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Vitamin B12 Deficiency 102 pm/ml is it very alarmingly low level ??

I just took a B12 test along with regular CBP and when i got the test results it was 102 pg/ml level which also flagged as Low . i contacted my cousin who is a neurologist and he told me to start taking B12 supplements immideately i am taking Cyanocobalamin injections 2ml Dose every alternative day so the last 10 days . Now since i started taking B12 injections i am getting Dark Black stools is this one of the side effects of B12 supplements ? plus anyone here who had B12 level at less than 150 pg/ml here how long it takes to recover from the deficiency and  what are all the symptoms you had for B12 deficiency ..
4 Responses
Avatar universal
This is not the right form of B12 for supplementation.  Also, did you take another B12 test to see if this one test result was an anomaly?  People's levels of nutrients do fluctuate.  Did anyone look for genetic problems with folate?  How did your folate and B6 come out, as these three are in balance in a healthy body?  I would guess that with injections, the form of the supplement takes on less importance, as you're being force-fed the stuff, but this form would not be the one to take if you were supplementing normally -- it doesn't get absorbed or used all that well.  Also, are you a vegan or vegetarian?  B12 is not easy to get without eating animal food, although it is very high in fresh water algae such as spirulina, so there might be a dietary reason for this as well.  Don't know about the stools -- that can happen with iron and can even happen when eating beets, but I'd ask your doctor about it just to be sure.
3 Comments
Also, if you were chronically very low in B12 one would expect fatigue -- that would be B12 anemia.  If you had no symptoms then still another reason you might have been wise to get tested again in a week or two to see if it was just one test at that one time on that one day.
No i had all the symptoms too much fatigue where i used to take stairs to reach my 11th floor flat before . Now i cannot even feel like having energy to walk from my flat to lift lobby , Plus to much of tingling pains in my fingers and feet other parts of body, Slight blurry vision and also pain in my head and pain in my tongue and throat and lips ..i had tested B12 in 2013 that time also it came Low but not sure what level it was and the doctor told to take me supplements i just ignored it Being an non vegetarian i thought i will overcome the deficiecy with my diet ..but this time it was very low ..I had a chat with my cousin who is doctor he said too much of beer drinking with poor diet can erode the B12 from the body faster ..which i think was the reason for last 2 years i was very high in binge drinking and poor diet .  
I just tested only my B12 not B6 and Folate should i need to test their levels too ???
649848 tn?1534637300
Vitamin B-12 at 102 is very low; you should not have ignored the low level in 2013 because it only kept going lower.  My level was that low at one time and I, too, must take injections to keep my levels up.  

Just because you are non-vegetarian doesn't mean you will 1) eat enough food containing B-12 and 2) absorb it once it gets to your gut... I happen to have been diagnosed with Pernicious Anemia, which when you don't absorb the B-12 through the gut.  Pernicious Anemia is an autoimmune condition that you have for life.

Long-standing B-12 deficiency can cause a variety of symptoms, ranging from the fatigue you mentioned, which for me, was the worst fatigue I've ever encountered, to easy bruising.  It can also cause Peripheral Neuropathy, which is tingling, burning, numbness in the hands, feet, and legs.  I have moderate PN because, for many years, doctors kept telling me that my fatigue was "in my head" and there was nothing wrong with me but they didn't ever test my B-12.  Once you have peripheral neuropathy, there's a good chance it will be permanent, so it's best to treat the B-12 deficiency to avoid the neuropathy in the first place... Trust me, it's miserable and there's little to be done about it...

You're correct that heavy alcohol use can deplete B-12 stores, so if you're still a drinker, it would be wise to stop or, at least, cut way back.  Aside from B-12 depletion, binge drinking can be dangerous for other reasons as well.

