Is Low B12 Level Simply My Norm?
I’m a 27-year-old woman weighing 147 pounds, and I’m currently on Norethindrone for birth control. I don’t smoke or drink alcohol. Since around 2020, I’ve been visiting my hematologist due to slightly abnormal lab results, which were flagged by my primary care doctor, along with various symptoms that prompted the referral. The symptoms I’ve been experiencing include: - An unusual sensation predominantly on the left side, described more as shock-like pressure rather than pain. - Tingly or numb feelings in my legs, arms, and hands, primarily on the left, but sometimes on the right as well. - Occasional left-sided facial twitching or a sensation of warmth. - Periodic eye discomfort, leading to a recent need for glasses, as I noticed I was struggling to read signs and see images clearly, which had not been an issue before. - A general feeling of weakness and fatigue. - Heart palpitations. These symptoms come and go, but they are consistently troubling. I regularly show low vitamin B12 levels and receive monthly injections. Additionally, my vitamin D levels are persistently low; the last reading showed just 10 ng/ml, so I’ve been prescribed a weekly vitamin D supplement. I hadn’t visited my hematologist in a while, but when I checked in February, my B12 was at 189 pg/ml, reaching 420 pg/ml by July, and it has recently decreased to 328 pg/ml. Given that my symptoms align with low B12, I suspect this could be the cause; however, it seems I am not retaining the B12 effectively. My hematologist ordered a brain MRI due to ongoing symptoms even after treatment, and it revealed “nonspecific minimal white matter disease.” Consequently, I have been referred to a neurologist, with an appointment scheduled in about four weeks. Additionally, she advised visiting a gastroenterologist, suspecting that my B12 absorption issues could stem from gastrointestinal problems. I do experience abdominal pain and have had intermittent rectal bleeding, yet a colonoscopy showed normal results. A few years ago, I was evaluated by a rheumatologist, who found mostly normal results except for positive indicators related to Antiphospholipid syndrome; however, I have never been diagnosed with this, as I’ve never experienced a miscarriage or a blood clot. Is it possible that my B12 level is just naturally lower without any underlying conditions? Does this indicate there must be a reason behind it, or could it just be normal for me? At this point, I’m beginning to think my body may just stabilize at a lower B12 level. Does this resonate with anyone, or should I continue to seek answers? After years of consultations, I still feel no closer to a resolution. Thank you!
Answers (1)
8/25/2025, 10:02:21 PM
OpenHealth AI
It sounds like you’ve been through a lot with your health, and your symptoms and labs certainly warrant careful attention. Here’s the main point: while it’s possible for some individuals to have lower vitamin B12 levels, your symptoms, lab results, and the recent MRI findings suggest there is likely an underlying reason for your B12 deficiency that needs to be investigated further.
Explanation
Vitamin B12 is vital for nerve function, and low levels can lead to neurological symptoms like tingling, numbness, and fatigue. Your fluctuating B12 levels indicate that your body may not be absorbing it effectively, which can be due to gastrointestinal issues. The persistent low vitamin D level and your other symptoms suggest a more complex picture that should not be overlooked.
Next Steps
-
Continue Monthly B12 Injections: Ensure you keep up with your B12 injections as prescribed by your hematologist, as this is crucial for managing your levels and associated symptoms.
-
Attend Your Appointments: Make sure to go to your scheduled neurologist and gastroenterologist appointments. These specialists can provide more insight into potential underlying causes of your symptoms and B12 absorption issues. Highlight your experiences and urgency about your symptoms during these visits.
-
Monitor Symptoms: Keep a journal of your symptoms, noting their duration, severity, and any patterns. This can help both your neurologist and gastroenterologist in their evaluation.
-
Healthy Diet: Consider incorporating foods rich in vitamin B12 (like eggs, dairy, meat, and fortified cereals) into your diet if they suit your regimen and emotional perspective. This won’t replace injections but may help support your overall nutrition.
-
Follow Up on Abdominal Pain: Make sure to communicate any ongoing abdominal pain or rectal bleeding to your gastroenterologist. They may recommend further tests to evaluate your gastrointestinal health.
-
Be Patient and Persistent: It can be frustrating to feel like you're not getting closer to answers. Remember, the process may take time but advocating for yourself and seeking comprehensive evaluations is essential.
You're doing the right thing by seeking answers, and it’s key to keep communication open with your healthcare team. Continue pushing for clarity on your health—it's your right to understand what's going on in your body. If you have further questions or need clarification on your symptoms, don’t hesitate to ask.
