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Optimal Levels of B12

Muef profile image
Muef
13 Replies

Hello.. I am male. 40 yrs old

1.What should be the ideal level of b 12 in body

2. After having 1000 mcg tablets daily for 2 weeks, is a level of 380 good enough.

3. How much does it take to solve symptoms related to b 12.

P.S. i have known to have b.12 deficiency and got injections for that in 2018. The levels were 150 in 2018 and i got 12, twice weekly injections.. level rose to 1400...

Like in 2017, my symptoms are same. Random Cold pricks/tingles all over the body. They come and go.. no other neural weakness.

Ozi

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Muef
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13 Replies
JanD236 profile image
JanD236

Unfortunately there’s no straightforward answer to your questions but I’ll have a go!

1 The ideal level for most people is within the range provided by the lab when they gave your B12 serum test result. It depends on the jab and the units used but this might be something like 200-900.

2 380 is within the range and would be a good enough level for many. However, if you’re having symptoms of B12d maybe it’s not a good level for you.

Is 380 higher than it was before you started the tablets? This would be useful to know.

3 There is no set answer to this. We’re all different in our response. For me it took about 18 months on injections to substantially improve my symptoms.

What was the cause of your deficiency in 2018 and was this resolved? For example, if the cause was dietary have you now changed your diet/supplements? Or was it something like poor absorption which is unlikely to have changed?

Why were your injections stopped?

What other symptoms of B12d do you have?

Nackapan profile image
Nackapan in reply to JanD236

I think wd were typing at the same time! So missed your reply.

Nackapan profile image
Nackapan

Well you are 'in range'only you know how you are feeling. Everyone operates on different levels. Even before any supplements.

Perhaps split the b12 doses over 2 . Or up it and see?? Then find a daily maintenence dose.

Have you had your folate iron vit d levrhs checked?

Thyroid.

Sounds like yoo are absorbing but need to carry on with daily doses to maintain levels

Do you know the cause?many if us guess but some know.

On tbd last Post cliveealive gives a long reply ....have a look.

Sleepybunny profile image
Sleepybunny

Hi,

Do you mind me asking which country you are in?

The reason I am asking is that patterns of treatment for B12 deficiency vary between countries and the type of B12 used can vary.

A few links that may be helpful.

Two B12 books I found helpful

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

Martyn Hooper is the chair of PAS (Pernicious Anaemia Society).

"Could it Be B12?: An Epidemic of Misdiagnoses" by Sally Pacholok and JJ. Stuart (US authors)

Very comprehensive with lots of case studies.

PAS (Pernicious Anaemia Society)

Based in Wales, UK.

pernicious-anaemia-society....

There is a helpline number that PAS members can ring.

B12 Deficiency Info website

b12deficiency.info/

B12 Awareness (US website)

b12awareness.org/

US link about PA

rarediseases.org/rare-disea...

Stichting B12 Tekort (Dutch website with English articles)

stichtingb12tekort.nl/weten...

B12 article from Mayo Clinic in US

ncbi.nlm.nih.gov/pmc/articl...

Table 1 in above article is about frequent misconceptions about B12 deficiency.

Films about b12 deficiency

b12deficiency.info/films/

There is more B12 info in the pinned posts on this forum. Some of the info may be specific to UK.

I am not medically trained.

Gambit62 profile image
Gambit62Administrator

Muef - optimal is a pretty meaningless concept when it comes to B12. There is no precise level that is good for everyone - that's true whether or not someone has had injections.So, serum B12 is a difficult test to interpret anyway - its more useful to see how levels change over time and if there is a significant downward trend which would indicate an absorption problem, but as you have an absorption problem already diagnosed that is pretty irrelevant.

Many people who are on injections report needing to maintain levels well above the normal range to feel well.

Injections make interpretting B12 results even more difficult because they actually raise serum B12 levels way outside the normal range and then it falls over time but how quickly it falls varies considerably and I don't think there is a meaningful level to aim for if you are on injections as a result.

The BCSH standards relating to cobalamin and folate disorders don't recommend retesting if someone is on injections - just continuing with injections and what you will see on here is that deciding the frequency, from a patients perspective is really about listening to symptoms and when they start to return.

I'm not sure where you are based but it sounds like you really need to try and get a medic to prescribe injections rather than trying to rely on tablets if you have neurological symptoms returning. Whilst high dose can be effective for some people with absorption problems it isn't effective for everyone and in any case it is going to be a slow process if you are already deficient and injections - like trying to fill a bath with a thimble when there is a perfectly good hose-pipe available.

Muef profile image
Muef

Thank you all. Let me be very honest and try to reply each one of you. Let me give u all some detailed background.