Cyanocobalamin is the most common type of B-12 used for injections.  I could see how it might affect the stools if taken by mouth, but I've never had it affect mine the whole time I've been doing my injections.  Could you have ingested something else that could have colored your stools in such a way?
3 Comments
My B12 injection has Cyanocobalamin 500 MCG+Folic acid 15 MG+Niacinamide 200 MG , Yes you are very right i stopped taking dairy products almost a decade ago and also not red meat i only used to take chicken and eggs . plus i had IBS for couple of years which made my digestion very bad ..I hope i didn't got PN but i have all the symptoms of skin burning in fingers and pins type pain in fingers and palm and also in other parts of the body . i also used to get tremors when sleeping this happened in the last 3 months that s when i realised there is something wrong with my body and got the B12 test done ..My vision has slowly degraded i am having sensitivity to bright sunlight and also little bit of blurry vision for last 6 months and what ever the eye drops the doctor prescribed didn't improve the conditions .

How long it takes for things to turn back to normal after starting B12 injections ??? Like i just completed my first course of 2 ML of B12 dose for 10 days . Not sure will this be enough or i need to start taking more injections before i move to diet based ..I had quit alcohol totally for last 5 months and don t think i will be touching it again for sometime now ..
Some of mine never did return to "normal"... I have permanent peripheral neuropathy, neurogenic bladder and of course, I had the early graying, as well.  Of course, once we've gone gray, we stay that way, but some other effects may resolve once levels are returned to normal.  It's just that my condition had been ignored for too long and the effects became permanent.

Because Pernicious Anemia is an autoimmune condition, once you have it, you have it for life.  I will take the injections the rest of my life (or until I'm forced to enter a nursing home or assisted living facility and some doctor refuses to prescribe them).  

When I started the injections, I was given 1 mL injection/week for 1 month, then dropped to 1 mL/month; however, the monthly shots weren't enough so the frequency was increased to every 2 weeks, which still wasn't enough and was eventually increased to weekly, which has remained for the past several years.

A small amount of alcohol is not damaging (as far as B-12 is concerned), but large amounts will again deplete your B-12...
So after a month of supplements and injections my B12 levels jumped up to 240 from 102 levels but still few symptoms of tingling pain in the fingers and leg are continuing along with easy bruising of the skin ..my doctor has told me to  continue the supplements for another 2 months ..Lets see how it helps
1756321 tn?1547098925
My lowest level was 68 pmol/L. A B12 of 0 is organ failure and death. I have autoimmune pernicious anaemia which is 100% fatal without treatment. I never had anaemia so blood cells never enlarged (masked megaloblastic anaemia). I suffered symptoms for decades unfortunately.

I take sublingual B12 (cyanocobalamin) spray daily which works well for me. This form of B12 is not retained in the tissues as long as methylcobalamin so if I stop my spray symptoms start to come back in days.

My symptoms of not enough B12 include...

Extreme fatigue/exhaustion
Brainfog
Tingling, numbness
Myclonic jerks
Permanent nerve damage
Enlarged pupils
Unpleasant body odor
Itchy skin
Blood on pillow every morning (blood from stomach)
Excessive drooling
Memory loss
Depression
OCD
Psychosis
Paranoia
ADD
Irritability
Anxiety
Bipolar mood swings
Suicidal thoughts
Feeling like I was going mad
Poor taste and smell
Poor immune system
Attracted a lot of mosquitoes - bites would turn into a large white lumps
Poor would healing
Clumsiness
Premature grey hair
Angular cheilitis
Enlarged red beefy tongue with crack down the middle
High pain threshold
Personality changes
Light sensitivity (eye pain)
Clotting issues (bled for an hour from a small nick)
Leg weakness
Dark circles (in my case an improvement after B12)
Hair not so greasy after B12 (still have issues with oily hair though)
White spots on forearms
Had to go to the bathroom immediately (incontinence)
Folate levels decreased in the range (increased again correcting B12 deficiency)
Aversions to fish and meat (a listed symptom that is possible as I only can eat bacon, chicken, ham, mince)
Poor appetite (still have this - possibly due to gastritis from antibodies attacking the stomach)
11 Comments
I forgot to add hyperpigmentation including brown spots.
Hi Red star

i have almost half of the symptoms you have mentioned including brown spots on my face both sides , Enlarged Pupils and Eye pain to bright light but along with that i also have slight redness in my eyes when i wake up everyday plus white discharge keep happening like twice a day from the eyes . Plus i have Eye Floaters too . i have Leg weakness on my left leg very badly .Premature greying my entire hairs from black went to grey in the last 6 months now i realise it was the B12 which caused this damage .

