All blood tests normal but still feel ill every day b12

[Piinkjuice]

I had some blood tests done last year in the summer as I wasn’t feeling well and they showed that my vitamin b12 was too low. I’ve been having injections every 12 weeks at my GP. The thing is, this feeling won’t go away. I feel perfect in the morning and then as soon as lunchtime hits I crash, I get a headache behind my eyes and feel sick/dizzy, i feel so tired but the tiredness is a side affect of my anxiety medication. I’ve pretty much felt this way for 3 years. It’s always in the afternoon and I don’t know what is causing it. I thought it was the b12 issue however I’ve been having my injections for months now and my levels are fine. I’ve probably had 8 injections so far, as I had to have a lot at the beginning and then they reduced to every 12 weeks for life, because my diet is not nutritious enough.

I drink 2 coffee per day, don’t eat until 10.30am at work I have some cereal or toast, then have some lunch at around 1pm. That’s when it hits me, right after lunch. I wondered if it was my blood sugar however it cant be possible because I don’t feel ill when I eat at 10.30 or don’t eat, same as dinner time.

The nurse suggested that I tell my GP again but she pointed out my blood results are fine. Does anyone have any advice? Thanks

Did you ever find out why do you have deficiency. Even if you are vegetarian you get b12 from dairy and even if you are vegan most cereal and plant based milk are fortified with b12. I am not grilling you, you together with your GP should know the reason. Do you have pernicious anemia? If yes, then fine.
Do you regularly suffer from dyspepsia - nausea, urge to vomit, heartburn or tummy ache.
If yes then one possibility is you might have bile acid malabsorption. It leads to low vitamin and mineral in your body, could give you headaches.
One other possibility is reflux. Reflux is known to cause sinus irritation which can cause headache behind eyes.
Listen to your body and don't go hungry for so long. Have some breakfast or a light snack with in an hour or 90 minutes of waking up.

OP firstly -
You can eat foods rich in B12 till it's coming out if your ears but it won't make the slightest difference.
B12 jabs are not given as a supplement for poor diet.

B12 in injection form is given because your body is unable to absorb B12 through food.

If it was just a case of poor diet you would have been prescribed or told to go and buy B12 supplements.

Next - the nurse saying your blood results are now fine is completely irrelevant because testing B12 levels once you are on the jabs is pointless and not recommended. The results are totally meaningless.

Google the pernicious society. You will find everything you need to know about B12 deficiency there.

Just to say, having B12 injections doesn’t mean you necessarily have pernicious anaemia, NICE guidelines for B12 of dietary origin still involve having B12 injections. Having said that OP, I would look at your diet? If you don’t have pernicious anaemia you should be able to get sufficient amounts in your diet; if you are not getting enough B12 is it possible you are not eating nutritiously enough to get other essential vitamins and nutrients? Which could be contributing to your symptoms?

Is it possible you are intolerant to something you eat at lunchtime?

Could it be something you are eating? Can you try having breakfast when you get up and then the same thing again for lunch and see how you are? Be interesting to see if symptoms are the same or decrease.

Are you drinking enough water, 1.5l per day? Fill a bottle or jug to keep track of how much you drink. Don’t count tea or coffee. In fact I’d avoid coffee as well for a few days and see how you get on.

I keep getting told my bloods are fine too but I don’t feel right a lot. Although I may be within the nhs parameters for iron b12 etc it may be that my own body isn’t average and needs more iron or whatever!

There are also loads of other things they can test. Like thyroid etc. Go back to the go and she should want to get more tests done to see what else it could be. Don’t give up. I’m thinking about going private to check out the other things my gp won’t test.

Thanks everyone
Elieza, I drink two coffees and then around one normal bottle of water and maybe a glass of juice. I know it’s no where near enough. I find it difficult to drink enough through the day as I’m on my feet a work a lot. I might start carrying my water bottle around with me. Thanks 🙏

Ask for your numeric results rather than just whether they’re within the normal range. I recently had a blood test and my ferritin was “normal” but when I looked at the number it was barely in the normal range. Have started to take iron tablets and am feeling better. Without knowing the number I wouldn’t have bothered.

You mention a curry medicine. These will make you very sleepy.

You might also not be getting restful sleep if you are suffering from anxiety.

Do you eat only carbs and orange juice for breakfast and lunch? Could you list a typical day of food and drink. As it happens after lunch, it does seem relevant. Is something else going on at lunchtime or in the afternoon? Additional work deadlines, pressure, stress...

You don’t seem to Take very good care of yourself. If I’d didn’t eat till 10:30 then had heavily processed food I’d feel pretty bad too.

Hi everyone

My typical work day mon-fri

5.30 wake up

7am coffee at work

8am another coffee

10am a bowl of cereal or some pancakes or toast with maybe some cheese or some kind of snack like banana

1pm lunch either rice, chips, stir fry, soup, pasta or chilli, chicken sauce and rice

1.30pm lunch break finished and the headache starts, slight nausea

3pm home time snack in car on way home maybe

4.15 pm Snack maybe

5.30 pm dinner

Normal working day I would fit in the equivalent of two cups of water and I might have a fruit juice

Before lunch - lots of energy

After lunch - feel like zombie it’s so bad I’ve been so sleepy while driving home. It takes me over 1 hour driving. I’m not actually asleep I’m just in a trance like state and im not fully alert. It’s scaring me I’ve tried everything to stay awake but nothing works. I used to fall asleep on the train too when traveling that way. I’ve told the doctor and I'm convinced it’s my Sertraline causing this extreme tiredness.

Im fine as soon as I stand up out of the car, perhaps I can find somewhere to stop halfway and stretch my legs for a minute to wake myself up then continue my journey home

What time do you take sertraline?.

You sound like me when my vitamin D levels were through the floor and I was subsequently diagnosed with hypothyroidism....

I take my Sertraline on my breakfast break 10-10.30am with my cereal or something everyday I try to take it at the same time

Maybe I should change the time

Take it an hour before bed, if your going to get drowsy you may as well be asleep.

I think the timing of your meals is a factor here.

It sounds like your body goes from 6pm to 10am (16hrs) without/not much food. This puts your body into fasting mode.
You get up, do a 1hr drive which takes mental energy and focus.
Then you give your body 2 cups of coffee on an empty stomach.
Plenty of caffeine but still no food.
You feel energised but you are running on an empty tank.
Your body gets a very light meal at 10am, 4.5hrs after getting up.
At 1pm you gets a dinner type portion as I expect you are ravenous at that point!
All the blood will rush to your stomach to digest that. Then you are still in sleep/digest mode at 3pm when you have to drive home.

Next week, can you eat much more at the early coffee breaks/breakfast and eat less at the work lunch?
Can you have a cereal bar with one of those early coffees?
Have additional food with the cereal with the 10am break.
Then a bit of meat/chicken and salad with the lunch meal.
Don't have the rice or chips or pasta part at lunch.
Can you put grapes into your car and eat them on the way home.

Thank you so much @sadie9 that’s a great idea. Im going to start eating something earlier

Have skimmed through and haven't seen you mention folate (Sorry if I've missed it!) Have you had those levels checked?

Also agree to change to taking sertraline an hour before bed, and with @sadie9 advice on your meals. I also think you need some more fuel earlier in the day

It says folate was 4.8 ug/L

Im not sure what that means

That's right at the lower end of normal- would suggest an OTC supplement