Macrocytic anemia returned

[etreas]

Hi all, I’m interested to hear about your experiences with different forms of B12 injections to see if you’ve find some forms ineffective compared to others. For some background, I found out I had macrocytic anemia due to B12 deficiency around 2016 and have been injecting monthly or so ever since. I had been feeling decent until recently, and my recent bloodwork showed the macrocytic anemia has returned (high MCV, low RBC, low hemoglobin, low hematocrit). The only thing different is that I switched from hydroxycobalamin to methylcobalamin maybe 6-9 months ago. Could it be that I’m unresponsive to methyl, or could my physiology have changed such that I just need more frequent injections for some reason? Thanks in advance for your advice!

[Nackapan]

If that's the only change .Change back to hydroxcobalamin.

Was your folate , iron and ferritin level okay ?

My friend in Canada tried all injectable forms.

For her cyanocobalamin suited best and more available and cheaper there .

Ive stuck with hydroxcobalamin so no personal experience

[Jillymo]

From what I have read hydroxycobalamin is favoured for the treatment of Macrocytic anemia. I seem to fair better on hydroxy than the methyl. Just a sugestion but you might find going back onto the hydroxy but doing another loading dose might help with the unwanted symptoms.

We are all so very different and what suits one doesn't seem to suit another.

It's all trial and error. 😘

[etreas]

Thank you Nackapan and Jillymo for your helpful replies! My doc ordered B12 and folate, which I assumed would be useless since I've been injecting monthly since 2016, and my B12 has been well above range (>2000) since starting injections. To my surprise, it was around 500 pg/mL which is "normal" but by far the lowest since I started injecting. I suspect the drastic drop is because I switch to methyl from hydroxo, and therefore requested a hydroxo prescription from my doc. He wasn't familiar enough with B12 deficiency to feel comfortable prescribing (fair enough) so I'm back to self-diagnosing, self-prescribing, and self-medicating (with hydroxo ampules from Germany). Hoping the hydroxocobalamin helps. Interestingly, I also noticed a continuous downward trend in my ferritin over the past several years, despite daily iron supplements. I understand low iron should lead to microcytic anemia (not macrocytic), but I'm also going to increase my iron supplements just in case it's additionally contributing to the low RBC/hemoglobin. If anyone has other suggestions, insights, I welcome your input!