What do all of these chronic diseases have in common?
- Alzheimer’s, dementia, cognitive decline, and memory loss (collectively referred to as “aging”)
- Multiple sclerosis (MS) and other neurological disorders
- Mental illnesses like depression, anxiety, bipolar disorder, and psychosis
- Cardiovascular disease
- Learning or developmental disorders in kids
- Autism spectrum disorder
- Autoimmune disease and immune dysregulation
- Cancer
- Male and female infertility
Answer: Their signs and symptoms can all be mimicked by a vitamin B12 deficiency.
An Invisible Epidemic
B12 deficiency isn’t a bizarre, mysterious disease. It’s written about in every medical textbook, and its causes and effects are well-established in the scientific literature.
However, the condition is far more common than most healthcare practitioners and the general public realize. Data from a Tufts University study suggests that 40 percent of people between the ages of 26 and 83 have plasma B12 levels in the low normal range—a range at which many experience neurological symptoms. Nine percent had an outright nutrient deficiency, and 16 percent exhibited “near deficiency.” Most surprising to the researchers was the fact that low B12 levels were as common in younger people as they were in the elderly. (1)
That said, this type of deficiency has been estimated to affect about 40 percent of people over 60 years of age. It’s entirely possible that at least some of the symptoms we attribute to “normal” aging—such as memory loss, cognitive decline, and decreased mobility—are at least in part caused by a deficiency.
Why Is It Underdiagnosed?
This is why most studies underestimate true levels of deficiency. Many deficient people have so-called “normal” levels of B12.
Yet, it is well-established in the scientific literature that people with B12 levels between 200 pg/mL and 350 pg/mL—levels considered “normal” in the U.S.—have clear vitamin deficiency symptoms. (2) Experts who specialize in the diagnosis and treatment of a deficiency, like Sally Pacholok, R.N., and Jeffrey Stuart, D.O., suggest treating all patients that are symptomatic and have B12 levels less than 450 pg/mL. (3) They also recommend treating patients who show normal B12 levels but also have elevated urinary methylmalonic acid (MMA), homocysteine, or holotranscobalamin, which are other markers of a deficiency in vitamin B12.
B12 deficiency can mimic the signs of Alzheimer’s, dementia, multiple sclerosis, and several mental illnesses. Find out what this vitamin does and learn how to treat a deficiency. #B12 #B12deficiency #cognitivedecline
In Japan and Europe, the lower limit for B12 is between 500 and 550 pg/mL. Those levels are associated with psychological and behavioral symptoms, such as:
- Cognitive decline
- Dementia
- Memory loss (4)
Some experts have speculated that the acceptance of higher levels as normal in Japan and the willingness to treat levels considered “normal” in the U.S. explain the low rates of Alzheimer’s and dementia in that country.
What Is Vitamin B12 and Why Do You Need It?
Vitamin B12 works together with folate in the synthesis of DNA and red blood cells. It’s also involved in the production of the myelin sheath around the nerves and the conduction of nerve impulses. You can think of the brain and the nervous system as a big tangle of wires. Myelin is the insulation that protects those wires and helps them to conduct messages.
Severe B12 deficiency in conditions like pernicious anemia (an autoimmune condition where the body destroys intrinsic factor, a protein necessary for the absorption of the vitamin) used to be fatal until scientists figured out death could be prevented by feeding patients raw liver, which contains high amounts of B12. But anemia is the final stage of a deficiency. Long before anemia sets in, deficient patients will experience several other problems, including fatigue, lethargy, weakness, memory loss, and neurological and psychiatric problems.
The Stages of a Deficiency
B12 deficiency occurs in four stages, beginning with declining blood levels of the vitamin (stage I), progressing to low cellular concentrations of the vitamin (stage II), an increased blood level of homocysteine and a decreased rate of DNA synthesis (stage III), and finally, macrocytic anemia (stage IV). (5)
Common B12 Deficiency Symptoms
The signs can look like the symptoms of several other serious disorders, and the neurological effects of low B12 can be especially troubling.
Here are some of the most common vitamin B12 deficiency symptoms:
- Tingling or numbness in the hands and feet
- Brain fog, confusion, and memory problems
- Depression
- Premature aging
- Cognitive decline
- Anemia
- Weakness
- Fatigue
- Reduced appetite and weight loss
- Constipation
- Trouble balancing (6)
Children can also show symptoms, including developmental issues and learning disabilities if their B12 levels are too low.
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Why Is It So Common?
The absorption of B12 is complex and involves several steps—any of which can go wrong. Any of the following can cause B12 malabsorption:
- Intestinal dysbiosis
- Leaky gut and gut inflammation
- Atrophic gastritis or hypochlorhydria, or low stomach acid
- Pernicious anemia
- Medications, especially proton pump inhibitors (PPIs) and other acid-suppressing drugs
- Alcohol
- Exposure to nitrous oxide, during either surgery or recreational use
This explains why a deficiency can occur even in people eating large amounts of B12-containing animal products. In fact, many of my patients that are B12 deficient are following a Paleo diet where they eat meat two or three times daily.
Who Is at Risk for a Deficiency?
In general, the following groups are at greatest risk for a deficiency:
- Vegetarians and vegans
- People aged 60 or over
- People who regularly use PPIs or acid-suppressing drugs
- People on diabetes drugs like metformin
- People with Crohn’s disease, ulcerative colitis, celiac, or IBS
- Women with a history of infertility and miscarriage
Note to Vegetarians and Vegans: B12 Is Found Only in Animal Products
You cannot get B12 from plant-based sources. This vitamin is only found in animal products. That’s why vegetarians and vegans need to know the signs of deficiency—and the steps necessary to fix the problem.
A common myth among vegetarians and vegans is that it’s possible to get B12 from plant sources like:
- Fermented soy
- Spirulina
- Brewers yeast
However, plant foods said to contain B12 actually contain B12 analogs called cobamides that block the intake of and increase the need for true B12. (7) That explains why studies consistently demonstrate that up to 50 percent of long-term vegetarians and 80 percent of vegans are deficient in B12. (8, 9)
Seaweed is another commonly cited plant source of B12, but this idea is controversial. Research indicates that there may be important differences in dried versus raw purple nori; namely, raw nori may be a good source of B12, while dried nori may not be. One study indicated that the drying process used for seaweed creates B12 analogs, making it a poor source of the vitamin, while animal research suggests that dried nori can correct a B12 deficiency. (10, 11) Seaweed may provide B12, but it’s not clear if those benefits are negated when that seaweed is dried. I recommend caution for that reason.
The Impact of a Deficiency on Children
The effects of B12 deficiency on kids are especially alarming. Studies have shown that kids raised until age six on a vegan diet are still B12 deficient even years after they start eating at least some animal products. In one study, the researchers found an association between a child’s B12 status and their performance on testing measuring:
- Spatial ability
- Fluid intelligence
- Short-term memory
Researchers found that formerly vegan children scored lower than their omnivorous counterparts in each area. (12)
The deficit in fluid intelligence is particularly troubling, the researchers said, because this area impacts a child’s ability to reason, work through complex problems, learn, and engage in abstract thinking. Defects in any of these areas could have long-term consequences for kids.
I recognize that there are many reasons why people choose to eat the way they do, and I respect people’s right to make their own choices. I also know that, like all parents, vegetarians and vegans want the best for their children. This is why it’s absolutely crucial for those that abstain from animal products to understand that there are no plant sources of B12 and that all vegans and most vegetarians should supplement with B12.
This is especially important for vegetarian or vegan children or pregnant women, whose need for B12 is even greater. If you’re not willing to take a dietary supplement, it may be time to think twice about your vegetarian or vegan diet.
How to Treat a Deficiency
One of the greatest tragedies of the B12 epidemic is that diagnosis and treatment are relatively easy and cheap—especially when compared to the treatment patients will need if they’re in a late stage of deficiency. A B12 test can be performed by any laboratory, and it should be covered by insurance. If you don’t have insurance, you can order it yourself from a lab like DirectLabs.com.
As always, adequate treatment depends on the underlying mechanism causing the problem. People with pernicious anemia or inflammatory gut disorders like Crohn’s disease are likely to have impaired absorption for their entire lives and will likely require B12 injections or high-dose oral cobalamin indefinitely. This may also be true for those with a severe deficiency that’s causing neurological symptoms.
