Determining the Duration for B12 Injections in Patients with Neurological Symptoms
At the age of 27, I’m a cisgender woman of 5'6" and weighing 100 pounds, living in the United States. My diet generally includes animal products; however, I have recently been diagnosed with several deficiencies, including iron deficiency anemia and a lack of vitamin D, alongside reduced levels of vitamin B12. After undergoing an iron infusion, I discovered that my B12 levels had dropped significantly. A doctor suggested administering a B12 shot, but I learned that this treatment might complicate tests intended to diagnose pernicious anemia or assess my ability to absorb B12. I have been advised to receive B12 injections, but my new physician wants to evaluate my levels before determining when to cease treatment after I’ve only completed the loading doses and a week of bi-weekly administration. Meanwhile, a different nurse informed me that the B12 injections I’m receiving (specifically cyanocobalamin) are washed out of the body within 24 to 48 hours due to their water-soluble nature. Thus, even if my blood test shows elevated levels, those figures might not be significant as they may not accurately reflect my body's long-term status. Moreover, another healthcare professional indicated that I should refrain from B12 intake for two weeks before testing for pernicious anemia. Despite these recommendations, I am experiencing persistent symptoms and am uncertain whether continuing the injections might aid in alleviating further complications. Since October, I've had lower back pain, nausea, tingling in my fingers, and a complete lack of appetite. I’ve been striving to convince doctors that my condition extends beyond mere dehydration. I am also dealing with dental pain, eye discomfort, gastrointestinal issues, and anxiety, yet other doctors advise returning to neurology. However, neurologists suggested not to focus too much on B12, despite my vitamin deficiencies, and mentioned several tests must be conducted before examining my spine. I have appointments scheduled with specialists in rheumatology and gastroenterology to investigate potential causes of my absorption difficulties. With my condition remaining unexplained, should I not continue B12 injections to prevent exacerbation of my symptoms? Additionally, during a visit to the eye doctor, it was confirmed that there are no signs indicating Leber's disease, which would warrant pausing cyanocobalamin treatments. As the injections are not addictive, it seems that avoiding them could lead to greater issues than continuing. I am puzzled as to why my physician would recommend reducing my treatment regimen at such a critical time.
Answers (1)
2/6/2026, 3:20:39 AM
OpenHealth AI
Your situation involves multiple health concerns and navigating through varying medical advice, which can be understandably confusing and concerning. It sounds like you're seeking clarity on whether to continue B12 injections to manage your symptoms, particularly given your neurological symptoms and the complexities surrounding your nutritional deficiencies.
Main Points:
- Ongoing B12 Injections Belief: B12 is crucial, especially with neurological symptoms; continuing injections may provide symptom relief.
- Monitoring Levels: Regularly assessing your B12 and overall health status is important for tailored treatment.
- Consider Coordination of Care: Having all your healthcare providers aligned can avoid conflicting advice and ensure comprehensive care.
Explanation:
Vitamin B12 (cobalamin) is vital for neurological function, and deficiencies can lead to serious symptoms like tingling, neurological issues, and even other systemic problems. Since you have experienced persistent neurological symptoms alongside your deficiencies, continuing treatment may be beneficial, particularly if your symptoms have not improved since the initiation of B12 injections.
While it's true that B12 is water-soluble and can be excreted quickly, its effects in the body can lead to improvements in energy levels and neurological health over time. Therefore, waiting for blood tests to show stable B12 levels before deciding to cease treatment may not be ideal if you are currently symptomatic.
Next Steps:
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Continue the B12 Injections: Talk to your physician about the benefits of continuing the injections, especially how they may affect your neurological symptoms. Given the contrasting information you've received, it’s reasonable to advocate for maintaining your treatment until a clearer resolution is reached regarding your symptoms.
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Communicate Symptoms Clearly: Document your symptoms consistently, and be sure to communicate these to all your healthcare providers. This might help them understand the severity and the impact of your symptoms more clearly.
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Schedule a Follow-Up Appointment: Request a follow-up appointment sooner than later to discuss the results of any tests being done and the ongoing treatment plan. This can also include a discussion about the implications of your other health appointments.
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Coordinate Care: Encourage communication among your healthcare providers (primary care, neurologist, rheumatologist, and gastroenterologist) to ensure that everyone is informed about your complete health picture. This helps in pooling their expertise toward a comprehensive approach to your care.
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Be Proactive with Third Opinions: If advice continues to feel inconsistent and unhelpful, consider seeking a third opinion or a specialist who is well-versed in nutritional deficiencies and related neurological symptoms.
It’s essential to prioritize your well-being through these next steps, considering your symptoms and the potential benefits of treatment. You are not alone in navigating this, and proactive communication can make a significant difference.
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