmune disease of the stomach. The most obvious effect is an inability to absorb B12. But it has other effects than can be described as an upset tummy.

Start off by examining your diet. Look at how much B12 you're consuming in meat/fish/eggs.dairy each day. If it is less than 5 mcg then you may have a dietary insufficiency. That's good news, because it can be fixed with a daily tablet.

If you're eating more than that you need to discuss the possibility of PA with your doctor.

[sbadd]

You should have been tested for intrinsic factor to see if you have the antibodies because if your not absorbing, then supplements wont help, 6 loading doses of b12 are usually given over 2 weeks then 3 monthly or more if needed and if test positive then injections for life, i would ask for h polari test aswell.

I too have hashimotis (underactive thyroid ) we are more prone to other autoimmune by having one, i had a b12 reading same as yours but tested negative but was still given the loading doses.