Warfarin and B12 injections?

[bookish]

Could anyone tell me if oral anticoagulation treatment has caused them any issues with B12 injections please? My father is on Warfarin for long-standing atrial fibrillation although I suspect that it was/is actually a B12 problem. He needs injections (family metabolism failure) but his doctor is uninterested and Dad can no longer remember enough to discuss it with him or us. May well have to try privately but little point if they refuse to do frequent injections due to the Warfarin. Needing both must be common enough, so I suspect that IM injections happen anyway, but any thoughts appreciated.

[Blearyeyed]

Studies show atrial fibrillation and other cardiac arrhythmias have a common link with vitamin B 12 deficiency and high homocysteine levels.Cardiac arrhythmias of different types often become worse or a triggered by vitamin B12 , Folate and other vitamin deficiencies.

As far as I know warfarin and B12 injections have no interaction and are safe to use by the same patient , although when injecting or taking an oral supplement for additional safety and better absorption for tablets you may want to leave 4-6 hours between taking an anticoagulant dose and a high dose vitamin , which is often better when using most supplements or iron.

If it appears that you have a family history of metabolic dysfunction, you may actually be better to at least have an introductory consultation with a private consultant whom specialises in B12 health issues and/ or metabolic syndromes.

In difficult cases , and areas of medicine that GPs or local Consultants aren't familiar with it saves a lot of time and misdiagnosis so it's worth the investment.

Consider looking on the PA society website for ones whom are recommended and also recognised by , or work in the NHS as well as privately.

It's worth travelling to get the right one .

You can get them to send a letter with treatment recommendations to your GP and a request to refer him on to a specialist nearer to home.

If it is a Familial issue you can also ask the Consultant to request that the GP sends your father and immediate family for Genetic testing on the NHS.

If it's possible, and they work in the NHS, you can always request if they will add you or your family on to their NHS book.

When it comes to dealing with B12 Deficiency in older patients or with various other long term health issues it's important to get as much professional advice and a proper diagnosis and treatment plan organised rather than just going down the self injection route without thorough testing.

Hope you get things sorted out for your father very soon , take care , Bee

[bookish in reply to Blearyeyed]

Thank you so much for your reply and kind words. I've already had the genetic testing that the NHS offer but that is limited and nothing useful was found. I had hoped that it would be, so that Dad would be looked at, but no luck. At least I'm now on injections. I'll look for a PA soc. list and see what can be arranged. Thanks again.

[HeartyGilly]

my AFib and B12 deficiency were diagnosed at the same time, so I am convinced they are linked. No problems with B12 injections and anticoagulants.

[bookish in reply to HeartyGilly]

Thank you. I too am sure there is a connection, given timing of appearance of other symptoms, but all treated as separate issues.

[Sailinglady]

Increased risk of bruising with the intramuscular injections whilst on anticoagulation. Might do better with a subcut injection. But not a complete contraindication to intramuscular injections. Otherwise, no problems that I'm aware of.

[bookish in reply to Sailinglady]

Thank you for that.

[Helliborous]

Hi bookish, I was diagnosed with paroxysmal AF just before a diagnosis of PA. I made the link and told my GP but she dismissed the theory, I knew they were connected as the the AF would start around 4 weeks following B12 injectinjection this was 15 years ago and I have taken warfarin since. I now do B12 injections weekly and my AF episodes are very very rare I now only have them if I have virus infections and I've experienced them following Covid injections . I take warfarin in the evening and always inject in the morning and have never had an issue

[bookish in reply to Helliborous]

That is really interesting and useful, thank you. Particularly the virus or injection reappearance - when I had covid my symptoms came back with a vengance, even though I upped my oral B12 as I knew it might be an issue. Best wishes

[HeartyGilly in reply to bookish]

If you have Pernicious Anaemia, oral B12 will not help, only injections work.

[bookish in reply to HeartyGilly]

That isn't always the case - some even with PA can get benefit from high dose oral alongside injections if they are unable to get adequate frequency for example. I don't have a PA diagnosis and high dose (increasing to vast) used to work both for me and Dad, although of course I have no way of knowing how much better injections would have worked if I'd be able to get them. Oral no longer seems to do much at all and I am getting injections at the moment.

[helvella]

Is there any mileage in considering whether he could change to one of the "modern" DOAC anticoagulants? Like Apixaban. Of course, there could be reasons that he cannot change.

It would at least avoid regular INR tests.

[bookish in reply to helvella]

Thanks for that. It was suggested a few months ago but ultimately decided against. Probably because the INR is the only measure of him actually remembering to take the medication.

[Sea-blue]

Hi Bookish, I’m on Apixipan oral anti coagulant . I still SI and have IM injections at my GP for PA. When I self inject and before the ones I get at the GP , I take my Apixipan after the injection. I did do an injection after a pill once . I bled a little more but nothing to be concerned about. Hope this helps

[bookish in reply to Sea-blue]

Thanks for your reply, which is very helpful. Best wishes