Typically in the past, most B12 experts recommended injections over high-dose oral cobalamin for people with pernicious anemia and an advanced deficiency involving neurological symptoms. However, recent studies have suggested that high-dose oral or nasal administration may be as effective as injections for those with B12 malabsorption problems. (13, 14)
Try Supplementing
Japanese studies indicate that methylcobalamin is even more effective in treating neurological symptoms and that it may be better absorbed because it bypasses several potential problems in the B12 absorption cycle. (15, 16) On top of that, methylcobalamin provides the body with methyl groups that play a role in various biological processes important to overall health.
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Change Your Diet
Nourishing your body through whole food is the best way to get the vitamins and nutrients you need. If you’re low on B12, try eating some vitamin-rich foods like:
- Liver
- Shellfish
- Clams
- Oysters
- Organ Meats
Eating other kinds of seafood, like octopus, fish eggs, lobster, and crab, can also help you attain normal B12 levels. If you’re seafood-averse, you can also get this vitamin from:
- Lamb
- Beef
- Eggs
- Cheese
It’s important to note, though, that the amount of B12 in these foods is nowhere near as high as the levels in shellfish and organ meats.
What to Do if You’re Experiencing Vitamin B12 Deficiency Symptoms
If you suspect you have a deficiency, the first step is to get tested. You need an accurate baseline to work from.
If you are B12 deficient, the next step is to identify the mechanism causing the deficiency. You’ll probably need help from a medical practitioner for this part. Once the mechanism is identified, the appropriate form (injection, oral, sublingual, or nasal) of supplementation, the dose, and the length of treatment can be selected.
So, next time you or someone you know is “having a senior moment,” remember: It might not be “just aging.” It could be B12 deficiency.
I feel so frustrated. My results came back as 142 p/mol and my doctors response was that i need to ‘stop reading up on B12 deficiency on the internet’ as my level is ‘normal’. I would like to start trying for a baby and would like my levels to be a lot higher. My GP told me that my B12 levels are of no concern. I could accept this if it were easy to simply get a second opinion however I live in a remote community and there is no other doctor. She honestly made me feel like I was a moron for requesting a B12 shot with my current levels. Crap Doctor award goes to her.
My B12 level was 232 pg/mL and my doctor had me come in everyday one week and get a shot, next week twice and I did twice a week for a month, then once a week for a month, then the following month bi-weekly, and then finally once a month. My symptoms were fatigue, tired all the time, depression, memory loss, body aches, and dizziness. But also my vitamin D level was horribly off along with the B12. If I were you I would get a second opinion. My level was 232 pg/mL but my physician said that was extremely too low. Good luck!!
Time for a new doctor!
New doctor….my thoughts exactly!
I never had my B12 checked prior to becoming pregnant.
Hi Kristy,
Unfortunately, a lot of doctors are ignorant about B12. They feel it is homeopathic nonsense. I had CLASSIC B12 symptoms, right down to the red sore tongue, but my doctor didn’t diagnose me. She was only worried about my blood pressure.
If I were you, I would definitly start taking at least 5000mcg a day of B12. I take Natural Factors that I get through Drugstore.com. You should also take Folic Acid. Some B-complex pills have it, and some don’t (you should take a B-complex, but ignore their B12). Check out different OTC pre-natal vitamins for the rest of your vitamins. See if your doctor will test you, and give you the right info for D. She might, they are all into D now. I don’t know what the right number is, but if it is low, make sure you spend 15 minutes in the sun every day without sun block — that includes face cream with sun block. If you have to take a supplement, I take VitaFusion D3.
Good Luck!
Many people cannot utilize folic acid, especially if they have the mthfr gene mutation. A prenatal with folate or methylfolate is much better than folic acid.
Ally, that is not really true. For a start folate is the ionized form of folic acid. It is used as the back-bone for many derivatives of folate. All people, regardless of their MTHFR status can use folate for their folate cycle, as it does not involved MTHFR. In contrast, you cannot use methyl-folate in the folate cycle unless you first remove the methyl group to make tetrahydrofolate. For this you need the enzyme methionine synthase, BUT in order for that enzyme to work you need methyl B12 as a co-factor for methionine synthase. Thus you cannot use 5MTHF if you are severely B12 deficient. This is regardless of your MTHFR status. MTHFR only becomes involved in this process in order to move folate out of the folate cycle so that you can use the resultant 5-MTHF as a methyl donor for the methylation cycle. So theoretically you can use either folic acid (folate) or 5MTHF for the folate cycle, but you can only use 5MTHF if you have sufficient B12 for methionine synthase to work.
Yes, I absolutley agree that methylcobalamin is needed. It’s very important to have adequate levels of b12, specifically adequate intracellular levels, in order to utilize methylfolate and improve methylation. I disagree on two things, however. Folic acid is NOT the same as folate. Folic acid is synthetic, while folate is found in food. The terms cannot be used interchangeably. Those with the mthfr mutation, especially those who are homozygous, lack the ability to break down folic acid. If one is heterozygous, the ability is approximately 30% reduced. If homozygous, the ability can be dangerously low at around 20-30%. Depending on other factors, including lifestyle, nutrition, other snp’s, etc, folic acid can build up in the blood in those who aren’t methylation well and cause many problems. If a woman knows she has mthfr, she is much better off supplementing with a prenatal that contains methylfolate. Pregnancy is a time of high demand for folate, and if the mother or baby have mthfr, and are not receiving adequate amounts of folate or methylfolate needed for growth, repair, methylation, etc, problems can arise. Again, I defenitley agree other cofactors are needed, but as a dietitian and someone with mthfr, I whole heartedly disagree that folic acid is safe for those with mthfr, especially women of child bearing age.
No Ally, you are not correct about folate. Folic acid, is the unionized form of the vitamin, the ionized salt form is folate, thus sodium folate, would be how you describe the sodium salt of folic acid. Thus if you take folic acid the carboxyl group is COOH, now if you then add sodium hydroxide to a solution of folic acid the change in pH will ionize the folic acid from COOH to COO-, The sodium ion (Na+) will then associate with the negative charge on the now ionized folic acid and form the complex sodium-folate Na+Folate-. This an incredibly basic bit of chemistry and I cannot understand why people don’t just check this. The same thing happens with most organic acid, such as acetic acid (R-COOH), when this is neutralized with sodium hydroxide, it becomes sodium acetate (Na+RCOO-), which you can purify as a salt. When you put folate into the stomach, the reduced pH in the stomach turns it into folic acid as the carboxyl group is now not ionized.
Once either folic acid (folate) or 5MTHF enter the folate cycle THEY ARE IDENTICAL no matter which form was administered.
I think we’re going to have to agree to disagree on this. I understand what you’re saying, but that doesn’t change the fact that those with mthfr cannot break down and utilize folic acid. They lack the enzyme to do so. Folate contains some methylfolate, but not enough to support methylation. Thus, with low amounts of the usable form of methylfolate in food, and an inability to breakdown folic acid, supplementation with methylfolate is necessary for those with mthfr. Again, as someone who has been directly affected by this mutation and who works in the field of nutrition (and yes, I took a lot of chemistry), I stand by my original statement. I encourage you to read and learn about how the two are different and how those with the mutation are affected. Here’s an article from Chris kresser himself explaining it. http://chriskresser.com/folate-vs-folic-acid/ There are MANY others if you do a simple search. There are even some comments from those on this thread with mthfr who commented about the need for methylfolate and methylcobalamin. I’m not tring to argue. I’m merely passionate about this topic because of how poorly it began affecting my life after having a baby.
Hi Ally, You seem to be mixing up two cycles, the folate cycle and the methylation cycle. In the folate cycle, the backbone molecule folic acid(folate) is modified to form different analogues/derivatives of folate. If you start with folate, you then make dihydro-folate, tetrahydro-folate, 5,10-methyelene-tetrahydro-folate and N10-formyltetrahydro-folate. Now these are all analogues/derivatives of folic acid, but in the pH of the body they would be derivatives of folate. They are NOT folate, they are folate analogues or derivatives. Nor are any of them involved in methylation directly. You can make all of these derivatives of folic acid by consuming folic acid as a supplement. So folic acid as a supplement will make all of the folate cycle analogues. For the folate cycle you do not even need MTHFR, as in the presence of enough SAH it is turned off.
