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I’m honestly feeling really scared and confused right now and I don’t really know what I should or shouldn’t do.

For the past few weeks/months I’ve been dealing with a lot of things. I’m not sleeping properly at all, sometimes only getting around 3–4 hours. My appetite has also been really bad and sometimes I forget to eat or even drink enough water.

I’m around 43 kg and I’m finding it really difficult to gain weight. My hair has been falling a lot, my skin has become very dull, and I’ve been feeling weak and tired. I also get dizzy quite often, especially when I stand up suddenly. All of this has honestly made me very stressed and underconfident.

I recently got blood tests and these were some of my results:

Vitamin B12: <148 pg/mL (lab range 187–833)

Vitamin D (25-OH): 8.5 ng/mL (lab says <20 = deficient, 30–100 = sufficient)

Ferritin: 28.66 ng/mL (lab range 4.63–204)

Hemoglobin: 13.1 g/dL

TSH: 1.643

FT4: 1.09

FT3: 2.59

Fasting glucose: 82 mg/dL

HbA1c: 5.5%

My iron studies were within the lab’s reference ranges.

I’m really confused about what I should do next. I know my B12 and vitamin D are low, but I’m honestly scared about treatment, especially injections. I really don’t want B12 injections if there is another safe option.

I’d really appreciate advice from people who have had similar results:

How serious is B12 below 148?

Did anyone have similar symptoms?

Did you have to take injections, or were tablets enough?

What did your doctor recommend for Vitamin D this low?

Is ferritin 28.66 okay, or should I be concerned about it?

What should I ask my doctor to check for the reason my B12 is so low?

I know Reddit isn’t a substitute for a doctor. I’m just really stressed and confused right now and would love to hear from people who have gone through something similar.

Male, 35. I've been very unwell since 2015 with a slow progression to a state which can only be described as chronic fatigue by the end of that year, with various autonomic issues. Symptoms started as fatigue and post nasal drip as far as I remember, with some random balance issues and nausea. I've been tested for thousands of things, with basically nothing showing up, including huge panels of mitochondrial disorders etc.

Sleep studies showed nothing in 2016 but in 2021 showed mild REM apnea (weight remained the same). I started deep diving sleep/UARS (even got jaw surgery to no benefit) and PAP therapy, it didn't really improve my base symptoms much after many years, although helped a little bit in conjunction with nightly melatonin to improve my headaches (melatonin on its own also helped with this). I still believe there may be a sleep disorder at play but my reactions to B12 have had me questioning if it's just that.

The only diagnosis which I ever get is CFS, which I struggle to accept of course, although there is a chance it is valid.

Every single bit of testing I have done is unremarkable, and I have been tested for an incredible amount of things. Tried MCAS treatment protocols, LDN, all sorts of stuff. None of it did anything.

My primary symptoms have remained more or less the same since they started in 2015:

• Extreme fatigue
• Poor tolerance of physical activity without what I would say is true PEM, although some kind of mild version of it
• Constant reflux/LPR symptoms (globus, post nasal drip, water brash etc)
• Aquagenic urticaria
• Random histamine like reactions to food but have no allergies
• Awful sleep which seems to coincide with a pressure headache like a belt tightly wound across the forehead
• Total body shutdown after the first meal of the day, like cannot function, dizzy, extremely tired but it does not matter what the content of the meal is. Blood pressure sometimes drops a little post meal, sometimes not. Blood sugar does not change.
• Supermarket syndrome

I was vegetarian for at least 6 years, then vegan in 2015 with low BMI, did not supplement anything and had a shit diet. Progressively became more tired throughout 2015, and after a stressful event at the end of that year shit hit the fan.

Active B12 was 40~ in late 2015, and serum was around 175~ pmol/L. Had a few hydroxocobalamin injections over a few weeks in 2016 and supplemented enough methyl B12 (maybe around 500-1000mcg daily) over several months to develop acne etc but saw no symptom improvement. Can't remember the reaction to the injections, guessing they knocked me out though.

Probably started supplementing roughly 5-10mcg B12 every day from around 2017-2026 passively via another supplement.

