Vitamin B12 injections-how long for improvement

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Hi all.

6 months ago I went to my GP complaining of severe tiredness, poor balance, headaches and tingling in hands and feet. A blood test showed a vit B12 deficiency. My Dr prescribed B12 injections once a month for three months. After three months my blood was tested again and it showed that the levels were still not raised enough so I have been continuing with injections every month. I am wondering if it is normal that I still get symptoms a week before each injection is due, and is it unusual that the levels have not risen much?


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  • Posted

    Hi there, sorry to hear you are only getting monthly injections. Usually, we are given six injections over a two week period. This is then followed up with a blood test and we go onto three monthly injections. The six are known as loading doses, and we often need a strong concentration at the start of treatment. I suggest you explain to your Doctor that the symptoms are returning before each injection, and see if he'll consider increasing the frequency of your injections. As your levels are failing to rise he must be wondering why his approach isn't working. Best wishes Marion
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  • Posted

    If you are in the uk then you have had wrong b12 treatment. You should have had alternate day injections until no further improvement as set out in the BNF and BCSH cobalamin guidelines. Folate levels are very important during b12 treatment as the b12 uses folate to be able to transfer to your cells and nerves to do repair. Ask for folate and ferritin results. Also ask for alternate day loading injections. Aim for your folate to be between 15-20 for a good uptake. Once b12 has metabolised to your cells the body uses ferritin (iron store) to produce new blood cells. Ferritin is very important too.
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  • Posted

    hi Caoilanna. think Marion & Heather has given all the important info.. all i'd add to this is, coz you've not had your b12 reserves in the Liver restocked by the 6 initial ''loading doses'' of b12, your body is using the b12 quicker that it's replinished by the monthly jabs. you certainly should have had, at the very least, the 6 loading doses. perhaps bringing this to Docs attention & emphasising your debilitating symptoms might nudge him/her on to script it for you.

    all good luck


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  • Posted

    Hi, you should really have had loading injections to start with - 6 over 2 weeks if you don't have neurological symptoms and if you do, they are meant to continue the injections until these symptoms subside. After the loading injections you are then put onto maintenance of one every 12 weeks or 8 weeks.

    Have you been tested for Intrinsic factor? There is a high incidence of false negatives though - positive means you have pernicious anaemia.

    Can I suggest you read up as much as you can- Dr's rarely know a great deal about B12d/PA !

    You may also feel worse first as your body heals, everyone is different.

    Ensure you take a good active B complex - I hope your ferritin and folate were checked? You need to ensure you have plenty of both or the B12 won't be able to work properly. Your vit D should also be checked.

    Read the NICE guidelines for a start and the book Could it be B12 - available easily on kindle. Look at PAS website and the healthunblocked forum. 😀

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  • Posted

    hello, i have celliac and crohn colitis which has led to the pernicious anemia and have to have shots every two weeks, plus i have to take an oral supplement daily for the rest of my life. usually a week up to 4 days before my next shot i can tell when the levels are low.  so it is possible to feel the usual symptoms before you are do for a shot. also found out that stress, alcohol, illness and certain medicines taken while on shots can lower your levels. these are thing to check into and make sure that you dont have another problem going with other parts of your system.

    hope this helps some.

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    • Posted

      indeed, this corroborates the subjectivity with which each person responds to b12. each of us use & need different amounts & frequency of replenishing intervals according to our body's individual needs. the 2-3 monthly intervals is too much of a 'blanket' approach to meet individual needs.


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