Now the methylation cycle is very different. Here, technically you don’t need folate analogues at all. If you eat enough methionine you can get your methylation from methionine and thereby make SAM. Now you would have to eat a lot of methionine though. Similarly, if you provided enough methyl B12, you still wouldn’t need 5MTHF, you only need 5MTHF to regenerate methyl B12, once it has donated its methyl group to homocysteine to make methionine. Technically, if you provided enough folic acid, you technically don’t need to provide 5MTHF at all, as you borrow it from the folate cycle, strip it of its methyl group and RETURN it to the folate cycle. Being a cycle the folate backbone goes round and round being modified and forming the various folate analogues.
So the problem happens when you want to move the folate analogue out of the folate cycle so that the methyl group that was put onto THF by SHMT can be used to regenerate demethylated methyl B12. This is when you use MTHFR. It has nothing to do with dietary folic acid, 5MTHF or folinic acid, it has to do with modifying 5,10-MTHF and reducing it to 5MTHF. Thus, regardless of the source of the folate backbone, be it folic acid, folinic acid, THF, 5MTHF, it is the 5,10-MTHF that is modified to form 5MTHF. What appears to have happened in the “Great Folate Debate”” is that somewhere along the debate someone has shortened the common “folate analogues” description of all of the folate derivatives in the folate and methylation cycles and changed the terminology to “folates”. One would normally only do this in a paper, or similar publication where you would tell the reader that you were going to group all of these analogues under the terminology “Folate” with the added “analogues” being then understood. FYI despite the claim that folic acid did not exist before supplementation, this is incredibly unlikely as you have the enzyme dihydrofolate synthase. From an evolutionary point of view one would not bother making an enzyme for which their never had been a use, and then maintaining it in the population. Similarly it was the addition of folic acid to food that reduced the incidence of spina bifida, not 5MTHF.
Ally, you are also wrong about MTHFR. MTHFR has nothing to do with the initial processing of dietary 5MTHF. This B2/B3 dependent enzyme is responsible for reducing 5,10-methylene-THF (hence the name reductase) to form 5-MTHF. So the enzyme moves and converts folate out of the folate cycle and makes it available to donate the methyl to regenerate Met from homocysteine. Thus, MTHFR has no idea where the 5,10-methylene THF originated from, either as folate or as 5MTHF. Thus MTHFR mutations have no variable influence on the processing of either type of folate analogue. In fact in the absence of B12, only 5,10-methyleneTHF, which has originated from folic acid (folate) will be processed by MTHFR. The good news is though that most people have at least a very small amount of B12 (they would be dead otherwise).
I’m not wrong, but maybe you’re misunderstanding what I’m saying. Yes, that’s what mthfr does, but those with the mutation, esp those who are homozygous, have a greatly reduced ability to convert 5,10-methylene-THF to 5-MTHF. 5-mthf is what the body needs and uses to function. Folate from food is a better option for those w the mutation because it already contains some methylfolate. With a 70-80% reduced capacity to metabolize folic acid, it starts to build up in the blood and cause many problems (high homocysteine, birth defects, etc), esp for those who are homozygous, meaning both copies are defected and do not function properly. Low b12 only adds to the issues. Most people with mthfr have problems utilizing b vitamins as well. Generally speaking, supplementing w methylfolate and other b vitamins, bypasses the ineffectiveness of the defected genes, and provides the body with the necessary amount needed for methylation.
Ah, Ally, we have a saying, “convince a person against their will….”. We have studied the incidence of over 165 SNPs in many people with CFS and in the children and mothers of children with ASD. There is no difference in the incidence of MTHFR alleles than in the general population. I even have people who are “-” for all of the common alleles in MTHFR and yet they have CFS. IT IS NOT THE REASON THAT THEY HAVE CFS. What is more they were perfectly fine with their genetics for all their life until they got sick. What is more we have been able to basically cure the CFS without using 5MTHF at all, so once again IT IS NOT THE SOLUTION. It is your nutrition, not your genetics that is the problem.
http://www.seekinghealth.com/media/MTHFR-Introduction-Basic.pdf
1. Folate is vitamin B9
2. Critical regulator of methylation
3. Essential for DNA synthesis and repair
4. Essential for neurotransmitter production
5. Essential for WBC, RBC and platelet formation and maturation
6. Essential for detoxification of homocysteine
7. Folic acid is unnatural to the human body
8. There are over 150 forms of folate in food
9. Use the appropriate term – don’t just say ‘ folate ’ – be specific
10. Folic acid must undergo numerous steps in order for humans to utilize it
11. Various nutrients and enzymes are needed to convert folic acid into methylfolate
12. MTHFR is the last and final step from the conversion of folic acid into methylfolate
http://seekinghealth.org/gift/folatevideo/
Thank you Molly Malone!
Thank you Molley for those functional aspects of the “folate derivatives. Technically you only need to convert folic acid to DHF, which can be used for regeneration of BH2, so it doesn’t need a lot of steps to contribute. Most of the functions come from the folate cycle. In addition, I would regard 5MTHF as being more a regenerative molecule to make methyl B12. It is methyl B12 in combination with methionine synthase that reacts with homocysteine, but it is also betaine. Further, homocysteine should not build up in the cell if CBS is working properly. Evidence now suggests that it is lack of function of CBS that leads to Hcy accumulation. MeCbl is probably really only used when dietary methionine is low and you need to recycle the Hcy, though to Met, then make SAM.
As for the 150 different “analogues of folate” most of these would be accounted for by polyglutamate modfication of the various analogues, thus having 1,2,3, 4 or 5 glutamates would increase the number of analogues,. I am sure that you realize that this is required to keep the analogues in the cell. 5MTHF from diet is not polyglutaminated but (like folic acid) must enter the folate cycle for this to occur. In contrast to folic acid though, in the absence of MeB12 this won’t happen with 5MTHF and leads to elevated serum folate, confusing the picture for the diagnostician, particularly when B12 levels are low.
Kristy–If you have the insurance or simply can afford the b 12 shot–Demand It. I live with a b 12 deficiency. I get a shot every 2 weeks and I’m not even 40. It has taken a permanent disabling toll on my body–overlooked for so long. Lord knows–those babies will suck the life out of you! Babies get ‘fed’ first, right? Don’t be afraid to tell your doctor–“It’s my body–Give me the shot.” Then-do your research. Sometimes we just can’t trust the doc to take care of us. Try to find your underlying cause and start there. Best of luck. Get em.
Kristy,
Dug up that Japanese study and take it to your doctor, along with info from the CDC that says under 200 is low.
There are also some writeups by doctors for doctors online. Print and take to the doctor as well.
Good luck!
Learner,
That was very nice of you but I am willing to bet that Kristy’s doctor will not read anything, make a face, and say something nasty.
Kristy,
At 142 your B12 is low. The gray area where neurological damage can occur is 200-450 pg/mL which corresponds to 148 – 332 pmol/L. I sincerely hope you have gotten treatment by now as you are definitely deficient.
To convert pg/mL to pmol/L, multiply by 0.738. In the US, we typically use pg/mL. For the lower level of 200 pg/mL, 200 * 0.738 = 148 pmol/L.
Or to convert your 142 pmol/L to pg/mL, divide it by 0.738. So in more familiar units to those of us in the US, your B12 was 192 pg/mL. Low!
Kristy,
10 yrs. ago I was having numbness and tingling in my feet.
Went to numerous doctors who couldn’t find out what was causing it. Two years later a doctor did bloodwork on me and found out I had a severe B12 deficiency. By then nerve damage and muscle weakness had already set in. The doctor had me get a B12 injection every day for a month and then broke it down to where I hasd to get a shot once a month.At the time when my deficiency was found my level was an extremely low 41.
Don’t let this happen to you. Start to get injections or some sort of absorbable way.Good luck.
Is there anyone that has severe spacticty from a B12 deficiency in their legs? And if so, is there anything to help it. My legs get so very stiff cuz of neuropathy.
According to my drs, that is a low level. Years ago, mine hit 102. I now have nerve damage, irreversible and progressing. Don’t waste time, you nerd to be treated. I was started on b12 shots, 2 per week first month, then 1 a week for a month and then one per month since. Until recently my level has stayed between 500-700.
Hi, I’d like to suggest you add symptoms of allergy to your list of things b12 def mimics. At age 21, I was diagnosed with b12 deficiency, at the same time I had random strange allergic episodes of facial swelling/itch etc. The b12 deficiency was put down to vegetarian diet. The facial oedema just stopped happening (I think now because my B12 defiency was treated). Ten years later I was b12 deficient again, and again was having random allergic reactions that included severe facial swelling (I did not connect the 2 things back then). Allergists were never able to come up with an answer other than to take antihistamines. At the same time but unconnected, my b12 defiency was treated and the swelling episodes went away. Fast forward another 15 years and I am plagued by urticaria, again an allergist can’t explain adequately why this has come on but recommends daily antihistamines. I continue on these for a few years – then I am diagnosed with b12 defiency again (and finally confirmed as pernicious anaemia). And again, treatment of the b12 deficiency leads to complete resolution of my allergic symptoms. Can’t be coincidence?