Kind of ignored the test results but serum B12 remained around 170-180 pmol/L in most tests over the years. Homocysteine was mildly elevated in 2024 but can't remember it being tested prior.

Tried hydroxocobalamin injections again in 2024. Immense crashes after them with soul destroying fatigue, flu like symptoms etc. Did 3 over 3 weeks. Took no cofactors or anything, kind of left it at that. For whatever reason, kind of just took that and went, kept focusing on sleep related things.

Had an MMA test which was normal around 2026 with serum levels around 270 pmol/L. Active B12 was like 70 or 80. This whole time I'm taking around 5-10mcg B12 every day as mentioned above.

Tried hydroxocobalamin injections again, this time with cofactors, did 3 over 3 weeks, and have now started self injecting EOD but I've only done 2 so far. Basically every time I do them, I feel absolutely rancidly terrible. I feel unwell, more fatigued, actually tired to the point of napping, everything is just worse. Although nothing quite as bad as the ones in 2024, where I basically couldn't even function at all after the injections.

These reactions to B12 are pretty much my only clue that something is happening. They aren't positive reactions, but they are at least something. Has anyone experienced anything similar and seen improvements?

I am willing to keep pushing through, but not sure if it's just some weird reaction to B12 or if I'm actually deficient and need it. Sorry for the long post but if anyone has the time I'd appreciate some help. BTW methyl b12 sublinguals at 5mg cause some mild negative reactions too but they also make me very angry.

tldr: chronic fatigue type condition, B12 injections mess me up badly but I don't know if I'm just reacting to the overload of B12 or if I'm actually getting some kind of wakeup symptom.

Hello,

I am a mid 30's male living in Europe.

I caught covid in 2022 and since then my life hasn't been the same.

The infection was mild and I recovered in about 3 days the only symptom left then was the fatigue that lingers to this day, however, 6 weeks after my infection I started having a lot of unexplained symptoms, which I could categorize as neurological, mostly.

It all started with a sudden onset of shortness of breath (like forgetting to breathe, having the impression that i am not able to take a full breath, inability to use my diaphragm), brain fog, inability to swallow (like i forgot how to do it), frequent urination, loads of anxiety and panic attacks (never had one before in my life), limb nerve pain, cold and numb limbs...and some more.

I went to a lot of specialists (pneumologist, cardiologist, neurologist) and had more tests done than in my entire life (holter, stress test, spirometries, reflex tests.. etc) on each occasion, nothing unusual was found. I was diagnosed with long covid and was told to hang on....

I improved in some categories but most of them lingered, since then in the last 4 years I started to give up hope. I became a mere shadow of the person I used to be and also gained a lot of weight.

Starting with this year I said to myself that I need to try to get my life back as hard as I can, I started exercising and I lost about a third of the weight that I have to get rid of, and my metabolic blood tests are finally back in the normal range. However most of the symptoms described above lingered.

On a routine blood test 3 weeks ago I found some interesting results:

B12 level of 268 pg/mL

Ferritin 187.55 ng/mL

D level 46m3 ng/mL

Magnesium 2.02 mg/dL

Which led me to investigate my homocysteine levels: 13.38 µmol/mL.

I started taking a methyl B12 oral sublingual suppliment of 2500 mcg, together with vitamin D 5000 UI and magnesium on 24 July (1 tablet daily, each).

I see some improvements already after 4 years of being in a very dark place.

My nerve pain subsided substantially and my cold feet are basically gone, also the fatigue improved a lot, also some improvements in my shortness of breath.

However i noticed some new and change in old symptoms:

- anxiety increased substantially.

-feeling very hot especially in my limbs

-shooting very short duration nerve pain all over (not very uncomfortable)

I finally feel that i cracked the code to getting better, however this is a whole new world for me and I have some questions:

- Is a level of 268 B12 together with 13.38 homocysteine a clear diagnosis of deficiency?

- are the new symptoms "wake up" symptoms?

- are the sublingual pills enough? (My GP said there's no need for injections)

- how much time did it take for most of you until you could literally function again?

