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Pernicious Anaemia Society

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high levels of B12 in blood

Countrylou profile image
12 Replies

I have been self injecting B12 for around 4 years. I am prescribed 3 monthly by my GP and supplement with injections bought on-line from Germany.

It was trial and error with regards to dosing. I inject every 2 weeks and the reason for this is peripheral neuropathy in my feet (mainly at night) and migraine headaches.

I went to see my GP to ask him if he would prescribe monthly (I didn't tell him I was injecting fortnightly) as I am struggling to purchase the vials now we are post Brexit (I live in the UK). He asked me to have a blood test which I said would be pointless as my levels would be high ( >150 pmol>L on the last test) He then said in all his career (35 years) he had never prescribed more than 3 monthly.

He did agree to refer me to a neurologist for the nerve damage but the neurologist wrote back to my GP and told him, if I'm deficient in B12 he can prescribe more.

Following this I left it 3 weeks before injecting to see if I could manage but I had a bad headache for 10 days running and the neuropathy in my feet was insane!

So basically I'm back to square one! I know this is a common problem but when I spoke to my GP again, he agreed that if I could find some quality research (presumably peer reviewed etc) he would consider it.

Does anyone know of any such research which determines that high B12 is harmless and also that it is needed for nerve damage?

Thank you so much

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Countrylou
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12 Replies
Jillymo profile image
Jillymo

I managed with a battle to persuade my Gp to give every 2 mnths but she refused to give more frequent. You are very lucky to have a neurologist with insight of the condition where as mine simply labelled me with functional neurological disorder, he refused to listen to my B12 symptoms. Google for information on the treatment for the neurological symptoms. I am sure others will have some info at hand.

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

There has been a lot of changes within guide lines with regard to patients who have suffered long term damage and neuropathy but I did stuble across this. nhs.uk/conditions/vitamin-b...

nhs.uk/conditions/periphera...

Thrones12 profile image
Thrones12

Hi there I spoke to a young gp I know about my chronic migraines,I was supposed to have injections at an oxford clinic for them but I was more interested in why I was having them and chickened out.My young private gp showed me onscreen that the first line treatment now for migraine recommended by NICE is vitamin b2 so having nothing to lose I tried it. It worked a treat have a google and find out some more info on it but I highly recommend.

Best of luck x

ACritical121 profile image
ACritical121 in reply to Thrones12

MY NEUROLOGIST PUT ME ON ALL VITAMIN B'S AS I WAS DEFICIENT IN ALL B12 HYDROXOCOBALAMIN INJECTIONS EVERY OTHER DAY UNTIL NO FURTHER IMPROVEMENTS THEN MONTHLY OR MORE FREQUENTLY WHEN NEEDED. WORKED A TREAT, THE MIGRAINES WERE THE FIRST SYMPTOMS TO BE REMEDIED. ALL THE OTHERS TOOKA LOT LONGER AND SOME NEVER IMPROVED.

Sleepybunny profile image
Sleepybunny

Hi,

Hopefully there might be something useful in these links.

Misconceptions (wrong ideas) about B12 deficiency

I think this next article would be a good one to pass onto GP.

B12 article from Mayo Clinic in US

The Many Faces of Cobalamin (Vitamin B12) Deficiency

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

Table 1 in above article is about frequent misconceptions about B12 deficiency that health professionals may have.

Misconceptions about a B12 deficiency

(From Dutch B12 website - units, ref ranges, treatment patterns may vary from UK)

stichtingb12tekort.nl/engli...

Diagnosis and Treatment Pitfalls

(From B12 Institute in Netherlands - units, ref ranges, treatment patterns may vary from UK)

b12-institute.nl/en/diagnos...

UK treatment for B12 deficiency

(Check the treatment pattern for those with "neurological involvement" in link below as my understanding is that you should be on this.)

Management of B12 deficiency - NICE CKS

cks.nice.org.uk/topics/anae...

Hydroxocobalamin - BNF (British National Formulary)

Click "Indications and doses" then "For hydroxocobalamin"

bnf.nice.org.uk/drugs/hydro...

Local B12 deficiency Guidelines

If you haven't already, find the local B12 deficiency guidelines for your ICB (Integrated Care Board) or Health Board.

List of ICBs in England

nhs.uk/nhs-services/find-yo...

If you can't find them online or by searching forum posts here, best bet is to submit a FOI request to ICB/Health Board asking which B12 deficiency guidelines are used locally and for a link to or copy of them.

Some GPs are unwilling to prescribe extra B12 injections if that is not mentioned in local guidelines.

Some local B12 deficiency guidelines are unhelpful...see blog post below.

