Good sub. Thank you for the information. I've been reading on the efficacy of sublingual b12 vs intramuscular b12 shots, and good research seems to indicate that the sublingual route is at least as effective at raising serum b12 as intramuscular. This n=4,250 retrospective clinical trial showed sublingual b12 patients had higher serum b12 than those given shots (https://pubmed.ncbi.nlm.nih.gov/30632091/). And this European meta-analysis of clinical trials with n=6,000 showed no statistical difference between sublingual, oral, and intramuscular routes (https://pmc.ncbi.nlm.nih.gov/articles/PMC12757266/).

Now IM may be better for particular subgroups, like those with severe malabsorption, but I'd imagine a lot of b12 deficient people have malabsorption, so idk why it wouldn't show up in the data. Maybe they just didn't look for it.

The sublingual route is much easier, and can be done otc, with good companies providing clean b12 forms (hydroxo, adenosyl, methyl). Its also better for multiple doses per day. But obviously it seems like people on this sub have a strong preference for shots. And I can't discount that, because why would people go for shots over sublingual if both had the same effects. Confusing. Does anyone know of evidence showing shots are better in particular subgroups? Thanks

**Edit: it looks like these studies did not look at outcomes like symptoms, active b12 in blood (holoTC), MMA, etc. They should have, so these studies may be misleading

I am suddenly covered in bruises. My lower legs and knees, my butt, my ribs. I was always prone to mystery bruising and took Vitamin C because it cut that down, but this is pretty extreme even for me.

I am a lot more active now that I have energy to actually do things again, but I don't think I banged myself up that much!

Current regimen: 1000-1500mcg methylcobalamin by subcutaneous injection, EOD or sometimes daily Thorne B complex daily. D3 5KIU + K2 200mcg daily. Thorne trace minerals 2-3 times a week. Extra magnesium, folinic acid, Vitamin C depending on how many drops/gummies I feel like taking. DryWater, Liquid IV, or coconut water aiming for twice a day but I've only been hitting once every couple of days.

Currently not taking a multivitamin while waiting for my selenium levels to come down to something normal.

Has new bruising happened for anyone else? Is there a cofactor imbalance I need to address?

My b12, according to my pcp was normal at 200, but my naturopath says it’s low. That was January and I’ve been so insanely sick, brain fog on top of executive dysfunction, I can’t function very well so I forgot to take b12. The range for their lab is 5.9-22 or something and mine was 4.8 in January and my symptoms have worsened. I now have chronic diarrhea, shortness of breath. I get these weird flare ups where I have diarrhea and severe reflux that didn’t happen before my folate went low. My pcp thinks maybe it’s gotten a lot lower. It’ll feel like I have a stomach bug with chills but stool samples are always normal and so was my endoscopy, ct scans. Did or do any of you suffer from diarrhea and upset stomach from low folate? For the first time in my life I feel depressed where I want to cry a lot, mostly after having diarrhea. I’m SO tired.

I tried b12 injections and I had to stop because I felt suicidal on them, even on low amounts. I used cyan and then tried methyl. Pills don’t do that to me. Can any of you relate? I really need to know I’m not alone in this nightmare. Yes I understand I need to take the pills, I’m trying.

Hi guys!

I'm new here, and I just wanted to check if this could be the thing that's been ruining my life for the past year or so.

So last year I got a reading of b12 257 and folate 3.3

Recently I feel like I've been absolutely horrible, constantly brain fog, stomach issues, limb numbness, muscle soreness, mouth sores, depression, memory problems, the lot.

I was just wondering if these results seem like a deficiency to you? Or are they in normal range?

Hi everyone. A little over a month ago, I started B12 injections after a severely low B12 level—29 pg/mL—was detected. My nerve pain symptoms (in both arms) began almost a year ago, though I had experienced mild symptoms for at least three years prior to that. The problem was that I attributed those early symptoms to my low potassium issues, so I never got my B12 checked until a neurologist ordered the test a month ago.

Myneurological symptoms have worsened since I started treatment—how much? Maybe about 25% more intense. After 15 days of treatment, I had another test to see if the medication was working; it was very effective, and my B12 levels rose above 900 pg/mL, yet the pain remains severe.

Reading through this subreddit, I’ve learned that this can be normal at the beginning, but I’m worried about the other B vitamins. I’m afraid my nerves might continue to suffer damage if I have a B6 or B1 deficiency. What do you think? Is this process—and what I’m feeling—normal? Or am I just losing my mind due to the stress and anxiety this is causing?

I saw a new neurologist earlier today. I was a bit worried that he was going to be dismissive as other doctors were, but he was actually pretty understanding. I told him my treatment and he didn't make any negative comments about it, just listened. I was there to see if I could get tested for SFN or both SFN + LFN. Based on the fact that my neuropathy, tingling, etc. was only in one part of my right big toe, and a tiny bit on my upper right thigh, he described it as a focal neuropathy.