Related Questions
Severe Limitations Due to Dysautonomia Following Cancer Treatments
Hello. I'm a 38-year-old woman who completed her second round of cancer treatment in March. Over the years, I've encountered various unexplained medical issues (which you can find summarized at the end). My treatment journey was briefly interrupted because my mother was receiving hospice care. However, after resuming immunotherapy last September, I now find myself nearly confined to my bed. Whenever I attempt to stand up, I experience significant nausea (which often leads to vomiting or dry heaving, along with a runny nose and hot flashes). This reaction occurs reliably if I remain upright for more than 1 to 3 minutes. On some days, I manage to cope a little better, but many other days are quite challenging. My overall quality of life has greatly decreased, largely due to these severe episodes which often leave me feeling unwell for the remainder of the day. Additionally, I've noticed a significant increase in my heart rate, particularly in the mornings and during hormonal changes. I have been prescribed odanestron and olanzapine; however, their effect is minimal and only allows me to maintain an upright position for a slightly longer period. Before my cancer diagnosis, I experienced widespread pain and petit mal seizures. In my childhood, I dealt with several conditions, including: - Suspected long QT syndrome (originally SVT, but it evolved over time) - A lazy eye - Scoliosis - Inward-turned hips The vomiting episodes have compelled me to keep vomit bags strategically placed throughout my home, in my purse, and even in our vehicles. Currently, I've reached a point where I can only manage the essential tasks, such as visiting the restroom, and I’m largely unable to leave the house or navigate effectively within it. If relevant, I should mention that I've developed a patchy rash on my lower legs (from the knees downward) since starting immunotherapy. Dysautonomia has come up in conversations regarding my condition; prior to this, there was a suspicion of paraneoplastic syndrome. I'm reaching out in hopes of receiving some advice or recommendations. My limitations have led to my approval for disabled placards, and I've even applied for disability assistance, as standing has become an extreme challenge for me.
Issues with Gag Reflex and Nausea
A 20-year-old assigned female at birth has been experiencing recurrent gagging and vomiting episodes for the past two years, a situation that seemed to coincide with the onset of a new job, suggesting potential stress-related influences. This individual frequently encounters gagging or dry heaving when transitioning from a sitting to a standing position, and on occasion, they may even spit up. The symptoms appear to intensify during allergy season or when there is excess phlegm present in the throat. Following meals, the individual struggles with nausea, particularly when trying to change positions, such as sitting up slightly, standing, or taking short walks. Even after several hours post-meal, standing too quickly can trigger gagging or vomiting. While the person does have pre-existing heart concerns, they report no accompanying dizziness, and notably, they usually have a high tolerance for unpleasant stimuli, making these episodes particularly perplexing. An upcoming appointment with a doctor is anticipated, as this individual hopes to gain clarity about their symptoms—an endeavor that previous online searches have not illuminated.
Concerns About Potential GI Bleeding?
Profile: Age 22, Weight 180 lbs. For the past couple of days, I've experienced bowel movements that were black and liquid, though they were not tar-like in appearance, rather just a thin consistency. I have not consumed anything unusual or taken any supplements that I'm aware of that would explain this change. My most recent stool was normal in texture, and I have not experienced any accompanying symptoms like lightheadedness or nausea. Recently, my diet included Mexican cuisine and spaghetti, along with consuming a bottle of wine. Although I haven't had the unusual black stools for two days, my friends continue to recommend that I seek medical attention. It's worth mentioning that my grandmother had colon cancer, though I'm uncertain if there's a hereditary aspect to this. I have a history of bulimia and alcohol misuse in the past, but I've been stable lately and haven't encountered any ongoing health issues related to these experiences. Given that my last stool was typical and I do not feel fatigued, should I still consider visiting a hospital? I would like to point out that I am a financially-strapped college student with limited health insurance, so I intend to avoid the hospital unless it's truly essential.
Understanding Prolonged Bruise Healing: A Personal Account
At 30 years old, weighing 170 pounds and standing 5 feet tall, I contend with Crohn's disease and arthritis. My treatment regimen includes methotrexate, Stelara, and trazodone. One issue I encounter frequently is the prolonged duration of my bruises. While the discomfort subsides quickly and the initial discoloration fades as expected, the skin remains discolored for extended periods—often up to a year. For example, I sustained a significant bruise on June 7, 2024, after falling during an obstacle course, and it was quite severe on my knee. Even now, I observe that the pigmentation has not completely faded, lingering visibly. Regarding my overall health, I do not believe I suffer from anemia. My latest ferritin levels were at the lower end of the normal range, but they were acceptable according to my physician's assessment. I suspect I could have lipedema, but I have yet to receive a definitive diagnosis. What could be the reason behind my skin's delayed recovery? I seek to understand this frustrating aspect of my condition.
Concerns Over a 1.2 cm Thyroid Nodule
I’m a 24-year-old male, standing at 5 feet 11 inches tall, and I weigh around 220 pounds. Currently, I am not on any medications. In my childhood, I was diagnosed with gastritis, and I also underwent a tonsillectomy. Recently, I visited the hospital due to an unusual sensation in my throat. It hasn’t been painful, nor have I experienced any related symptoms. During my examination, a doctor performed a CT scan enhanced with contrast material and detected a nodule measuring 1.2 centimeters on my thyroid. He informed me that all other aspects of the scan looked normal, as did my blood results. Following this, he recommended that I consult with a specialist. While I understand that I should refrain from worrying too much at this stage, I’ve already scheduled an appointment with a specialist for a more thorough assessment. I would appreciate any thoughts on how to handle this situation, especially considering my work in law enforcement, where I tend to overthink matters like these.