Does regular B12 injections as frequent as EOD lower ferritin levels?

[WorkingProgress]

Is this true or another erroneous facebook forum statement?

Here is the statement:-

B12 will deplete ferritin/iron not raise it.

In very simple terms b12 makes new red blood cells which in turn requires a lot of iron.

Ferritin is kinda your body's store cupboard for iron and any time your body requires a lot more iron than normal it will then dip into that store cupboard.

So the more b12 you have the faster you make new/more red blood cells = more than normal iron used = ferritin levels dropping"

[Foggyme Administrator]

So…Facebook groups again… 🤷‍♀️🤦‍♀️

Here’s the thing - briefly and simplisticly - about ferritin…

1. It is used in the production of red blood cells

2. If megoblastic anaemia (large red blood cells) are present at diagnosis of B12 deficiency, red cell production is increased via treatment with B12 (to 'fix' the over large blood cells by replacing with newly made ones (but not everybody has megoblastic anaemia with B12 deficiency - most people don’t)

3. Ferritin levels may drop slightly (mostly in the first 4 weeks) when B12 treatment commences (but only if megoblastic anaemia is present and the over- large red cells need replacing - ergo, increased red cell production ). An associated small drop in ferritin levels can usually be rectified by increasing iron in the diet

4. Vitamin B12 injections per se do not increase the need for supplementation with iron.

5. Iron supplementation should only be done on advice from a qualified medical practitioner, where a proven iron deficiency exists.

6. Over supplementation with iron can be very dangerous - causes something called iron overload (excess iron 'bleeds out` (for want of a better way of putting it) and can lodge in organs etc)

Here's some information…

onlinelibrary.wiley.com/doi...

Where B12 deficiency is caused by an absorption problem, it’s not unusual to get other deficiencies, vitamin D, folate and iron being the biggest culprits. Levels of these can be tested by a GP, who can prescribe accordingly if deficiencies are identified.

So…in short…the Facebook advice to take iron just because one is having B12 injections (however frequent) is not appropriate.

Iron - and the way the body uses it - is very complex and ferritin levels alone are a poor indicator of iron status (a full iron panel gives a clearer picture). If iron deficiency anaemia is diagnosed, investigations should ensue to identity the cause (absorption issues or short term dip due to rectifying megoblastic anaemia are not the only potential causes - there are many others too - and these need ruling out (or in, as the case may be).

Facebook 🤷‍♀️🤦‍♀️😬.

[Frodo in reply to Foggyme]

"...the Facebook advice to take iron just because one is having B12 injections (however frequent) is not appropriate."

I don't think that's what is being said, I don't think anyone is being advised to take iron. I think it sounds like a reply to a question about whether having B12 treatment will raise iron levels (some people hear the word 'anaemia' in Pernicious Anaemia and get confused). The person replying is confirming that treating B12 will not raise iron levels, but rather, as you say yourself: "Ferritin levels may drop slightly (mostly in the first 4 weeks) when B12 treatment commences..."

Your explanation is really good though, and makes things very clear.

😊

[Curlygal in reply to Foggyme]

What investigations should be carried out if iron deficiency anaemia is diagnosed?

[Nackapan]

Only if you have megobalastic/anaemia as well it seems.My daughters levels were deplete before b12 treatment started . Of iron folate and vit d alongside b12 deficiency.

Shd hac thd enlarged blood cell anaemia.

Not everyone does.

I didn't. However s few months in my ferritin levels did drop. Enough to causes extra symotknd tk get it tested.

Before treatment commenced fortin wax 68.

B12 106

Tge ferritin was 29.

First time I've ever been prescribed iron.

So it does happen.

So an odd one with blood test results.

Other explanations cd be ferritin raises with inflammation.

I had high inflammatory markers at the time of that 68 reading.

Of an absorbtion problem comes later?? later ??

Of sknd is used in healing??

With me if was vit d plummeting first

So I imagine that's where confusing happens.

Yoh certainly must only take iron prescribed unless tiny amounts in a multivit.