1. On 15th Dec 2014, woke up with a stiff neck which increased to light-headedness. Went to my gp, referred to ent, diagnosed to have bppv, given countless medicines and manouvers.. none helped much. Actually i always told docs that i dont have the tell tale signs of vertigo. It was just that i felt a bit dozed off and needed to focus more... never had the world spinning.

Anyway Things got better themselves..

2015: Referred to neurologist(s), had mris done, thankfully nothing found. Given relexants.. helped a bit..

2016 to 2017: One problem or the other more towards gastro.. kept going to doctors and had gazillion medicines. By this time, surely had developed anxiety especially health.... btw i have always been the anxious type. Gp advised blood work.

1. Uric Acid was way high 9.1 (3.5 to 7.0)

2. B12: 150

Put on injections and more meds (ua). Got a bit better but it was still there but by this time, my heath obsession had taken over and i had one problem or another. B 12 was 1400 by oct 2017. So injections stopped and told to monitor.. other problems but no tingling as yet.

2018: developed random tingling/cold pricks.. they are sporadic.. somtimes in leg.. another moment in scalp.. then in arms.. found impossible to sleep. Anxiety had touched the roof. Went to another gp.. did some blood work..

B12: 250 .. gp said.. its ok

UA: 8.5

Gp gave oral b12.. neurobion.. 200 mcg ...advised to consult a psychologist. Went to one.. tingling was still there.. she convinced me that i am not dying and after 10 15 sessions.. it was better and then resolved....

Then 2019.. was fairly fine.. little glitches

2020 : Covid times

2021:

Developed tingling.. same as before.. and the same feelings.. self started oral b12 1000mcg for the last 4 weeks.

Privately got tested for b12 3 days back: 380 after 4 weeks of b12 1000 mcg and multivitamin all round the covid time..

U.A: 8.3 (dont know why had stopped the med for this as i thought i will control through walk)

So this is my story for almost 8 years.... and now again, my mind is wandering.. if i have some serious shit...

Muef

Live in UAE

Indian Origin. Non Veg. Eat meat a lot.

Have IBS since teens

Take BP medicine since i was 27

Muef profile image
Muef in reply to Muef

Gambit62 . Sleepybunny Nackapan JanD236 JanD236

Please see my reply above

Muef profile image
Muef in reply to Muef

Btw, the problem pressing righ now is tingling.. all others have resolved

Akashrajput profile image
Akashrajput in reply to Muef

I'm an indian too with low b12 So low that the lab gave reading <83 below 83

The b12 level doesn't matter what matters is your symptoms u can have extremely high levels like 1000-2000 but if u have active symptoms then it's of no use on the other hand if u have recovered don't feel any symptoms like 1-2 will do like numbness or tingling they aren't that big of a deal and your levels are between 250-450 with all symptoms nearly gone u have won the fight but still as b12 is water soluble u will have to continue taking tablets like twice or thrice a weak just to make sure levels don't go down

Take care of yourself brother don't worry everything will be alright

Loads of love from Hindustan stay safe ❤️

Gambit62 profile image
Gambit62Administrator in reply to Muef

IBS could be consequence of PA and reduction in stomach acidity that results.curious as to the monitoring of UA - do you have gout? If so you might want to up your intake of folate rich foods and cut down on red meat. Has your doctor talked to you about diet at all?

The anxiety and the tingling are potential B12 deficiency issues.

If you were taken of injections because you had a test for IFAB and it came back negative then your doctor needs to be aware of the problems with insensitivity of IFAB test - positive is good evidence of PA - negative is a long way from ruling it out - gives false negatives about half the time.

This is a link to the BCSH standards for diagnosis and treatment of B12 and folate disorders

You could try encouraging your doctor to take a look at it to understand the limitations of tests that they are doing and improve their interpretation of the results.

onlinelibrary.wiley.com/doi...

and ask to go back onto injections.

Muef profile image
Muef in reply to Gambit62

Thanks for the reply. Actually i dont know why doctors here do not take b 12 seriously. He said levels of above 200 are generally ok.. but the more i read, the more i found this to be incorrect. Still i managed to convince him to do more tests and he has gotten my folate test and intrinsic body.. Folate rsult arrived today and is well within the normal range but intrinsic body factor results will come by 28th april...

Nevertheless as far as gout is concerned, i always had high ua.. though i did have heel pain but never a flare up of gout pain.. am on meds again... was wondering if high ua is related to these cold pricks i randomely feel all over the body..

These pricks certainly wreck My peace and triggers my anxiety and i find it extremely hard to get a good nights sleep.. only yesterday i as awake till 5 30 am

Feel quite helpless these days 😢

Purplegirl2 profile image
Purplegirl2

My neurologist said ideal b12 level is greater than 600, for optimal brain function.

Muef profile image
Muef in reply to Purplegirl2

Thats interesting.. any reason or research on this.

I also heard that in japan, the normal ranges is from 500 to 1300..

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