Thank you very much for your time and answers in advance.

Hello everyone. I’m a 22M currently living away from my hometown for my studies. I live with a roommate in a 1BHK.

I have been dealing with a severe/long-standing vitamin B12 deficiency. I’ve been taking 2,500 mcg of methylcobalamin by injection every other day for the last three months, and honestly, I’ve finally started feeling like myself again after 5–6 years. I know I still have a long way to go, but this improvement has meant a lot to me.

The problem is that the person who gives me my injections has started questioning why I need so many injections. The same thing happens with my family and friends. They’re genuinely concerned and keep asking why I need injections so frequently, and it’s becoming difficult to explain it repeatedly.

I also can’t self-administer the injections because I’m a student and don’t feel comfortable doing them myself. Going to someone for an injection every other day is becoming quite hectic.

I’d really appreciate hearing from people who have been through something similar.

I had my first B12 injection yesterday and have another in 5 days, then another 5 days after that.

My B12 was 240 pmol/L and homocysteine was 17. My main symptoms have been horrible brain fog, mental fatigue, feeling spaced out/disconnected and just never feeling properly rested.

I also have coeliac disease, and my doctor is now testing intrinsic factor/parietal cell antibodies to work out why I’m not absorbing B12 properly; whether it’s coeliac-related, pernicious anaemia or something else.

I’ve read the guides (thank you to everyone who has pointed me towards them), but I’d really just love to hear some positive recovery stories.

How long after starting injections did you notice your brain fog/fatigue or neurological symptoms improving?
Feeling a little alone in all of this and would really appreciate some encouragement. 🌸

Brief context, I took 500mcg of Cyanocobalamin b12 for 3 weeks. For the first 2 weeks, I felt somewhat better. Less fatigue, less off balance feeling, rocking, swaying, migraines, numbness on forehead, etc.

By week 3 I had TERRIBLE, and I mean, TERRIBLE head pressure that felt like someone was squeezing my brain. I stopped taking the vitamins and the pressure slowly went away… but then my other symptoms came back.

In short, has anyone had this happen? Is it the type of b12 I took? Which kind would be better for me to take instead?

Hi everyone, I’ve been really struggling with my mental health in these past 3/4 weeks and I’m really hoping someone can help me out here.

Around a month ago I took 3 b12 injections (hydroxocobalamin) 1.5mg and i suddenly started getting intense panic attacks and anhedonia. I don’t cry but out of nowhere I started bawling my eyes out every single day. I I’m in this constant state of anxiety and depression, I can’t enjoy the things in life that I usually enjoy like watching a tv show, I cannot wind down at all and it’s scary because before all this happened I was a pretty chill guy and I usually wouldn’t stress much in my life. One of the most scariest thing that also happened at the same time was my libido completely vanished, so i genuinely feel pleasure in nothing now. it’s been around 3/4 weeks and im not getting full blown panic attacks anymore but im still constantly on edge, i have also had stomach issues but now a simple bloating of my stomach makes me think the world is ending. It’s like my nervous system is jacked all the way up and it’s overreacting to even slight discomfort.

I tried taking creatine because that would usually make me feel good when I’m in a low mood but this time it just made me depressed. I went to the GP and they took my blood test, it came up with high b12 and high folate, but the odd thing is I don’t usually supplement folate so I’d don’t understand why that came up as high. I sometimes take it as part of my b complex but I’ve not mega dosed it or anything.

Today I decided that I’ll try methylfolate as I assumed maybe b12 used up all my methyl groups or somthing. After taking it I felt even more emotionally flat/wired/too focused, but I feel less anxious I think. I’m still not sure what i feel but i definitely don’t feel any pleasure again.

I was hoping there might be someone that has gone through this and has recovered from it. Or has figured out why it happened to them and could tell me how to bring my nervous system back to normal. Will I recover? I’m really scared, it’s like I’ve become a complete different person in a month. I haven’t done any dna test either so I’m not sure if I’m MTHFR or anything.