Just asked my primary care doctor to test me for PA. B12 was 214 and intrinsic factor antibody test was 1. Both were stated to be normal on the report but since they were both borderline, I was told to follow up with a GI. I have numbness/tingling in hands and feet, severe fatigue, anxiety, cold intolerance and eye twitches. My mother had PA otherwise I would never have thought to get checked. I want to be sure I am prepared with the right questions for my appointment. Any advice? I am also hypothyroid. I am quite disappointed that since the two conditions are often seen together I was tested for RA, Lupus, Celiac and kidney issues but never PA until my request. How can I trust the next doctor and yet I am unsure of what might be involved to ask the right questions. Appointment is five days away and everyday it seems symptoms are a little worse. So hard to be patient while feeling so unwell. Nothing I can do but wait.
I guess you are waiting to see if you can get the shots. I think you should accentuate your B12 symptoms — though I had CLASSIC symptoms right down to the red painful tongue, and nobody thought I was deficient.
Anyway, if the next doctor doesn’t give you the injections, don’t wait, start taking the sublinguals or start using the oils.
For hypothyroid, make sure you eat foods with high iodine, and use iodized salt.
For the eye twitch, take Magnesium. A word of warning, though, if you get the poops often from the lack of B12, magnesium might worsen that.
See if you are D deficient, that’s any easy one to diagnose.
Be careful on the dosage of the other vitamins and minerals, they are not as safe as B12, but you don’t have to worry too much if they are, I’d say, as a rule of thumb, up to 200% the daily recommended allowance.
There was a study recently that Vitamin E intake might seem like it is adequate, but it can attach itself to certain fat molecules ( I don’t think they were specific about which ones) in the bloodstream, and never make it into the cells at all. Well B12 is the same way, only more things can keep it from doing its job. Then “they” say that taking vitamins does nothing. How they quantify this, I don’t know. The medical community really needs to wake up and learn how bodies really work rather than how they theoretically work.
You sound like my clone. I just had a doctor’s appointment today and found out I have this problem. The thing that gets me is I’ve had every symptom almost over a 10 year period. A fluke thing had me at this gastrologist who thank God knew what was going on! I’ve had so many tests over the years and never once was tested for this.
Who is your doctor. I need help to get to someone who knows what they are doing!
Sara
Over the last 3 months, I have started to suffered from what seems like musclular pains, started, in my shoulder and moved around to my knee, foot arm and hands causing a lot of swelling, and stiffness. I have now had 2 blood tests that have ruled out iron and B12. Also, I tend to start having a period 1st one after 19 days lasting 10 days 2nd after 17 days lasting 7 days,started to feel numbness and swelling to the hands and shoulder, and started to bleed after only 6 days, doctor has suggested more bloods to be done in a month I am so tried – think I should go and get bloods tested earlier, any advice.
Hi Dawn,
First, the muscle pain could simply be caused by your pillow. Every time my arm goes numb and my hip and knee hurt, I know it’s time for a new pillow — use a higher, firmer one rather than two.
With regards to your period woes, you didn’t say how old you were, but I am in my early 50’s, and starting to go through menopause. I was originally getting my period every 31 days exactly. Then last yearish, I started getting it every 3 weeks, then 33 days, then 3 weeks. Now twice (I am on the second time) I haven’t gotten one for about three months. In between I had 3 in 1 month. The first day of the 3rd one, I had to call my husband at work to ask him to buy me iron on his way home. I definitely think you should be taking iron and zinc to help absorption. I use Feosol (Bifera, the purple one that doesn’t stop up your colon). I have used the regular Feosol in the red, every once in a while I couldn’t go, and it turns my stool the same color as the pill, but it works well and is a lot cheaper.
Problems with periods can also be caused by cysts/fibroids. I’m not sure, but I think your OB/GYN can use an ultrasound to detect them. You should ask.
Defintely try B12 5,000mcg, it couldn’t hurt, and it might help. Try it before they diagnose you with Lupus or some other thing when all you might need is B12.
I did have joint pain and problems with my period for about six months before I started taking B12, so you might have luck with it as well. Good Luck.
How long after start b12 5000 mcg did you start feeling better?
Hi MJ,
I had such pains in my legs and feet that I could barely walk. I started by trying cyanocobalamin, and 2 weeks after I started, I realized that I didn’t have as much pain, and within a month, I could walk up and down stairs with no problem at all.
The feeling that everything was just too overwhelming took about 2 months to START going away.
I actually started by taking FOUR 5,000mcg pills a day for, I think, about a year. I eventually lowered the dose to ONE 5,000mcg a day, but my symptoms, especially the foot pain came back after about one month, so now I take 2 about every other day, and that seems to work out well for me.
I also take TWO Phillips Magnesium pills a day
TWO VitaFusion Platinum gummies a day
FOUR VitaFusion D3 a day (I was practically negative)
ONE Nature Made Super B-Complex every so often. I should take it more often, but it makes me so instantly hungry that I feel extremely nauseous. Vitamins can do that.
ONE Feosol Bifera a week. ONE a day if I get my period.
ONE Zinc when I take my iron, but I should probably take one a day, or every other day.
TWO Sundown Prebiotic every day(ish).
TWO Sundown Probiotic every day(ish).
ONE Cod Liver Oil pill or 1 TEASPOON Cod Liver Oil in the bottle a day.
ONE pill Jet Alert when I need energy — sometimes none, sometimes 4x a day.
It’s 4 1/2 years since I first started taking B12, and about 3 years since I started the other supplements, and I noticed a few weeks ago that I am starting to feel like my old self again! I still get super tired super fast, and I do still have a real problem with mucus, but I feel pretty good! I don’t feel overwhelmed by the smallest thing, I feel a lot more lighthearted again, and I have my balance back — another symptom was that I kept walking into walls.
Hope this helps.
MJ-
I get b 12 injections every 2 weeks. You can tell when I need them–I get, let’s say-cranky. I can’t find my words, constant headache, unsteady, nauseous, over-tired etc. If I go too long I start to get the numb tingling in my face and limbs. To answer your question–I feel better immediately after my shot. Makes my jaw drop. My Father-in-law was the same way. I don’t know how you go from one extreme to the other- but I tried the supplement pills and the sub-lingual liquid…nothing works like the shots. My underlying cause is pernicious anemia if that applies to you.
Dawn,
I just saw on Doctor Oz PCOS — poly cystic ovarian syndrome (I think syndrome).
So, take B12, but it’s one more thing to check out.
I have recently been diagnosed with ME/CFS. My b12 level is 268 which is in normal range, however I believe if I was given b12 injections my symptoms would improve. But I am having trouble getting the doctor to listen to me. I am thinking of getting a second opinion and getting further tests done. Listening and reading other peoples stories b12 does seem to be a miracle in helping people rid or easing the symptoms
Go get a second opinion. You may want to try a naturopathic doctor, they seem to be much more aware of B12 and gluten issues.
You can always supplement B12 yourself. Amazon has sublinguals and mouth spray. Cyanocobalamin, the form most US doctors usually administer, is the worst option as the body has to convert it to a usable form and rid itself of the cyanide. Hydroxocobalamin (used in the UK) or methylcobalamin are much better. You can find injectable methylcobalamin over the internet, I did and from a YouTube video learned how to inject myself subcutaneously. I have pernicious anemia so sublingual B12 doesn’t work very well.
I have just been told mine is 218 and a friend told me her naturopath said it shouldn’t be below 500
Thank you so much for this forum! In the last two years, I have experienced worsening tingling in my legs, arms, and just recently around my lips. I had blood work done and my b12 is low, but still in the range. I’m a vegetarian of 5 years, but I still eat cheese on a daily basis. I thought that would provide the b12 I needed. When I became a vegetarian, the books advised b12 supplements but I had no idea that a deficiency could have such lasting effects. What’s the best way to reverse all this? I’m really concerned now about lasting nerve damage. What’s the best route – is a supplement sufficient or should I ask my doctor for shots? She didn’t suggest anything because my levels were still in the acceptable range. Thank you!