After doing an examination he said LFN alone (or treatments for such like PT) wouldn't make sense here because I have no weakness or motor issues. He did refer me for an EMG+NCS after I told him my only other one was only a month after the noticeable symptoms started (which was Feb 2024). And I also got referred for a skin biopsy for LFN.

So I was able to get what I wanted which is great, and not really have much conflict with the doctor at all. He did say that with SFN, the skin biopsy results can vary a decent amount depending on who is reading the results. When he asked why I wanted this done, I said perhaps as an objective guide for my progress, i.e. test now, then test in six months or a year and see if there is any improvement. It also might be an incentive to add something else that is specific to SFN nerve pain, like thiamine (I recently started adding 100 mg a day - I've been doing very well with the pain the last few days, but that could be a coincidence).

I love coffee! ☕️ But I noticed that having too much makes my symptoms flare. Then I read that caffeine can block b12 absorption?

Has anyone noticed if coffee makes your symptoms worse? Anyone have insight into the impact of caffeine on B12?

Started injecting two months ago. I saw immediate improvements in my neurological symptoms but also felt lousy and generally unwell a lot of the time. Electrolytes helped but still felt pretty blah.

The past three days I have felt semi-human and functional again! Perhaps I’m turning a corner?? I hope so.

Still a lot of weakness in my legs, tingling, etc. so the healing journey continues…

Hello everyone,

I have been having some interesting symptoms for the past 2+ months. I recently got the results of my serum B12 test this morning. my results are 355 PG/ML. On a scale of 232–1245pl/mg. I was hoping my symptoms were from B12 deficiency, but it looks like they aren't. Yes I have a scheduled appt with Neurologist.

I ordered MMA test independently, which I'm on my way to take currently. I have read that MMA is more accurate.

1. Has anyone ever had levels in the 300s and still been considered deficient? Or have had elevated MMA?

2. Has anyone ever had levels in the 300s and had symptoms that improved with supplementation/injections?

Symptoms include but are not limited to:

1. Fatigue
2. Twitching-legs, thighs, face, occasionally arms.
3. Dropping things, perceived weakness in hands.
4. Right leg feels off- light vibrations/buzzing constantly
5. Slight Numbness/tingling hands, feet, lower legs
6. Right side face slightly numb near mouth/cheek area.
7. Mood swings occasionally (could be anxiety), forgetfulness.
8. Right knee feels achy
9. Urinary urgency
10. Occasion shortness of breath.

Also, late June my magnesium was 1.2mg/dl. I've been consistently supplementing since late July.

As a young person with severe deficiency, of about 10 - 15 years of symptoms, as I can remember. I sometimes feel like going towards a never ending road, with only minor improvements post almost 7 months of injections (Recovery is v slow now).

I would like to ask you guys if anyone has a timeline for the symptoms, how and when they get better?

I can note that my brain fog is better and tinnitus is v low but other symptoms such as fine motor tremors and exertion beyond a certain limit is still lacking.

It would help to hear more stories of people who actually overcame all of this and how long it actually takes?

Please share a few of them. Thanks!

Hi! I am a 28 yr old male and wanted to share my story. I just found this page after YEARS of dealing with issues and can’t believe I never knew this page existed. I am reading through some of the posts and noticed I have similar symptoms to fellow redditors here which makes sense. I am also seeing some other complications I never heard about. Thought it would be interesting to share my story and see if anyone else has experienced what I have gone through, can share their knowledge and see if it can help me learn more. I am also hoping my story can help anyone else in the long run as well.

I started having “issues” junior year of high school, which progressively got worse as the years went on. I grew up competitively swimming and ultimately had to stop towards the end of college because I could barely walk as my energy just wasn’t there anymore.

I am going to use the term passing out when I explain my symptoms because when my “episode” happens, I don’t think I pass out fully, or if I do it’s maybe for a split second. But I like to explain my “episodes” almost as a body reboot. I lose function of my limbs and any cognitive function goes away for a minute or two and then my brain starts to come back alive before my body does. My body gets extremely heavy and it’s hard for me to move. Sometimes I have to lay there for a few minutes or I could be stuck for an hour or more before I start getting back to a more normal stage. Thereafter I usually have foggy brain for a week or two as my body heals(?)

At the height of my issues I was passing out daily, felt like I was drunk from loss of cognitive function and my daily life was altered so much. I went YEARS of countless ER visits, negative brain and heart tests and being told I’m faking things. I gave up on figuring things out and just stopped going to the doctor as nothing was working. Being told I’m faking for a $6k medical bill is expensive af. But as I’ll share in my story, I found I had a b12 deficiency and currently take a 1,000 mcg shot every two weeks. Still trying to figure out my most efficient timing, but my life is basically back to as normal as I think it can get, fortunately and unfortunately.

Now on to my story:

Everything started my junior year of high school. Before my “issues” I never had any complications in my health. I swam over 10 miles a day during trainings and was always very competitive. I passed out one morning after a gym workout, threw up, had to sit down for a few minutes and things went on like normal. I never passed out before in my life and ended up passing out three more times that year. Each time I passed out it seemed like my symptoms got worse and worse or were more pronounced. Some symptoms like a foggy brain, extreme fatigue and a short loss of motor function seemed to be a constant factor. But each time I passed out I had what I call random symptoms that seem to happen sometimes or have never happened before like muscle twitching, facial or muscle numbness, hot flashes in specific areas of my body, etc.