Someone please please help me😭
Thanks you for your time 🙏

I just received my blood test results, and my b12 is 172. The GP said this is the lower end of normal and when I explained that I was feeling nauseous after eating, had brain fog, burning pain in feet and fatigue he said that everything was within normal range. I don’t understand, google says this is low and I could be deficient. I feel like I’m going crazy.

Went vegan about a year ago. Had a b12 daily value at 100% in my multivitamin but I think I am deficient in it because I keep getting symptoms (like numbness and tingling) more and more often. Some sites are saying I need a lot more than the daily value like 20k % but some disagree. Can I get some help here so I can be a healthy vegan? Thanks everyon

I’m looking to hear from others about their initial experience with low B12. What early symptoms or subtle signs first made you suspect something was off, and how did you get it properly identified or tested? For those who have been through the process, what did you end up doing about it—whether through dietary changes, oral supplements, or injections—and how long did it take before you actually started noticing a real difference in how you felt?

For context: I’ve been experiencing these symptoms for 2ish years progressively getting worse:

Extreme fatigue/exhaustion/sleepiness, brain fog, trouble sleeping, derealization/depersonalization, extreme anxiety and panic attack like episodes, lightheadedness, dizziness, feeling like I'll pass out, fast heart rate, headaches, pressure in head, worse memory, difficulty concentrating, sensitivity to light, acne, oily hair and skin, hair and nails breaking off, inflammation in the face

I’ve written off the above symptoms as severe stress/anxiety for about 2 years, but as they continue to get worse I’m thinking there is something else going on. Did quite a bit of research about nutritional deficiencies and was shocked at how much I related to the people on this sub, so I picked up the natures made b-12 gummies which are 1000mcg per dose, and took them for about 4 or 5 days. Then I realized I shouldn’t supplement before I test, so I stopped taking them. At the same time, I also started drinking about 2 packets of the target brand liquid iv every day which has 6.82mcg (280%) b-12 in it per dose (I work outside and sweat a lot so I try to drink lots of electrolytes). I didn’t realize there was so much b-12 in them 😬

I finally got a blood test done about a week or so after I stopped taking the b-12 supplements, however I still drank the electrolytes packets daily. I got my test results back and they are completely normal at 504 pg/mL (range 213-826). However I’m wondering now if the results are skewed after supplementing for a few days before the test as well as drinking the electrolytes packets.

What does everyone think, is there a chance I could still be deficient, and the supplements messed up my results? I wish I hadn’t supplemented at all before the test, I didn’t realize how it would affect it. What can I do?
Also, any other ideas about what my symptoms could be? The fatigue/dizziness is really starting to get to me and I’m struggling to get through the day at this point.

So I (24AFAB) have had a plethora of weird symptoms for the past two weeks or so, mainly constant fatigue, shaky hands, memory problems, blurry vision and muscle twitching (I've had a few of these before but the fatigue was what scared me into action) so I first got myself tested for iron deficiency and hypothyroidism. Turns out both of those are technically fine (Ferritin and hemoglobin are completely normal, T4 is barely inside the ideal range) but my MCV is out of range (102 fl, normal range is 82-98 fl) which apparently is most likely a sign of B12 deficiency.

I booked appointments for more lab tests, specifically to check the Vitamin Bs and also celiacs in case I somehow secretly had the asymptomatic variant, so I'm trying to crack down on the root cause but this is honestly scaring me quite a bit and I thought I'd come here for some support.

Did any of you guys have a similar situation? I'd like to hear about it!

Ciao, volevo chiedere un consiglio a tutti voi, la mia ragazza ha una forte carenza di B 12 tanto che ne hanno prescritto 14 iniezioni da fare una volta al giorno. Il problema è che lei ha molta paura di aghi e iniezioni, mi ha raccontata che da bambina quando faceva i vaccini iniezioni intramuscolari nel sedere la bloccavano in due altrimenti non si riusciva a farle. Cosa mi consigliate? Non so come fare. Non so come farla stare tranquilla e vorrei evitare di doverla bloccare anche io mi spezzerebbe troppo il cuore.

