Pernicious Anaemia Society

Do I need injections more frequently

Totally stressed out! Had loading doses 7 wks ago left me with 1572 as a level, so 7wks on and my level is 310 I'm depleting at a average 160 a week, 5 wks to go and I fear I will be out of B12 again.

I'm still struggling and have felt no benefits, if I deplete so quickly how will one injection help?

I also have VitaminD deficiency and an Underactive thyroid :-(

Any advice greatfully received.......

2 Replies

Hi Susie,

It is possible, my serum B12 drops rapidly. I believe its because there is no storage of B12 and no recycling from bile with PA. It seems to be very different per person what is taken up and or stored, may depend on how much , if any, IF people still have... I inject cyano cobalamin B12 once every 10 days and hydroxocobalamin once every 2 months, but my serum B12 may just stay near the 300. If I inject less it drops, and I personally do not feel well when my serum B12 drops under the 300. Also things like folate def can make a difference to how well B12 is taken up, other B vitamins are also needed. . Anyway your best bet is to go back to GP and perhaps try to get this "Active B12" test done, including MMA and homocysteine if low, see:

I hope this helps,

Kind regards,



Hi Susie,

The fact of the matter is, you're not receiving regular enough injections. Most people require them atleast once a month and to be honest with you, most have to resort to self-injecting by getting a supply of B12 from a private doctor. It varies from person to person how often they require injections as that is dependent on homocysteine and folic acid levels, but most people notice their symptoms return after a month. The only thing you can do is push for more regular injections and make sure to take a daily supplement of folic acid (this is essential to convert the hydroxocobalamin you are given to methylcobalamin). The Active B12 test is great for peace of mind, but you already know you have B12 deficiency and the results of that test will not sway your GP at all, they only follow NHS guidelines. If you cannot convince your GP to give you more regular injections, the only alternative is going private, where you get your own supply of B12 and taught how to self-inject safely.

Best Wishes,



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