My B12 is under 100. Four months ago I was getting shots and it was at 1500. Four months later its under 100 and Im so weak, dizzy, muscle pains, cant think, overly moody when Im not a moody person. All I want to do is cry because NO one will help me. What do I do next? Please I beg for help
Hi, Karen,
I used to have many of the symptoms you describe too, before I took charge of my health and started taking B12 supplement daily. I feel MILES better now that I’ve been taking it daily for some time.
You can buy it on Amazon.com:
http://www.amazon.com/Jarrow-Formulas-Methylcobalamin-5000mcg-Lozenges/dp/B0013OQGO6
This is the brand I use and it works great, though I’m sure any brand offering the same ingredients would work equally well.
Karen, have you been tested for pernicious anemia?
If you have PA then oral supplements won’t work very well as you have antibodies to intrinsic factor in your gut which is what absorbs the B12 from your food and transports it to where it is needed in your GI system.
With PA you will need B12 supplemented for life (usually by injection but there is a nasal spray available). Pay attention to the kind of B12, cyanocobalamin is readily available in the US but considered inferior as the body needs to convert it to a usable form and flush out the cyanide.
With your B12 so low, you can get serious neurological damage. My B12 was 196 and even at that level I could hardly walk. I had terrible sciatic pain and pain in my feet for months before finally diagnosed with a B12 deficiency. Then I tested positive for PA.
I am have been veggie for years and always had normal Blood results, until recently, my latest tests show B12 deficiency. Nothing changed in my diet, i guess I just finally depleted my reserves.
can b12 defficiency cause alot of weight loss??
Hi Sacha,
I have never heard of a B12 deficiency causing weight loss, only the opposite. Though it’s possible I suppose.
One friend of mine started losing weight rapidly, and it turned out she had diabetes. Another friend of mine had an overactive thyroid that caused her weight loss. I would see my doctor and ask about those two as well as any other thing he could think of that would cause unexplained weight loss. However, it also wouldn’t hurt any if you took B12.
Yes I think for some B12D can cause weight loss. You may not have sufficient stomach acid, which aids in digestion. Then you could have malabsorption of nutrients from your food.
I lost 15 lbs. over several months and I was quite thin to start with (my BMI is currently 19, low for a woman). Not sure whether it was my Paleo diet which is pretty lean in starches, or my deficiency (I have pernicious anemia), or both. Still struggling to gain some of it back. I don’t tolerate fat well, a higher fat diet makes me feel horrible.
Hi Tracy,
Do you know if you have hypothyroidism as well as the PA, or have you not been checked?. There is quite a bit of evidence to suggest that hypoT may precede PA in some cases.
Hi Roy,
I certainly had hypothyroid symptoms (severe insomnia, night sweats, weight loss) but my lab tests never showed TSH to be out of normal range. My endocrinologist did not run any other thyroid tests (T3, etc.). When I was so very ill it felt like my thyroid was fluctuating between hypoT and hyperT but never could catch it in the labs. And docs in the US won’t treat thyroid based on symptoms alone. Part of my treatment has been acupuncture, the actupuncturist said those symptoms were classic PA where red blood cells becoming enlarged (mine are currently at the top of the normal range in size).
I recently learned I also have erythromelalgia (feet turn red at night, are very hypersensitive) and hypohidrosis (I don’t sweat much, real danger of heat exhaustion). So maybe some of my symptoms were related to that.
That would seem to be a problem. There are many steps between the secretion of thyroid hormone and making active B2 as FAD/FMN, one of which of course is the iodination to make T3/T4, which requires dietary iodine (hard to get naturally without seafood), selenium (which is low in many areas), then of course there is dietary B2, which is hard to get enough of if you don’t eat dairy. You would be surprised at how many “euthyroid” people come up as functionally B2 deficient.
Hi tracy
My problem is also similar to yours. When i had b12 deficiency last year i had unexplained weight loss. This time also from the past 2 months my weight is decreasing along with some other symptoms. Did you get any solution now?
Hi, I had the MTHFR test done and i am not sure what i need to be taking. I have two mutations. C677t and A1298c. My doctor have me a cream but i dont think it is working too well. What other things could i try. Thanks!!
I had to ask my primary care to include testing for homocysteine in the course of a routine exam and blood workup (age 64) and he wanted to know why I wanted it. It turned out my homoscysteine level was 20 (which I think is dangerously high) and I immediately switched some of the B12 folic acid supplement to a folate 5- methyltetrahydrofolic acid alternative. When I had first started taking B12 years ago my urine turned quite pungent and strong. I didn’t notice over the years that to have changed. As soon as I started the folate, the strong pungent urine returned…… which I take to be an indication that the folate is doing its job. I have a retest coming up and will be waiting to see that verified.
Hi Everyone, I had gastric bypass Oct 2014 after surgery I started getting weekly B12 injections and soon as I get the injection I start to feel like in having a allergic reaction to it. I loose my voice, my throat gets tight and I loose my train of thought. I’ve had food allergies my whole life this is the same type of symptoms I get when I have a allergie to food. Has anyone ever heard of someone being allergic to a b12 shot? Oh and I receive mine from a natural path and I use a vitamin B 12 with methyl.
I got the shots at first when my B-12 was low. Yes, I also had some kind of allergic reaction after my 3rd shot. My chest and neck got a large red rash all over my skin. Looked like I had been in the sun way to long. Told my Endo and he stopped the shots and put me on B-12 1000 mcg sublingual. I’ve been on this for almost two years now. Just had my B-12 checked and it was high so they are having me to take 1 every other day or 500 mcg daily. I’m also taking D3-5000 IU daily. Doc will see me again in June.
I am male 37 year old
I am use cholesterol medicine.
Imy vitamin d level 28.
b 12 level 128.
use injection last 2 week.
I a have pain chest tightness every time.
heart palpation.
any experience pls share
regards
Bukky
Bukky – you need to take a potassium supplement until your body has built up its B12 reserves. Correcting B12 anemia temporarily drains your own potassium reserves.
Same thing happened to me, palpitations and chest pain. Once I started taking potassium the pains went, and I was able to stop taking it once the B12 levels had got up to normal. I used a soluble potassium “Sando-K”
Your doctor should know about this.
Hope this helps.
Start taking Vitamin C (Food Based like Rose Hip or Camu powder or the one by MegaFood) to help the absorption and to increase levels of B12. Usually Vitamin C deficiency is the cause of low B12.
I’m wondering that since Chris says there are no vegetarian forms of B12, why do some methylcobalamin supplements say “suitable for vegans”. I’ve tried unsuccessfully to find out how B12 supplements are made. Someone online mentions that they are made from bacteria, and that the only reason animals have this in their gut is because they eat the plants that have the bacteria on them. Ultimately I need a methylcobalamin supplement, but want to make sure I’m taking one derived from the right source?
I have been vegan for over 4 years and vegetarian for over 10 years and I am not deficient in b12. i am also currently pregnant, so my b12 needs are higher. I take a vegan methylcobalamin spray once a day and my most recent blood test showed my b12 to be in perfect range. The methylcobalamin spray I take is from Garden Of Life, Kind Organics (certified vegan) and is produced from Saccharomyces cerevisiae ( a food yeast grown on molasses solution). I am living proof that Vegan b12 exists and this article is BS, meat eating propoganda. We have 0 nutritional requirements for animal flesh or their secretions. period.
I believe that Chris was talking about FOOD sources of B12–and he is right.
I’m not sure exactly why you are taking such a nasty tone. I don’t consider this to be ‘meat-eating propaganda,’ I consider this to be factual. The supplement you are taking is industrially produced, and is not ‘food.’
Incidentally, I’ve been a vegetarian since 1969, so I’m not exactly a tool of the meat industry.
I agree with David. I always find it curious that a supposedly “normal vegetarian or vegan” life-style is in fact one highly supplemented with B12. You may be surprised at what they feed the yeast or bacteria that they use to make the B12. Normally the amino acid supply comes from acid hydrolysed casein, which is obviously a milk product from cows, so it is hardly Vegan. I would also be very careful of assuming that your B12 levels are “normal”. What you are measuring in serum is what you put into serum, and in your case it was methyl B12. This does not necessarily correlate with what is in your cells, where you need both methyl and adenosyl form of B12.
OK David and Roy, please tell me then – why, after being vegan for 20 years do I have a normal B12 level along with a normal blood cell count and full blood work up?