This B12 is not just any normal Vitamin to be taken casual which i am realising after all these painful experience ..I Just pray people take real care about the B12 and treat them before its too late .
My suspicion is that none of you have this because of poor diet.  As mentioned by the two above who have this problem, some people are born with a problem in absorbing B12, folate, and B6.  Generally the only people with dietary problems are radical vegans and vegetarians who aren't aware this can be a problem for them and don't compensate for it by adding foods that have this in them -- there are vegetarian ways to get it but they aren't necessarily in a normal diet (vegetarian diets can also lead to a lack of methionine).  But since you aren't a vegetarian, your problem is probably something you were born with and has broken out -- or did a few years ago and neither you nor your doctor took it as seriously as it now appears you both should have, but hindsight is 20/20.  For you, you need to do what your doctor tells you to do, including how long you'll need injections and what to do after that.  As I said, there are some genetic defects that many people have that can lead to to this problem, but that doesn't mean if you have those defects you'll have this problem, it just means the probability is higher.  One way to tell is if your homocysteine levels get high, which is controlled in part by the right combination of folate, B6 and B12. Some throw this out of balance by loading up on B12 for energy, but that isn't the case here.  You're in your doc's hands now.  Best of luck.
Thanks let me see i completed my 5 doses of injections today will wait for few days and see if there is any improvements in my symptoms and then will check with my doctor for the course of action ..
Paxiled... red meat, dairy, and eggs have always been some of my favorite foods (even liver... lol), so lack of B-12 intake was never part of my problem... I struggled with symptoms, mostly fatigue, for years.  An old country doctor back when I was in my 20's suggested Pernicious Anemia and started me on B-12 shots but back then, there was no such thing as insurance and with small children, we couldn't afford to maintain the weekly shots, besides I didn't notice a difference in the way I felt.  I stopped doing them and forgot all about that diagnosis.  

Over the years, my fatigue got worse and worse and my doctors blamed it on everything under the sun (from simply raising kids to alcoholism even though I wasn't a big drinker), but none of them ever tested B-12.  One doctor told me there was "nothing" other than alcoholism that causes red blood cells to be larger than normal (macrocytosis)... At the time, I didn't know B-12 deficiency/Pernicious Anemia does.  Even going without alcohol for 3 entire months, which is the time he said it takes for red blood cells to regenerate didn't bring them back to normal size.  He only accused me of not stopping alcohol like he'd instructed...wow!!  

Other symptoms appeared that were never connected to the fatigue because my doctors simply thought that was caused by "other things"... Finally, when I began having peripheral neuropathy, cutting my feet because I couldn't feel what was happening the doctor I had at the time, finally had a "lightbulb moment" and sent me for a B-12 test...

I was started, immediately, on injections and they helped some, but not as much as he thought they would.  It was only a year later that I was diagnosed with Hashimoto's/hypothyroidism.  Pernicious Anemia and Hashimoto's are both autoimmune and we know that once we have one autoimmune condition, we have greater chances of getting another or more.  It's not unusual to see Pernicious Anemia and Hashimoto's together.

In addition, my doctor had not tested folate levels and when I changed doctors a year after being diagnosed with Hashimoto's, my homocysteine level was quite high and folate was non-existent.  I began taking a methyl-folate supplement and between the B-12 injections, folate and balancing thyroid hormones, I began my journey back to better health.  I'm not there yet because I have other issues that my doctors are still reluctant to address, but I think I'll eventually be able to convince them they need to.

sierrakilo... you are correct that this B-12 deficiency is not a "normal" vitamin, but then none of them really are... our body needs all of them, as they perform activities in our that we often have no clue about.  Deficiency in any one of them can cause a variety of ill effects, so it's necessary to try to eat a balanced diet and get all the necessary vitamins/minerals we need.