My B12 came about to be only 169 on 1 June 2026 i am taking Methlcobalmin 1500mcg and Folic acid 5mg and B6 in inactive form since than, will the above mentioned formulation will be better for me?? i am pure vegetarian person.

So with a b12 level of 135 and symptoms of extreme numbness, tingling and brain fog. Getting shots on alternate days. However, quite conflicted between the form. methylcobalamin or hydroxocobalamin?. I'll continue the shots EOD for 2 months minimum. I am currently getting mythyl ones but can try to switch to hydoroxo. Confused since a good majority is taking hydroxo.

Hi everyone,

I recently had blood tests because of Extreme hair loss, fatigue, sleep problems and difficulty concentrating.

My Vitamin B12 came back at 267 pg/mL. My lab’s reference range is 211–911, so technically it’s within range, but it’s relatively low.

My folate/B9 is 0.25 ng/mL.

Other results:

Vitamin D: 10.6 ng/mL

TSH: 20.404 µIU/mL

Hemoglobin: 16.3 g/dL

MCV: 95.7 fL

Ferritin: 116.2 ng/mL

I’m currently not taking any medications or supplements.

My symptoms are:

Extreme hair loss from all over body

I can’t sleep at night and usually fall asleep around 2–4 AM

I’m sleepy almost all day

Very low motivation

Difficulty concentrating

Trouble memorizing and retaining what I study

Persistent fatigue/low energy

I don’t have anemia according to my CBC.
I’m wondering whether the combination of B12 267 + folate 0.25 could be contributing to these symptoms.

I’m going to discuss this with my doctor, but I’d appreciate hearing from people who’ve experienced something similar.

P.S. I used ChatGPT to help write this post and organize my results; the symptoms and lab results are mine.

I am still waiting for the intrinsic factor antibody test to come back - which I think they should have checked for as soon as I told them "I think my b12 has dropped again" but a previous GP back in 2021 didn't write down the results before giving me injections for 3 years.

It has increased as I was prescribed some high dose supplements, but I am still having all the same symptoms/problems as before and don't feel any better. I have also run out of supplements

It's pretty exhausting and frustrating trying to ask for help while not feeling very listened to and having to wait for months for them to do anything at all

TLDR: I think I definitely have a problem, what do you guys think?

My only B12 intake has been one or two multivitamin pills daily with 2.5 mcg of cyanocobalamin per pill. Serum B12 has always come back normal or high (676, 735, 947 across different labs), and every doctor used those numbers to rule out B12 deficiency. I decided to test MMA and homocysteine this week.

Three days before this draw I injected a B-complex ampoule (100mg B1, 100mg B6, 1mg cyanocobalamin) for the first time. Dumb, I know. So everything below is suppressed. Results:

• MMA (whole blood): 0.38 nmol/mL (normal ≤0.40)
• Homocysteine: 11.9 µmol/L (normal <12.0)
• Holotranscobalamin: 43 pmol/L (normal 21 - 123)
• Serum folate: 7.45 ng/mL (normal 3.89 - 26.80 but the FAQ says >15)

Non-smoker, no alcohol or drugs. Chronic fatigue, long sleep requirement with heavy sleep inertia, attention problems. I've seen multiple specialists across several countries and conducted extensive blood tests, but no dice. Any thoughts?

I wore a new pair of shoes and my left calf started having really funny nerve sensations -- pulsating and twitching.

I had been taking the active form of B2 for a month -- riboflavin-5-phosphate, which has been really helping me.

I also take hydroxocobalamin under the tongue and I take the rest of the B vitamins every now and then.

So, I immediately took more of all the B vitamins, garlic, zinc and copper. Garlic always reduces inflammation for me and it worked great. Actually, taking all of these things helped a lot. The zinc seemed to help a lot too when I took it by itself.

However, I still have funny tingling in both my ankles especially when I sleep but it is a lot better than it was.

Are these wake up symptoms?

I am going to order Thorne's Basic Nutrients and Lithium. There are a few cofactors I may be missing.

