B12 Injection dose

[Spick]

Hi All,

I have been on B12 3 monthly injections for years recently they don't seem to lasting and getting side effects

Spoke to the practice pharmacy nurse who said she would ask the Doctor for me to have a blood test before my next injection? Two months ago heard nothing.

My question/help is are there different strengths of the injection I can ask to be given ?

[Jillymo]

Hi Spick,

Why did they retest your B12 when you have been on injections for years ? It is common sense your levels would be high . This is the reason why it states in the guidelines no need to recheck........ nice.org.uk/guidance/ng239/....

As far as I am aware B12 injections come in 1000mcg but dont quote me on that one. I would chase them up to see what is going on and if withdrawn because of high levels point out the new guidelines. Good luck

[Spick in reply to Jillymo]

Hi Jillymo,

Thank you for your reply.

I may have not put the question in the correct sense. My injections have not been stopped

Good news

I am having a blood test 1 month before my next B12 injection also a urine test

Thanks

[Jillymo in reply to Spick]

H Spick,

Maybe your in need of more frequent injections if your symptoms are returning. I am always dubious of having a B12 blood test once treatment has started because levels will be high and it gives them an opportunity to withdraw your injections.

All the best.

[Clare184]

Were 3 monthly working for you before? If not you may need more frequent injections, if you have neurological symptoms you can ask the doctor to do 8 weekly instead. Unlikely to find a doctor willing to do more than that sadly hence why so many self inject. There is only one strength as far as I know, the trouble is we don't keep b12 in our bodies as it's water soluble so any not used quickly is excreted out in urine. So most of us need way more frequent top ups to stay well.

If 3 monthly was working for you then it may be cofactors that are low. Things like iron and folate being low can impact b12 absorbtion and cause other anemia too.

[Spick in reply to Clare184]

Hi Clare184

Thank you for your response

Good news

I am having a blood test 1 month before my next B12 injection also a urine test

Thanks

[Narwhal10]

Hi Spick,

It’s all 1 mg/ml of Hydroxycobalamin intramuscular injection. That’s more or less how it is documented on drug charts and computer system. Although there would be abbreviations.

Now, the fun bit. A higher dose with this medication does not last longer. Medics do not understand how it is ‘metabolised.’ We excrete excess via the renal system and urine.

Often, I use the phrase, We do what we have to.

I noted your medical history and I am very sorry to learn. This is the easiest medical article I could find :-

ahajournals.org/doi/full/10...

Now there is a chemical called Homocysteine and when levels get too high there is an increased risk of stroke. So, it may be worth discussing with your doctor that B12, B6 and folate break that Homocysteine down. Could they consider an increase in frequency of injections because :-

1) They are not lasting.

2) You have already had 1 stroke.

Best wishes.

[Spick in reply to Narwhal10]

Hi , Narwhal10

Thanks for the reply and information

Good news

I am having a blood test 1 month before my next B12 injection also a urine test

Thanks

[Sleepybunny]

Hi,

Have you read the new NICE B12 deficiency guideline published March 6th 2024?

nice.org.uk/guidance/ng239

Articles about Testing B12 during treatment

pernicious-anaemia-society....

stichtingb12tekort.nl/engli...

I left a detailed reply on this recent thread that might have some useful info.

healthunlocked.com/pasoc/po...

I'm not medically trained.

[Spick in reply to Sleepybunny]

Hi Sleepybunny,

Thank you for all the information and links

Good news

I am having a blood test 1 month before my next B12 injection also a urine test

Thanks

[am111]

Your absorption seems to have gone down. I believe more B12 is needed when the absorption decreases as the re-absorption of the bile B12 from the gut decreases leading to more loss of B12.

You need more frequent injections...

[Spick in reply to am111]

Hi am111

Thanks for your valued response.

Good news

I am having a blood test 1 month before my next B12 injection also a urine test

Thanks

[OldmanD]

Very few people can get by on 3 monthly jabs forever unless they want to put up with being exhausted plus other symptoms. . . .

[Spick in reply to OldmanD]

Hi Oldman D

Thanks for your valued response.

Exhaustion is the worst of my side effects my injections last 7-8 weeks

[OldmanD in reply to Spick]

Inn one way you are lucky but on the other you suffer for 4 weeks and probably a little more while it creeps in on you . . . . . . . I hope you get more help

[Spick in reply to OldmanD]

I am having a blood test 1 month before my next B12 injection also a urine test

Thanks