I have been tested various times over the 20 years, and there is no variation from when I was a massive meat and dairy eater. Why? After seeing these kind of articles this shouldn’t be the case, but it is. I am wondering what the real cause of B12 deficiency is, and whether it actually has anything to do with being vegan or not.
I heard that humans used to be able to produce B12 in their gut like other animals, but somehow lost the ability. Maybe that is not a universal truth. I’m not saying to ignore the issue. I think people need to pay more attention to their B12 levels. I’m just asking you to check your rhetoric and tell me why I don’t have a B12 deficiency.
Cathy, I’m happy for you in that you are healthy and have good B12 levels, albeit having to supplement.
What I find frustrating is your apparent superiority because you don’t eat meat. This is a choice and as far as I am aware always is rather than your bodies intolerance. Unlike many including my daughter who has Fructose intolerance (the sugar in fruit and veg, also no gluten, wheat, or spices), without eating meat she would live on potatoes and rice and would probably not survive long (also has cfs due to above plus vitamin deficiency). It’s great that you’re healthy and able to make a lifestyle ‘choice’, but others aren’t so fortunate.
Great response. I have in my life been all over the board. 16 years vegetarian many on and off years as vegan. I’m often anemic and b12 deficient. Started getting chronic uticarea( hives), but no one ever diagnosed it to be related to the b12. Currently I’m having like mental fog and constant headaches and haven’t been taking supplements for a long time. I’m only about 80% vegan if there is such a thing. Any recommendations on the right form of B 12 that I could get from Amazon that would help me right away? Thanks
Laurie, a vitamin b12 deficiency is an insidious condition and you have stores of the vitamin in your liver, estimated to last 2-4 years so it will take several years to become deficient but it will happen, your body can not survive without b12, it’s vital, so please don’t believe that this article is BS, because it’s not. You are correct when you say that your unborn baby will be drawing on your nutrients and I am happy to read that you are supplementing. Please continue to do so and if you are intending on your child following a vegan diet then it is paramount that you supplement your child too because during their years of growth and brain development, vitamin b12 is essential. Trust me when I say that having irreversible neurological damage from an undiagnosed vitamin b12 deficiency, is the last thing that you would want.
I have MTHFR polymorphism. I just found out that my B12 is very low. I know from reading Dr. Ben Lynch’s website that I need to be careful with methylfolate but does that include being careful with methyl B12? I need B12 injections and not sure whether to take the methyl B-12 my doc wants me to use (which has methylfolate included) or ask for hydroxocobalamin. I am already having severe neurological symptoms. Any ideas? Thanks.
Do you see a Endocrinologist? This type of doctor deals with these kind of chemical problems in the body. A Endocrinologist will test your B-12, folate, thyroid function, Vitamin D, with a few other test. My family doctor has never tested my B-12 or my vitamin d. I’ve had long term symptoms and was being treated but medication never helped. I had depression, crying spells, body aches/spasms, fatigue, mild seizures, memory loss. The family doctor stated he thought with all of these symptoms, i was bipolar. The word depression … So off i go to see a doctor for depression and this guy orders new lab work and he never checks my b-12 or my vitamin d level! I ended up in the ER after passing out in the shower. The ER tested me for B 12 deficiency and told me to get to an Endo first thing the next morning. I started out with B-12 injections for a few months to get my level back into a normal range. Then I changed over to 1000mg B12 sublingual once a day. Also, When your b-12 is low it effects your thyroid levels, they correlate together.
I know methylcobalamin treats the neurological symptoms and occurs naturally in the body. When you start the shots it can take a few months before you start feeling better. If you’re seeing an Endocrinologist he will know the best treatment for you based on your test results.
I’ve been to many, many endocrinologists and not one did any type of nutritional testing. No, I find if you have B12 deficient tingling feet and go to the average endocrinologist you get put on Lyrica. Your endo is very unique. If the nutritional tests he gives you are serum testing instead of red blood cell tests I would find a more knowledgable alternative doctor.
California recently passed a bill making it mandatory that its medical schools require substantial nutritional training… first state in the union to require it. Right now future doctors have minimal training in nutrition and can opt out of it.
“On average, (medical) students received 23.9 contact hours of nutrition instruction during medical school”
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2430660/
A good Endocrinologist does more than just a CBC or give you a prescription telling you to try it and see if it helps your symptoms. They do Metabolic profile, Amino Acids, A1C, etc. These are the chemicals your body needs to sustain life. Tingling feet? I never had that with B-12 or vitamin D deficiency. I do know a few people that are diabetic and they complain of tingling feet. They’re also being treated with Lyrica.
I have been with the same endocrinologist for 22 years. You couldn’t pay me to see his assistants, much less a different endocrinologist. No matter what your medical situation maybe, he talks about weight and nutrition with all of his patients.
I am a PA working for an Internal Medicine practice and I routinely check patients for their Vit B12, Vit D, etc. I must agree that during my schooling I received very little nutrition education. I have learned a lot from this and other sites.
Not all PAs are the same. You could always tell your physician what it is you like about him/her and why you don’t want to see their assistants. They may have one that has a similar thought process they would recommend to you should the physician not be available.
I had foot surgery late last summer for pain I’d had for well over a year, which was diagnosed as a neuroma (swollen nerve). A couple weeks post surgery, I started having major problems (horrible insomnia, surgery foot just didn’t feel right, felt depressed, had terrible pains in my legs and feet, heart palpitations, fatigue). My PCP referred me to an endocrinologist who had me get a whole battery of tests. But she NEVER ordered a B12 test (or vitamin D test for that matter). My cortisol was a little higher than normal, but that’s about all she found.
My PCP then decided I needed an antidepressant, Lexapro. That made me feel just awful and it was causing me vision problems, so I quit taking it after a week. Fast forward two months later, I was using a walker to get around and was seriously feeling like I wasn’t going live to see the New Year. No one at my HMO could figure out what was wrong with me, nor did they care. About every couple of weeks I would make an appointment to see my doctore and ask for yet another set of tests, hoping to figure out what was going on with me.
Finally in late Oct a doctor who was substituting for my regular physician for that day ordered a B12 test, which was found to be 196. My PCP said it was so close to the low cutoff of 200 that he didn’t think it was significant. Since by then it was the ONLY test that appeared abnormal, I did some internet research and learned my symptoms matched many of those for B12 deficiency. I then insisted he begin treating me for B12 deficiency. Another blood test later on determined I had pernicious anemia.
It’s now 5 months after I began treatment and am still recovering from neurological symptoms and may have permanent nerve damage to my feet. As yet I am unable to to work (I was an engineer and lost my job since I’ve been out since Aug) and have difficulty walking due to pain in my feet.
I am so angry with the medical system for 1) not catching this simple vitamin deficiency, 2) using a low cutoff of 200 which is WAY TOO LOW, and 3) doing a poor job of helping me manage my treatment (cyanocobalamin worked for me at the beginning but now makes me very sick for about a day after I get a shot and I have had to find alternatives on my own as the HMO formulary only has cyanocobalamin).
Tracy, I had the same thing happen. I would like to talk to you if you are still having symptoms. Thanks!
Lisa,
Yes I am still having symptoms and I would like to talk to you too. How do you suggest we connect? There isn’t a private message capability on this site. I am a member of the Pernicious Anemia facebook group so you could find me there.
Hello!
I am experiencing symptoms that are exactly associated with B12 deficiency.
