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
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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.
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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.
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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.
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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.
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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.
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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.
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