They can also get reviewed unexpectedly so keep an eye on your local guidelines.

b12deficiency.info/gloucest...

Unhappy with Treatment (UK info)?

How to write letters to GPs about B12 deficiency

b12deficiency.info/b12-writ...

Point 1 in above link is about being under treated for B12 deficiency with neuro symptoms present.

Vital to get adequate treatment. There have been forum members who developed spinal cord damage from delayed or inadequate treatment.

You may want to discuss with GPs, in any letters or conversations, the increased risk of developing SACD (sub acute combined degeneration of the spinal cord) if under treated.

PAS article about SACD, sub acute combined degeneration of the spinal cord

pernicious-anaemia-society....

You would need to be a PAS member to access full article.

pernicious-anaemia-society....

PAS website has lots of useful articles and a page for health professionals that your GP might find interesting.

Blog post from Martyn Hooper's blog, mentions SACD

martynhooper.com/2010/09/21...

Has your GP got a copy of all your symptoms, especially every neuro symptom and definitely any that affect spinal area?

Symptoms of B12 Deficiency (folate deficiency also mentioned)

I used PAS list below and added extra symptoms at bottom of list.

pernicious-anaemia-society....

b12deficiency.info/signs-an...

cks.nice.org.uk/topics/anae...

b12-institute.nl/en/symptom... (from B12 Institute Netherlands)

Symptoms of Peripheral Neuropathy (damage to peripheral nerves)

nhs.uk/conditions/periphera...

Peripheral neuropathy can be associated with B12 deficiency and sometimes with folate deficiency.

Other articles that might be useful

Treatment with high dose vitamin B12 been shown to be safe for more than 50 years

stichtingb12tekort.nl/engli...

BSH Cobalamin and Folate Guidelines (published 2014)

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

NICE CKS (Clinical Knowledge Summary) B12 deficiency and Folate deficiency

cks.nice.org.uk/topics/anae...

New NICE guidelines for PA and B12 deficiency will be published in November 2023.

Link to draft document

nice.org.uk/guidance/indeve...

If you click on "project documents" then on "consultation comments and responses" it gives a good insight into current issues around diagnosis and treatment.

Club B12

Here's a website that your GP might find useful.

Club B12 is a group of researchers and other interested people who share knowledge and research into B12.

club-12.org/

Links to forum threads where I left detailed replies with lots of B12 deficiency info eg causes and symptoms, more UK B12 documents, B12 books, B12 websites and B12 articles and a few hints on dealing with unhelpful GPs.

Some links may have details that could be upsetting.

Some of the info will be specific to UK.

healthunlocked.com/pasoc/po...

healthunlocked.com/pasoc/po...

healthunlocked.com/pasoc/po...

Thread about Patient Safety, has useful links for those having difficult health experiences

healthunlocked.com/pasoc/po...

I'm not a health professional, just someone who suffered for years from unrecognised and untreated B12 deficiency.

Countrylou profile image
Countrylou in reply to Sleepybunny

brilliant, thank you

Technoid profile image
Technoid in reply to Countrylou

Countrylou just to draw your attention to the link in SleepyBunnys post

stichtingb12tekort.nl/engli...

which specifically addresses the question of proven safety of high dose b12.

CarlaEP profile image
CarlaEP

you can buy B12 from Ampavit.com

Gwyn25 profile image
Gwyn25

I struggle with tiredness, constant viruses and general poor health. Often wondered if my B12 levels are responsible for this. Never asked for more but obviously would get same answer. Would like to know if b12 supplements eg tablets would be absorbed?

FabiMckay profile image
FabiMckay

Have you ever tried taking TMJ BETAINE ANHYDROUS ? It was the only way for to me to get better. I take now TMJ, a under the tongue dissolvable B12 ever day, and my homocysteine is lower so is my neuropathy. The amount of B12 in blood is still high but I do not have much problems anymore. Fix your gut too! For the iron deficiency I started taking Vit C infusions and my iron went up. I do take iron few times a week too.

Good Luck

Countrylou profile image
Countrylou in reply to FabiMckay

thank you I will look into that, I've never heard of it

Technoid profile image
Technoid in reply to Countrylou

TMG/Betaine. The TMG stands for Trimethylglycine. It recycles homocysteine to methionine in a metabolic pathway that works independently from B12/folate. Can be a useful supplement for B12-deficient patients to help to to bring down homocysteine more quickly.

Mizuzfritz profile image
Mizuzfritz

There is a book by a Dr on b12d.org and also check out the book "Could It be B12?" By Pachlock, Sally M , RN, BSN and Jefferey J Stuart, DO.

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