B12 asking for advice. More a wwyd?

[VitsQ]

I've been to the GP recently because of strange sensations in my feet. Dr has done vitamin tests and I've got some results back. The B12 result is 386 ng/L. That came back as normal. I've googled and it's on the lower end of normal. I'm wondering what to do?
Should I query this? Or maybe get a B12 spray from a health shop?

I would probably just get a good quality supplement and take it for a few weeks to see if you have any improvement.

I have nerve pain in my face, I started taking vit B complex, vit D and K2 and magnesium and it has definitely helped. I had strange sensations from the nerve eg crawling, itching and its gone - it could be a coincidence but I will continue taking it anyway.

If there is no improvement I would go back to the GP.

You went to the doctor and the doctor said you don't need anymore Vitamin B12 and now you want to know if you should take more B12?

The doctor should know more than Mumsnet TBH

I had the same. My feet were what made me go for help. I was just on the edge in terms of numbers. but my goodness it helped with my feet and my brain fog. Unfortunately a supplement won’t help if ur body isn’t taking in b12 in its own naturally.
I would go back to ur doctor and have another conversation or look into getting it privately.
it really is life changing to have it. And I didn’t realise even with my numbers just how bad I was feeling until I wasn’t anymore.

Thanks. I know in the UK the acceptable level is low. Glad it helped you.

The guidance is unhelpful in the UK. If it’s acceptable, which is actually quite low in the range, they don’t offer anything more. I had similar and disregarded the GP and checked research, liaised with European colleagues and started supplementing with high quality supplements plus diet change which led to a much better quality of life.

Try sublingual B12. It's effective. I use cytoplan but there's lots out there

The 'lower end of normal' is still normal.

You can google B12 injections at pharmacies near you - you might find that supplements don't work if you have an absorption issue and the injection boosts straight into the bloodstream so might just perk it up enough to feel better. If you were very low you'd need a full set of loading doses which you would get on NHS before they make you pay for monthly injections of B12 for pernicious anemia.

Thanks for the advice.

FYI B12 isn't toxic so if you don't need the extra your body will expel in sweat and urine, so no harm done and a chance of feeling better.

I had same recently. ’borderline low’. GP wants me to eat cornflakes and marmite. His words lol

Of the doctor didn't say you need b12 then don't take it. Magnesium, thiamine and other supplements can help with some kinds of foot pain. But I was prescribed those and was malnourished. So it's different for everyone.

But I would take the doctors advice.

I'd recommend joining the Facebook group Vitamin B12 Wake Up, they are very helpful, there is also a UK based B12 group. They will offer good advice.

B12 'normal' levels are set too high here in the UK, many people suffer greatly and are still told all is ok and so action needed when B12 jabs and the right supplements (usually sublingual) help greatly.

Also do you know your folate levels? If they are low that can falsely elevate your B12 levels.

There is also an anaesthetist in Cambridge, Dr Andrew Klein, he has an interest in B12 deficiencies and will answer any questions via email, I have found him to be very helpful.

Yikes! I've just ordered a sublingual one so I'll report back in a few weeks.

I concur with the post above about the Facebook group. They've helped me a great deal after years of suffering with symptoms and being ignored by gps. Sublingual won't help if you eat meat and dairy, you need injections. I now inject myself every other day and supplement folate and a b complex. You need to have your full blood count, folate, vit D and ferritin tested before you start supplementing.

I'm glad you're ok now. How low were you?

Whilst that is technically within the normal range in the UK, it’s definitely on the low end . The UK test also shows all B12, not just active B12, which can be much lower. You can experience neurological symptoms at that level.

When you say strange sensations, do you mean tingling / numbness / burning / crawling sensations? Do you have any other symptoms like brain fog, fatigue, memory issues? Is your GP investigating other possible causes?

B12 comes from animal products like meat and dairy, so people who don’t eat much of these can become deficient and a supplement or spray should help. However, there’s also an autoimmune condition known as Pernicious Anaemia (PA) that prevents absorption - if you have that then supplements will not help.

An Intrinstic Factor Antibody test is used to identify PA, although it’s not fully accurate and is known to give false negatives even when someone has PA. If you have PA then you will need B12 injections for life, regardless of what your B12 levels are. A GP can request this blood test for you.

If it’s not PA then the spray should help, although it may take a bit of time to reverse any nerve damage. The sooner low B12 is treated the better.

You may also want to check your co-factors are in range to support with healing - folate, ferritin, potassium and vitamin D. If you have PA there’s a chance it’ll also be affecting you absorbing other things. I would not recommend taking folate supplements while your B12 is initially being treated though as it can mask the symptoms of a B12 deficiency.

I’d recommend having a look at the Pernicious Anaemia Society website - they have a list of symptoms and loads of info on B12 deficiency and PA. They also have a helpline.
https://pernicious-anaemia-society.org

Also have a look at their Health Unlocked forum for advice from others with the condition.
https://healthunlocked.com/pasoc

NICE guidelines - https://www.nice.org.uk/guidance/ng239/chapter/recommendations#recognising-vitamin-b12-deficiency

Please ignore the comments about doing nothing if you have symptoms of a potential B12 deficiency / PA. PA is woefully misunderstood and frequently misdiagnosed or treated incorrectly - it can cause permanent damage if left untreated. B12 is water soluble so you can’t take too much as your body will get rid of any you don’t need. I suggest doing your own research and deciding on the best course of action for you.

@VitsQ The lowest I've been is 350 but my MCV and MCH have been out of range for 20 years. My folate has also been low the whole time. You can have 'normal' Serum b12 and still have a functional deficiency. Post your blood test results in the Facebook group and people will help you. There's also a GP in the group who specialises in B12 deficiency, I had and consultation with him and he's given me a letter to send to my gp

@TheSunshineSanctuaryand some others are speaking sense here, others not so much. Do not blindly trust your GP when it comes to B12, and do not take supplements unless you are vegan as this will skew any further results.

There is no gold standard test for B12 deficiency. You can be deficient despite the levels measured in your blood being in range if you can’t absorb it. Specialists go by symptoms and a range of tests to rule things in/out.

If you’re having neurological symptoms and you suspect B12 deficiency you may need to ask your GP to refer you to haematology for further tests. Many GPs are not up to speed with recent guidelines re B12 and don’t follow the NICE guidelines.