I have numbness in my legs and feet, twitching/spasms in muscles and a finger, memory loss, loss of concentration and hairloss. I do have a lot of dairy in my diet and i do eat red meat. Which doctor should i go to for these symptoms ?
i just was told by my ”stroke Dr.” that my b-12 and vitamin d is serverly low and i have to take injections .i had 2 strokes 2 yrsa ago and have had alot of mental and physical problems.but finally 2 months ago i can walk without a cane or worrying when i will tumble.i was early fifties when i had my stroke just lost alot weight the right way and walking 3 miles a day then it hit me .so i am concerned about the supplements because i take my blood thinners .i was also told i had corti basal degenration diease.the stroke damaged 2 parts of my brain memory short term the other i do not know.could being low in these vitamins cause the symtoms
I am new to all this although I have suffered with constant pain for a lot of years now And I think now that I have been mis diagnosed I have ostio arthritis in a lot of my joints I have had both hips and one of my shoulders replaced also my knees are bad and now my feet more left than right has started with very serious pain my hands are now very swollen and my fingers are quite bent now so sore some days it’s just like toothache the swelling is round all my knuckles as well .I also have depression which seems to never go away I cry and get very emotional all the time .this has gone on for years. I take mess for depression,my stomache(gallbladder has been removed due to stones and pain) Flicky legs and arms pain patches and paracetamol and trampoline I get what I can only describe as electric shocks in feet and hands .my hands also go in to spasms and lock very painful when this happens . I was very obese .But I had a gastric bypass in 2010 and that’s when they discovered my B12 was low and I was started on B12 injections at first 3 monthly then and and now every 8 weeks ( and for a few days I do feel more myself .) I do have fatigue were I will just go to sleep can’t stop it and then most nights don’t sleep tired but can’t sleep. The pain is the worse thing it’s all over my body my joints,muscles in my legs and arms and although they have replaced joint I still get pian in them .Anyway I am know thinking that all this may well be caused by the B12 not being right I have seen lots of doctors for all the different thing but never for all of the symptoms together They all seem to latch on to the depression. But I get tearful every time I see a doctor it’s like banging my head against a wall .I have had this (depression) for years or have I ? Sorry for the long post but I am at the end of my tether P.S I am now being sent to see a rumatoligist but they say I don’t have that .
Hi Yvonne,
Gastric bypass? If you weren’t deficirnt B12, you are now. Better to be at a healthy weight, though, and then deal with anything that comes up!
Besides B12, first, try to eliminate problems with your thyroid, pituitary, and any other endocrine gland you have. Second, I’ve been reading about the problems an overgrowth of Candida (the yeast in your body naturally) can do, so have that checked out. I know this is weird, but if you can, get your heart checked for holes. It’s always in the back of my head, because every once in a while, I hear a story of someone who had seemingly unrelated symptoms, until doctors found a “pinhole” in the patients heart, and once it was fixed, the person’s various symptoms disappeared.
B12 deficiency can cause all kinds of problems, unfortunately, bringing your levels up to normal doesn’t help fix what it helped break, but it will help you to feel better, and stop any more problems from occurring. If you can’t increase the frequency of your shots, at least take B12 supplements in between. Make sure you also take Magnesium, Zinc, Potassium ( but watch the levels), and B complex with Folic acid. In order to absorb vitamins, even the water soluble ones, you need to take them with some kind of fat — if you are not lactose intolerant, regular homogenized milk with the red cap will do. Plus, if you take them with food or milk, they usually don’t cause nausea. I know from experience, that some brands/forms of vitamins will give you GAS! If you take them at least 12 hours before you go out, you should be o.k.. If it doesn’t let up after a month, try another brand or form of a particular vitamin, like, oh, say, if supposedly easy-to-absorb Magnesium Citrate gives you so much gas you offend a skunk, then switch to Phillips’.
Fats are more important to your diet than modern medicine would like to admit. I know you are counting calories (understatement, right?), but if you can, add 2 tablespoons of olive oil, avacado oil or grapeseed oil to your diet. If you take the oil straight up, you will need to take a half a slice of bread right after in order to stop it from repeating on you.
A lot of people are claiming miracles after they take Turmeric pills for joint pain. Please, try drinking chamomile or Sleepytime tea 3 times a day for two weeks, and see if it doesn’t help ease your mind, help a little with that depression, and help you sleep. Two things I realized when I had trouble falling asleep or falling into a deep sleep: even though I felt warm enough, once I put on an extra blanket, I fell right to sleep, and, if I had a collar on my pajamas, I was a lot more likely to have trouble sleeping than if I had no collar. Which leads me to add, always block the light from stereos, cable boxes, alarm clocks, etc., and always wear 100% cotton to bed.
Lastly, try daily Yoga and meditation.
I hope this can help, even a little.
This helps a lot. Thank you for writing.
You need an Endocrinologist
Hey Yvonne,
I found this on the web today .. Your diet after gastric bypass surgery!
After gastric bypass surgery, your body will not absorb some important vitamins and minerals. You will need to take these vitamins and minerals for the rest of your life:
Multivitamin with iron
Vitamin B 12
Calcium (1,200 mg per day) and vitamin D. Your body can absorb only about 500 mg of calcium at a time. Divide your calcium into 2 or 3 doses during the day. Calcium must be taken in the “citrate” form.
You may need to take other supplements also.
You will need to have regular checkups with your doctor to keep track of your weight and to make sure you are eating well. These visits are a good time to talk with your doctor about any problems you are having with your diet, or about other issues related to your recovery.
I hope this helps you too.
Your symptoms identical to mine re pain and electric shock feelings. Living in Australia was put on antidepressants. Moved to UK where a specialist took 5 mins to diagnose Fybromyalgia. An Aussie doctor I emailed said “that doesn’t exist” although the UK specialist gave me a whole book on living with and managing it produced by arthritis UK. A UK eye specialist (elderly lady) echoed that it didn’t exist but my heart surgeon, cardiologist and gastroenterologist say it does exist and is diagnosed via clinical observation rather than a blood test. Existing or not I am getting on top of it and it is months since I had a bad day. You will tell from the number of specialists I see that I have a lot of health issues but my local doctor (she is young and very on the ball) guides me constantly with nutrition etc and slowly we are unravelling the mess of issues and improving my life. You too may have many intertwining conditions but keep up the search. Incidentally, the book I mentioned is available online from Arthritis UK. Best wishes. Michael.
It sounds like you have food allergies. I used to wake up with tingling arms, swollen hands and bloating off and on. I went to Center for Advanced Med. and they took me off Night Shades (tomatoes, potatoes, peppers) b/c I could not digest them. They are very acidic. Also, my intestinal bloating went away when I went gluten/dairy free(couldn’t digest the milk protein, cassein. I would get heart palpitations too, but this got better at first with some extra potassium and cal/magnesium. I suggest you do a ten day elimination diet, w/ doc’s approval. You can do bone broth every day with green veggies. You may feel worse the first few days, but by day 7 or 8 you should feel better.
i was diagnosed with vit b12 deficiency when i was 18.
had continuous pain in my left wrist and left calf.
when i take the injection the pain goes away and comes back in 5 days.
have taken more than 30 2 ml injections.
still there is no relief
also i forgot to mention that i feel tingling sensation in my right thigh and upper left back.
my knees get cold very quickly.
my b12 level in 2012 was 180 and after 30 injections in 2 yrs it is 230 .
i am from india.
and a strict vegetarian.
should i take any other vitamins for efficient absorption of B12????
any tips ??
First, I have to say, that although many people do well being vegetarians, once you know you have vitamin defifiencies, particularly B12, you might want to think about eating meat. I am convinced that the best thing is to eat soups and stews, particularly ones that use blood and bone as well as meat, because so many nutrients depend on one another for absorbtion. This is more like do as I say, not as I do — my own diet is HORRIBLE! No stews, and I don’t suppose you would call instant Ramen soup.
More to the point, if you only feel the effects of your injections for 5 days, you really should have them once a week. You will have to take B12 for the rest of your life, sorry. Unless, of course, you start eating meat and your levels shoot up. Even then, I would still recommend taking a tablet once a day.
I take the B12 you can dissolve under your tongue (3 a day for 15,000 micrograms) but somebody here mentioned the B12 oils which are supposed to be better absorbed.
Make sure you take other vitamins, such as Magnesium, Zinc, and Folic Acid as well.
Good Luck!
thanks a lot.
can you help me with self injecting vit B12.
the amount of the liquid and the ideal place for injecting?
any precautions i should take?
and also the procedure?
I have never taken the injections, so I have no idea. Others here might write back about that. In the meantime, try YouTube. It always surprises me howmuch different info they have on there.
I was just thinking, with the cold knees, you might be deficient in iron as well. I know the one from animals is better absorbed, but I haven’t had any problems with the regular ferrous sulfate. Just take it with vitamin C and zinc.
once again.thanks a lot.
really appreciate your help.