Good luck...
barb135 Thanks for your detailed info i will continue with my B12 injections for at least one more week before i move to supplements and try to take it over by diet . i haven't tested By Folate and B6 not sure should i get tested for those two also and start taking supplements.
Barb, I was agreeing with you -- guess I didn't say it well.  I was saying diet isn't the problem for any of you here, it's something else, perhaps genetic, and therefore in the hands of the docs for now.  The question is what to do after the B12 levels normalize, and that is when the issue of the cause comes up, assuming someone can determine the cause.  If the person is now told to supplement, the important thing is to take forms other than the cyano form, as that's the least usable for the body.  You get much more bang for your buck with methyl, for example, and often it's the methylation process that is the genetic problem.  But not knowing the cause in this case, I'm leaving it to the docs for now until the poster learns something about why this happened.
Oh, forgot to say, the reason I'm bringing this part up is to make sure the poster doesn't end up taking so much B12 that it affects adversely the folate and B6 levels, which is why the cause is nice to know and repeated testing is also important.  
Thaks Paxiled for the valuable info i will get tested for B6 and Folate levels too once i complete the course of my supplements for 4 weeks ...Yes i should also find out the root cause that will give me a clear picture whether this is going to be short term issue or a long term one ..
Paxiled... I kind of realized that after I responded... sorry.

As for what happens after the B-12 normalizes... mine only stays at normal levels as long as I take my shots.  A week after my injection, I'm feeling like something the cat dragged in and if I skip a couple of weeks my level starts dropping like rocks, even if I take an oral supplement of the methylcobalamin in liquid or sublingual form.

The thing is, my blood levels of B-12 may be high enough because of the injections, but am I really getting all the benefit from them because they "are" the cyano form rather than methyl?  There is methylcobalamin in injection form but I'm not sure why my doctor isn't prescribing it.

My record says my Pernicious Anemia is caused by lack of intrinsic factor; we'll see if the original poster turns out with a similar diagnosis if the doctor goes far enough as to look for a cause.
I'm no expert for sure on injections, but I've got to believe that an injection is so direct and potent that the form takes on less importance than when you take a supplement, but if a problem with methylation is your problem, then maybe it makes a bigger difference.  It used to be that all supplementation offered by doctors was the wrong form for best absorption because doctors are owned lock stock and barrel by the pharmaceutical companies and the latter only care about selling high a product they get at low price.  It would be interesting you ask your doc and see if he even has a clue about what he's giving you -- if his eyes glaze over when you mention there are other forms of B12, why are you giving me this one?  My doctor knows a little which makes him even more dangerous, because he's always arguing with me lately about things he knows nothing about but has "heard" things about.  But again, an injection is a pretty potent way to get anything, while supplements are much harder to get where you want them to go.  Who knows?
1756321 tn?1547098925
I hope you don't have permanent nerve damage. There are many other possible symptoms of course. My sister, who also has autoimmune pernicious anaemia, had some of the same symptoms I did and other symptoms including jaundice, low blood pressure, tremors, insomnia, small pupils. She also had cervical dysplacia and had unnecessary surgery since vitamin B12 deficiency caused the irregular cells and the cells become healthy again with B12.

The B12 awareness website lists causes of B12 deficiency.

"What are the causes of vitamin B12 deficiency?

Decreased stomach acid
Atrophic gastritis
Autoimmune pernicious anemia
Helicobacter pylori
Gastrectomy, intestinal resection
Gastric bypass surgery
Malabsorption syndromes
Crohn’s disease
Celiac disease (gluten enteropathy)
Chronic pancreatitis
Bacterial overgrowth (small bowel)
Fish tapeworm
Alcoholism
Malnutrition—Eating disorders
Vegetarianism
Advanced liver disease
Transcobalamin II deficiency
Inborn errors of B12 metabolism
Certain drugs
Nitrous oxide"


3 Comments
I thought of another one of my B12 deficiency symptoms - spider veins. My sister had this symptom far worse then I did. She also had hair loss. Some of her symptoms are related to anaemia (her blood cells enlarged where as mine did not).
Funny i had just got B-12 test done and it dropped back to 160 pm after going all the way to 327 pm just 4 months ago ..now i have to again start taking the injections for B-12 ...looks like something is really affecting my stomach in absorption of B-12
Have you been tested for a genetic disorder some have that can affect absorption and conversion of the homocycteine vitamins B6, B12 and folate?  Also, are you vegan or vegetarian?
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