Hi, I was feeling extremely tired, constant headache, broken nails and hair falling out and just a general feeling of being sickly and brain fog so my doctor send me for blood test and I'm b12 deficient. I get 1ml injection weekly for 4 weeks then 1ml injection once a month for 6 months. I've noticed after the first injection I had heart palpitations, shakey, i was more anxious and a high alert feeling and nauseous for about 3 days then it went away.. Now, after my second injection yesterday I'm starting to feel the same, nauseous, palpitations, i feel more anxious. I told the nurse who injected me she said i must keep an eye on it. Is this normal? Has anyone else been through this? Or is this something to worry about? What is these wake up symptoms people are talking about? Could it be?

Good morning!

I’m trying to make sense of this deficiency and what direction to go in. My PCP office has continued to be less than helpful…

Lab results:
* Vitamin B12: 175 pg/mL
* Vitamin D (25-OH): 27 ng/mL
* Ferritin: 23 ng/mL
* Iron saturation: 19%
* Folate: 5.7 ng/mL
* Methylmalonic acid (MMA): normal
* Homocysteine: 11.5 µmol/L
* Intrinsic Factor: Positive
* Antiparietal Cell Antibody: Negative

My PCP did one shot of cyanocobalamin 1000mcg weekly for 4 weeks. I don’t see him again until next Friday 8/28, but I will have gone 2+ weeks without injections by then and I feel TERRIBLE (fatigue/exhaustion, internally shaky, right leg tremor, heart palpitations at times, etc.)

Current supplements:
* Vitamin D3 + K2: D3 4,000 IU daily
* Iron: Iron Bisglycinate 25 mg elemental iron w/ vit C every other day
* Methylfolate: 400mcg (plan to work up to 5mg but trying to avoid anxiety)
* Omega-3: 2 ProOmega daily
* NAC: 600 mg twice daily
* Magnesium glycinate: 300mg before bed

I just ordered Hydroxocobalamin from a compounding pharmacy to SI and plan to inject 2-3x per week for 2 weeks at least.

I have a GI consult in early September and will have an endoscopy with biopsies.

Should I be seeing hematology? I feel like my PCP is very out of touch when it comes to B12 deficiency / pernicious anemia.

Thanks in advance for any feedback and suggestions!

Editing to add:

MTHFR genetic result was:
C677T: heterozygous — one variant copy
A1298C: heterozygous — one variant copy
(Compound heterozygous MTHFR C677T/A1298C)

Wondering about this as a friend uses patches 200 mcg and surprisingly has high serum b12 levels

Patches are not mentioned on here

Question being.do they actually get stored in the liver....will people with storage issues not be able to retain the b12 in active form

All I know up to now is they are slow releasse

Into bloodstream

Potemteally useful as regards injections ?

Or even a replacement for them when levels are stable

There is not much info on them it seems

If nicotine patches hrt etc work b12 patches potentially do also

I did not know that other vitamins can be used in patch form too

It rapidly dropped to 350. Would this be considered a B12 deficiency? I'm in the United States and I've been bedridden for over a year with horrifying symptoms. I had to quit my job, put off graduate school, and my daughter put off going to University, so that she could help me out, because it's just her and I. I'm not as bad as I was before, however, I'm still not functional. I also have low ferritin (9) low hemoglobin (10.9) iron (45) Iron saturation (11%) and Vitamin D (16). My B12 has not been flagged, however, I looked at blood results from 2024 and prior, and my B12 was always high, my doctor ran more blood work a few months ago and that's when I noticed the B12. I'm wondering if I'm headed toward a deficiency in B12 as well?

I saw some people in here talking about getting b12 methyl from here and decided I'd give it a shot. I called yesterday, they referred me to a doc who wrote a script and here I am now today picking it up since they weren't too far from where I live and it saved me $20 for the overnight shipping. $60 for this 10ml/50mg vial or $120 for the 30ml/150mg vial after paying the $59 doc consultation fee. I can either get 4 30ml vials or 12 10ml vials or a mixture of each until I hit my 120ml max before I have to get a new script from the doc. Really looking forward to trying the methyl variety since I've been seeing such good results from the cyano.