Anyone know anything about b12?

This is broadly what my GP said. After years of being successfully treated with injections I didn’t want to experiment with b12 tablets - I tried them before, they didn’t work, the numbness, pins/needles and dizziness were horrible, I was too unwell to work.

Thankfully my GP continued with injections after coming to the conclusion that I don’t absorb b12 very well, I don’t have PA and I’m not vegetarian

I have low B12 (despite taking supplement and eating meat). Was told I needed injections which a big no for needle phobic me. I use a spray under my tongue. I never had any symptoms anyway. The people I know with PA were having pins & needles etc

As a GP, I want to say we have no personal vendetta against B12 injections…. Wherever its injection or tablets makes little difference to the prescriber. TBH implementing the injection regime is the most straightforward method of addressing any form of b12 deficiency for us, regardless of cost. We aren’t paying for it and (any GP I know) have zero interest in cost saving against what is right for the patient in front of us.

The European model (even for malabsorption) suggests that flooding with the high dose b12 tablets can treat b12 deficiency in people with low absorption as they will absorb a percentage… for an unfixed period of time… (until no absorption): as I understand it, that’s the model that was adopted by NHS over the acute covid period… and has worked for some (definitely not all) B12 deficiency patients.

So it’s not an unreasonable option (as long as you check effectiveness with a blood test after a few months) for people with mild or incidental findings of low b12, who want to try an alternative daily supplement to regular injections.

Some people are terrifically needle phobic, some don’t want to sign up for lifelong 3mo injections without trialling oral replacement with a follow up blood test to check it’s working.

Having said that, anyone with low B12 and nerve symptoms, or a low blood count, should absolutely be on injection replacement.

There are many ways to approach things medically, treating a whole person rather than a number…

Exactly that @NearlyMonday

There seems to be massive resistance from some GP practices to give patients these injections as tablets are cheaper but if you can, stay on the injections as the absorption is far superior.

Absolutely - If your body can't absorb B12 from the food you eat, then it won't absorb B12 from tablets, the digestive principle is just the same!

Hey there,
oddly a balanced diet can actually work against vitamin and mineral absorbtion. Some compounds in some plants can interfere with the uptake of iron and b12.
A nice plate a beef liver cooked in butter, for breakfast every week.
I know. I eat liver once or twice a week, and quite like it, but it can be chore.

I've been having the injection for years. Doc mentioned intrinsic factor and warned of pernicious anaemia. Every 12 weeks for me. Don't look forward to it tbh, delivered into the upper arm so I rub the area briskly to warm up the skin just beforehand and swear that helps. 🙃

On a slightly separate note, I’d be having a chat with your GP about your acid blockers for your stomach. Sometimes the high dose you are on is needed and the risks are offset by the benefits. But it’s a worthy conversation.

High dose PPIs (the name for that group of medications) do come with some increased risk long term- bone density being the one that I always consider.

45 is so low - you must have felt horrific.
As an op said, some people just don’t absorb it very well and need the injections.

After you’ve had the loading dose - think it’s 5 over 10 days - you’ll feel a lot better & then have them every 8 or 12 weeks.

As to whether it hurts - that depends on who gives it, but even at its worst it’s bearable.

There seems to be massive resistance from some GP practices to give patients these injections as tablets are cheaper but if you can, stay on the injections as the absorption is far superior.

I have B12 injections every 12 weeks. I was 3 weeks late for the last one (forgot to go to the appointment, menopause brain but that’s for another thread). I felt like utter shite!! Absolutely exhausted and no amount of sleep helped. I’m picking up again now. They were a game changer for me. X

Oh plus i has pernicious and coeliac test which were negative. I had rarely been platelets when pregnant which is when I found out about my B12

I have B12 injections every 8 weeks. I have macrocytic anemia. Plus i have IBS which surely contributes to the fact i cannot absorb nutrients.

its a wonderful jab!!

I was diagnosed with a b12 deficiency my mid 40s. I had pins and needles, numbness and dizziness. The doctor tried me on supplements to start with but they didn’t help. I was tested for pernicious anaemia but I don’t have it. I am not vegetarian, I don’t smoke and have a fairly healthy diet and lifestyle.

So I had loading dose injections, which worked,thankfully, and now I have 3 monthly injections and I’m fine. My GP explained that some people just don’t absorb b12 very well, and therefore need injections

I don't find the injections painful. I have them every 12 weeks and had the loading dose which made a terrific difference.

I'm on b12 for life when i am due i start to feel very tired exhausted bit stumbling and slurring about 48 after i feel like i have a new lease of life.

I started having vit by injections nearly 4 years ago. I told the doctor I was vegetarian and he said it's more to do with my long term underactive thyroid. I didn't know that was an issue but apparently so

This is a recent paper on treatment of B12 deficiency from the BMJ. Moving people off injections to an oral supplement is not effective if the deficiency is caused by malabsorption. Blood tests for intrinsic factor aren't that great for diagnosing pernicious anaemia, and malabsorption can have other causes anyway. Hope this link works: article here

For 2 weeks you'll receive injections every other day. Did your GP not tell you this? It's the standard treatment.

The b12 will fix 80% of that (the exhaustion through kids it can't help with). But I would put money on it being the omeprazole.

If you are getting numbness then I’d definitely embark on the loading regime for injections asap btw. B12 deficiency affects certain nerve tracts in your spine…

I think you mean iron absorption is aided by Vit C 😬 so yes, if iron deficient then steak and broccoli washed down with a shot of OJ.

re B12 def: if eating a good diet and not on acid suppression meds then most likely pernicious anaemia. A blood test can help differentiate. At 45 the injections are probably the best call. Once replete you could trial switch to high dose (prescription dose) b12 tablets with a recheck blood test in 3 months (and if falling the back to injections) or just take the 3 monthly maintenance injection…

The NHS limit for injections is 140 and under. Diet plays a huge part in B12 levels and gastritis and associated medications can cause malabsorption issues

My B12 levels dropped to a similar level to yours and I was incredibly symptomatic (stumbling and loss of coordination) I'm surprised you've not noticed yourself! I get injections every 8 weeks for life and my Dr says I'm one of the few they're not going to tell to swap onto dietary supplements.