I have Hashimotos Thyroiditis and severe Graves eye disease. My labs just came back and my B12 was 299pg/ml. After reading this article I an assuming that is low. What type of B12 would you recommend to enhance my levels…
HI, I found this site very helpful for me. Since last 10 years I have been feeling very tried, always feel sleepy, can’t getup from bed in morning. I did lots of tests and couldn’t find any thing.poor apatite, always looks like lazy. I was scared about this.Last year I came USA and I went to the hospital and it is identified as vitamin B12 deficiency. My B12 level was only 98. Since then, I took shot every week for one month and once a month for next four month. I am very new to USA. I don’t know the treatment process here. I had Free insurance in New York. Now I moved Texas due to my work and stopped getting shots and started getting oral supplement ( 1000 MCG Daily) I still feel fell same pain and tried. Because of this continuous pain (specially in the feet) I couldn’t sleep properly for couple of days and had to visit even mental doctor. Now I am also having sleeping pills as prescribed by the doctor. Can anybody please help me how long does it take to have effect of injection/ Tablet of vitamin b12. How long does it take to get well . How dangerous deficiency is. I am new immigrant here. I am scared lot regarding my health as I need to do physical work for long hour even for my survival. I am mentally also disturbed because of this problem. My age is 30. I am sorry for my bad English
I’ve been doing a lot of research recently, and most of us cannot absorb b12 from pill form. Go get regular injections in a local clinic. Should be around $35 per shot.
Thank you so much for your information. If I again start getting injection normally how long does it take to feel better.
Part II Yadab. Sorry I disconnected by mistake. I went to HEB and bought Nature’s Bounty Vitamin B12 Quick Dissolve Methylcobalamin 1000 mcg. My doctor told me this is the BEST. It is “sublingual”, which means you put it under your tongue and let it dissolve. It is a small pink pill and dissolves very quickly.
From reading my google sites, I have also started eating red meat again (grass feed cows), eggs (free roaming non-caged), beef liver, natural salmon, tuna, scallops (not farm bred), and organic milk. Two weeks ago, Dec 8, 2014, my doctor ordered another blood test and my Vitamin B12 is now 650 (from 320 in Aug 2014).
I am feeling so much better. The semester is over and I can now run and exercise without too much pain. It takes time. I still feel tired and my energy is not 100% for running , exercising – but I feel is is 75% from one year ago. I will continue my B12 vitamin and good diet (meat, eggs, fish, milk, cheese – all natural, organic). My next B12 blood test will be in Mar 2014 – but I feel much better now.
Your culture may be vegan/vegetarian, and that will be a problem if you can’t change that (B12 deficiency is major in vegan countries). In that case, maybe two B12, 1000 micrograms a day would be ok. My doctor told me two vitamins a day is ok during treatment because our bodies need it at this point and it can’t harm.
Note: there is nothing else wrong with my health according to the tests, just a major diet change with no V-B12. Hope this helps.
Rudy,
Check your vitamin bottle. I’m pretty sure that Nature’s Bounty is Cyano, not methyl. If it’s working for you, fine, but I try to avoid cyanide, even when small, because a lot of things have it in, and it builds up. I use Natural Factors.
I found out I needed Magnesium as well. I thought I was getting enough through my diet, but I wasn’t, so I think everyone should take Magnesium as well. Just be prepared, some of them give you GAS.
As I recall (from the shelves at my own H-E-B–like Rudy, I’m an Austinite), Nature’s Bounty actually sells *both* forms, presumably for the simple reason that there’s a market for both. (The one virtue of cyanocobalamin is it’s cheaper to synthesize, but the bioavailability frankly cancels that out.)
A B12 level below 100 is a severe deficiency and I would not recommend taking sublingual in preference to injections. Even though sublingual bypasses the stomach absorption, you are still only getting small amounts of B12 – certainly not enough to treat a severe deficiency. Please find a doctor who will administer the shots again – once you start injections, you should be on them for life.
If you have been doing a lot of research, perhaps you should check out the Cochrane Reviews. The general conclusion from carefully controlled and reviewed studies is that oral administration CAN work as well as injection.
Hi Yadab,
I am from Austin, Texas, and also in treatment for Vitamin B-12 deficiency. I hope I can help you – there is hope. I am male and was always active in sport and good, health food, and vitamins. In Jan 2012 I started studying at college and working full time every semester. My diet changed – I became a vegan/vegetarian – no red meat, eggs, fish, cheese, milk. I ate lots of salads and chicken, turkey. Working so much and studying – I often ate from cans and junk food. I also stopped my vitamins.
Last year, I started to feel sharp pains in both my legs and feet. Like pins and needles. In fact, they felt like they were on fire. I also felt nerve sensations in my lower back – I could feel electric currents in my lower spine. I was so scared.
I could not walk very well either. I would lose my balance when walking, and always the “fire” in my legs and feet. Many times my feet and legs would jerk because of the electric current. I would become so tired and could not work in gym or run (I would just lose my energy).
In Aug 2014 I FINALLY went to my doctor of many years and told him. He did exams on me, and had me walk for him, and I lost my balance. I told him my history and he did a blood exam. I found out my B-12 was at 320 (normal is between 1000 – 1100 !!). In American, doctors still think levels are at danger below 250. In Europe, the danger level is below 500. I really thought I was going to be paralyzed and never walk again.
He was a smart doctor. He did not want to give me injections. He started me with 1000 micrograms of B-12 Methylcobalamin right away.
How are you feeling now Rudy?
If you ate chicken and turkey, you were not a vegetarian/vegan, because chicken and turkey are meat, and vegetarians and vegans do not eat any form of meat. Seafood is also meat, so if a person eats seafood they are not a vegetarian.
You are still classified as a vegetarian if you eat dairy and eggs, but vegans do not eat dairy and eggs. If you are a vegetarian for ethical reasons, an ethical vegetarian, then I can’t see how such a person could justify still eating eggs, since ALL hatcheries, cruelly kill all of the male chicks, including hatcheries sourced by free range egg farms.
Hatcheries have been caught suffocating the chicks crammed in large plastic bags and then just tossing them like that in the dumpster because it’s too much trouble and cost to bother gassing them, which is also hideously cruel and vile.
I need to find a doctor who knows this, plead help!
Hi Yadab,
I started taking FOUR 5,000mcg pills a day, so 20,000 mcg a day, and it was about 2 weeks before me feet and legs stopped hurting. I started with Cyanocobalamin, and have now switched to Methylcobalamin. I took the four pills for 2 years, then went down to one pill, but have had to go back to taking two a day. someone here writes about the oils, but I haven’t tried them yet.
Try taking Calms Forte by Hyland in order to help you sleep. It’s an all-natural pill. It used to be better, but it’s still o.k., or simply try chamomile or Sleepytime tea — you’d be surprised how well they work.
Be careful of any kind of prescriptions you are taking. I took one form of Blood Pressure pill, and noticed that I was jittery, depressed and paranoid, so I switched pill type right away.
You may want to either check your vitamin D or just get some subligual vitamin D at least 2000IU, I take 5000iu.. Vitamin B12 and V. D kind of go together.. if your deficient in B12 and D, taking just one of those isn’t going to help you.. If someone is deficient in Vit. D then they will always be deficient in B12 and Vice Versa.. usually not always of course.. Getting out in the sun isn’t always going to work either.. if you came from a Country where people work outdoors and it’s always sunny and you come here to the US.. you will surely be missing your usual Vt. D (which is actually a hormone by the way, and once it is low then all your other hormones get thrown off).. I bought myself a Sperti Vt. D sunlamp and take Vit. D by LA Naturals.. it’s the best I have found..highly absorbable.. good luck
Yadab, I agree with sunshine. If you have an absorption problem, you will need the injections, and you will need to monitor the B12 levels with regular testing.
Your feet might be hurting if you are working on your feet every day and constantly lifting things without a shock absorbing mat to stand on and/or without proper footwear. In this situation you can develop some kind of bone spur and even small fracturing of the bone. I had this happen to me and I had to do really firm massaging to the area on the bottom of my feet that were hurting, and switched to footwear with air cushioned soles that solved the problem, because I didn’t have mats to stand on at work. Target and K-mart usually sell air cushioned sneakers really cheap if you can wear sneakers to work, otherwise a shoe with a lot of cushioning in the sole, and you can add sports insoles too, which I add to all my shoes for shock absorption to prevent foot pain.
Also, in your situation, you may need a good general vitamin and mineral supplement to support your functioning because of the extra demand that your work schedule is having on your body’s entire system, which could even be contributing to the problem of absorbing B12. You don’t need an expensive vitamin and mineral supplement, just a good broad spectrum one that has everything in it.
Lastly, if you haven’t already, I urge you to get your thyroid gland functioning checked. My aunt and mother both had hypothyroidism (underactive thyroid) and it was a downhill slide of fatigue and tiredness that ended up with not being able to get out of bed. Of course fatigue and tiredness are symptoms that mimic symptoms of a whole range of things, but thyroid malfunction should be tested for. I hope things improve for you.