B12 and iron deficiency- symptoms returning during treatment

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About 4 weeks ago I was diagnosed with B12 and Iron deficiency. I'm on a course of weekly injections for 5 weeks and iron tablets. I've had 3 injections do far. I was starting to feel a little better .... Until I got my period! I'm exhausted again with dizziness and eyesight is affected again. Like i felt before treatment. My period has finished 2 days ago and I'm feeling no better. It's so disheartening. Is this normal as I'm on treatment so should be feeling better!! Help!

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  • Posted

    I was diagnosed 6 wks ago after months of Drs appointments. Have been on and off iron for several mths then the vitamin b12 diagnoses Received my 6 injections but actually feel worse!! My legs are like lead weights and feet feel numb, the stairs are a daily struggle Returned to Dr yesterday to ask about more injections to be told NO!! Muscle enzyme tests required and blood sugars - hope it's the vit b12!! Do u take any supplements? Any other medical problems?

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    • Posted

      Hi! Yes I'm also T2 diabetic. Metformin may be the cause of the deficiency in the first place. Only on iron which in finished in few days so not sure what I need to do following that!

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    • Posted

      Treatment of cobalamin deficiency should be as follows:

      "Current clinical practice within the U.K is to treat cobalamin deficiency with hydroxocobalamin in the intramuscular form outlined in the British National Formulary, BNF, 

      Standard initial therapy for patients without neurological involvement is 1000 µg intramuscularly (i.m.) three times a week for two weeks. 

      The BNF advises that patients presenting with neurological symptomsshould receive 1000 µg i.m. on alternative days until there is no further improvement.

      However, the GWG recommends a pragmatic approach in patients with neurological symptoms by reviewing the need for continuation of alternative day therapy after three weeks of treatment"You don't say if you know why you are deficient as there are many and varied causes."

      Your doctor should be treating your symptoms not looking at his computer screen.

      This makes me so mad....mad

       

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    • Posted

      Sorry - I hadn't seen this when I posted the list earlier.  

      Yes! Metformin does suppress B12 absorption.  I am also type 2 diabetic but as I've had P.A. for 45 years and receive B12 injections I don't think the Metformin is an issue with me as it wouid be with you.

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  • Posted

    Are you in the UK? Standard treatment here is six injections over two weeks to begin with, this is called a " loading dose". Then you would go onto a different regime, depending on your symptoms and if there are neurological symptoms. If you have a look at the Pernicious Anaemia Society website you will find a full symptom list and more detailed information about current recommendations.

    Often symptoms do worsen at the start of treatment, because we have been low for such a long time. I have heard it compared to a radio,the volume turned high to get a very weak signal. Suddenly all this B12 is there and our bodies need to reduce the "volume", all our cells are being flooded with what they need! So it does take a while for it to balance out. Marion 

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    • Posted

      Yes I'm in uk and the doctor only advised a course of 5 injections on weekly basis and then 1 every 3 months. I am also diabetic so it seems metformin may be the cause. I'm awaiting blood results for IF. I guess it's a long road.... One step forward and 2 steps back!!! The exhaustion is mental and even to get off the couch sends my heart racing!!!

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    • Posted

      It is helpful to take a good B Complex multivitamin to keep all the 'B' s in balance. The total exhaustion is truly awful, I hope things will begin to pick up for you soon. It does take time though. Your levels have probably been falling over a few years, and yes, the metformin is a cause of depleted B12. 

      Other causes are digestive issues, stomach surgery, the anaesthetic from surgery, vegetarian and a vegan diet. Good luck with feeling better.

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  • Posted

    I am not a medically qualified person and only a "mere male" but can say that it is not unusual for things to seemingly get worse before they get better when starting B12 injections.

    I'm somewhat surprised at the frequency of your injections as Treatment of cobalamin deficiency should be as follows:

    "Current clinical practice within the U.K is to treat cobalamin deficiency with hydroxocobalamin in the intramuscular form outlined in the British National Formulary, BNF, 

    Standard initial therapy for patients without neurological involvement is 1000 µg intramuscularly (i.m.) three times a week for two weeks. 

    The BNF advises that patients presenting with neurological symptoms should receive 1000 µg i.m. on alternative days until there is no further improvement.

    However, the GWG recommends a pragmatic approach in patients with neurological symptoms by reviewing the need for continuation of alternative day therapy after three weeks of treatment"You don't say if you know why you are deficient as there are many and varied causes.

    There is a list showing:-

    Who’s at greatest risk for B12 Deficiency?

    Anyone at any age, can become B12 deficient. Thus you need to be tested immediately if you develop the symptoms described  in this chapter. However, certain people are at an elevated risk. They include the following:

    Vegetarians, vegans and people eating macrobiotic diets.

    People aged sixty and over

    People who’ve undergone any gastric and/or intestinal surgery, including bariatric surgery for weight loss purposes (Gastric bypass).

    People who regularly use proton-pump- inhibitors. H2 blockers, antacids, Metformin, and related diabetes drugs, or other medications that can interfere with B12 absorption.

    People who undergo surgeries or dental procedures involving nitrous oxide, or who use the drug recreationally.

    People with a history of eating disorders (anorexia or bulimia).

    People with a history of alcoholism.

    People with a family history of pernicious anaemia.

    People diagnosed with anaemia (including iron deficiency anaemia, sickle cell anaemia and thalassaemia).

    People with Crohn’s disease, irritable bowel syndrome, gluten enteropathy (celiac disease), or any other disease that cause malabsorption of nutrients.

    People with autoimmune disorders (especially thyroid disorders such as Hashimoto’s thyroiditis and Grave’s disease) Type 1 diabetes, vitiligo, lupus, Addison’s disease, ulcerative colitis, infertility, acquired agammaglobulinemia, or a family history of these disorders.

    Women with a history of infertility or multiple miscarriages.

    Infants born to and/or breast fed by women who are symptomatic or are at risk for B12 deficiency."Can you identufy yourself in any of the above?  In addition, I believe the contraceptive Pill, stress and extreme exercise can also deplete (or use up) B12.

    I think you need to list and diarise your symptons and present these to your doctor (preferably with a friend who can vouch for your having them) and suggest more frequent injections as per the BNF guidelines.

    I wish you well.

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    • Posted

      Thank you for all of the info. I initially went to my doctor with all of the symptoms I was experiencing and he only focused on one and didn't seem to care after that. I don't know much about any of this so I assumed he was treating me correctly with the injection frequency but apparently not. It's so hard being too tired to have a life and a lot people who don't have the condition don't seem to understand the extent of it. Frustrating!

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