B12 and iron deficiency- symptoms returning during treatment

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?

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 

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.