Why is B12 depleted?

[MayV]

I am a 49-year-old woman. After feeling sick, run down, generally unwell, with erratic moods and unexplained, random pain, I had a full physical seven months ago. The extensive blood labs showed my B12 levels were very low, but my iron profile was perfectly normal. I was also very deficient in Vitamin D, and I take a prescription supplement for that.

The doctor put me on an oral B12 supplement and I take it daily, in addition to a combination B-vitamin supplement I've taken for a few years. My diet has been excellent, balanced, and healthy--no junk--for many years. I am 99% a vegetarian, but I eat fish once a week, and I regularly eat eggs, cheese, and yogurt.

So, why isn't my body holding onto the B12 I consume in my diet? Now that I've been taking 2,000 mcg B12 daily for seven or eight months, I expected to feel better, but I don't. How long does it take for these supplements to provide noticeable benefits?

[Renee Radenberg]

The Schilling test indicates if you have pernicious anemia (the body’s intrinsic factor is working or not). From the foods you stated you consume, it sounds like you are a “no red-meat” vegetarian. Vegan vegetarians are at high risk for Vitamin B12 deficiency if they do not take a supplement due lack of all meat products in their diet.  Suggest getting blood drawn again to see if your Vitamin B12 levels have improvement. Injections are the best treatment and recommend you have a discussion with your Doctor about injections if the levels did not improve.  

[sanmit]

mayv
hi there
u told that u have undergone many investigations.is all this ur recent investigation or 8 months back?if its not recent go through repeat vit. B12 & CBC and blood picture.it normally happens that in strict vegeterian diet vit B12 value goes down but u r not strict vegeterian and already taking vit supplement for 8 months.so level should come up.whether vit b12 is absorbed well or not this can be tested by schilling test.u need not to worry ask ur doctor for injectable supplement of vit b12.write again with ur recent reports and further development if any.
Take care.bye

[MayV]

I see this is the copied answer to another poster's question, so much of it doesn't apply to my questions. I am NOT receiving B12 shots--only oral supplements for almost eight months. The rest of my very complete blood work was normal, including serum folate, RBC folate, CBC, Iron binding capcity showed some availability, but was in the normal range.

How is it determined that a patient is or is not producing intrinsic factor?

I eat eggs, I eat fish once a week, I consume dairy of some sort (mostly yogurt and cheese) every day, and always have.

How long should it take before the B12 supplements make me feel better? It's been eight months--I was expecting to feel at least a little better by now!

[Renee Radenberg]

There is a factor in our stomach that we need for Vitamin B12 to work. If that is not present, pernicious anemia occurs and we become vitamin B12 deficient. Supplementation is used for mild vitamin B12 deficiency, such as, with chronic alcoholism, therapy for gastric acid inhibitors, vegan vegetarians, autoimmune disorders, or dementia. Vitamin B12 shots are the best method of treatment, which you are receiving, and normal treatment is once a month. Your blood levels are monitored while you are receiving injections. Some people have low vitamin B12 levels due to folate deficiency. You did not mention your folate levels. Suggest you get a complete Iron profile blood work, which includes MCV, Serum B12, MMA, serum folate, and RBC folate so you can see if you are really deficient in any vitamin Bs or not. Vegetarian diet needs Vitamin B12 supplementation due to lack of meat in diet. One egg a day and 1 cup low fat milk, to name a few vitamin B12 sources would help increase the vitamin. Hoped this helped you.