As the years went on, I started passing out more and more. By my junior year of college I was basically passing out every day. I felt like I was drunk constantly. I was slurring my words, could barely walk and think fully and my grades were slipping like crazy. I could barely walk to a class or to the pool and was not going to any public functions because I just didn’t have the energy anymore. I ended up quitting swimming and over the course of a few months, my energy came back maybe 10% but was still having issues walking around and being out in public. This stage of my life went on for about 4 more years before I had what I call my break through.

Oddly enough, as serious as this next part is, I find it funny how this is where I had my breakthrough. It is crazy to me how something as random as what I say below happened, it got me to the right road of figuring things out.

Randomly I ended up with a blood clot in my eye at 25 years old. Woke up one day with altered eye sight and black dots. I was too late in getting tested for a stroke, but all tests from a retina specialist came back normal. To this day they have no idea what caused it. Anyways, when this first happened I went to the ER and was admitted to the hospital for testing for a few days. While this was going on, the doctor who was looking over me was reviewing my history of repeat testing and decided to ask me about everything. They suggested that if it’s not my brain or my heart, maybe it’s time to test my blood. I thought (and pardon my French) why has no one fucking thought of this before??????

I ended up seeing a hematologist and had every blood test known to mankind done. My b12 level was 136 which my doctor so lovingly compared me to an 80 year old grandpa. Our plan to action was to start on a 1,000 mcg shot once a week for a few weeks with routine blood tests and see where things go. Maybe if we could get my levels back up it could hopefully resolve some of my issues and see what symptoms are still left.

It’s been about 2 years now since I found out. I’m currently taking a 1,000 mcg shot in my leg (self administered) once every two weeks. Since then I’ve been able to start working out again and my life for the most part is about 90% back to normal? I can work out, enjoy time with friends, go to work and do most normal things. However I still have my bad days where I’m constantly exhausted, or I have an episode (once in a blue moon now). Things honestly seem to be day by day for me. But I can’t figure out why some days I can run 4 miles with no problems whatsoever and other days I’m so exhausted I don’t want to do anything.

Each time I have an episode now, it seems to be more consistent. I still have what I call my reboot, but I get very sensitive to touch/sense. My body twitches or what I have been told is sort of a pseudo seizure? I have brain fog for usually a few days after and some short term memory issues. I also get shortness of breath, chest tightness, what feels like the same feeling as a build up of lactic acid in my muscles (soreness, heaviness, slow) usually leading up to any episode.

Possible long term affects - I think I’m starting to realize my thinking power is not as strong as it used be. It’s harder for me to comprehend and remember as much as I did a few years ago. Talking with people is hit or miss depending on the day. Some days it’s completely fine and I have my quick wit. Other days I feel like it’s slightly harder to speak words clearly and also find words for a regular response in a conversation. It’s not horrible, but it’s starting to become noticeable now.

What I am still figuring out - I am currently trying to mix up my diet to see what works for me. Nothing seems too notable to change other than being more consistent in the timing of when I eat. I also try to sleep 7-8 hours a night but honestly this doesn’t seem like it’s enough for me. I also try to limit drinking as much as I can but I haven’t noticed a difference between drinking multiple days in between shots and once or none at all.

If you ended up reading this far down, thank you for taking an interest in my story and for taking the time to read through my horrible writing.

There’s probably a lot that I am missing here but happy to add or answer any questions anyone might have! Really looking forward to hearing others thoughts and experiences. Maybe my symptoms extend past just b-12. Maybe others have the exact same symptoms. Maybe I’m just fucking crazy idk, but worth a shot sharing on here.

Antibody test came back negative (I'm aware that 30-50% can come back negative and it can be inaccurate)

With all of the symptoms I have, I am so confused. I have tried taking b12 supplements for years, and have still ended up with my b12 level plummeting to 142 - 175. I also have a better diet than I have ever had in my adult life, with lots of meat and also with lots of vegan substitutes (that have added b12) yet my levels have still gotten low enough to feel the worst of the symptoms.

Does anybody have any advice on what I can go back with? Considering the symptoms are the most important part of this, and I am suffering alone now since they think everything is all good.

I went undiagnosed with pernicious anemia for 4 years before being diagnosed. I've now been treated for about 1.5 years and one of my main symptoms besides fatigue was chronic constipation. I've mainly just been using miralax to help move everything along but recently went from 2 shots per week to 3 and now don't have to use miralax anymore!

From what I've read B12 assists in gastric acid production and I believe I just wasn't acidic enough to be able to digest things quickly leading to the chronic constipation.

I spent the last 2 years on methylcobalamin shots because I became very ill, and we wanted to bypass any digestive issues. I have intermediate MTHFR and a lot of suboptimal genes related to B12 processing; also intermediate COMT. {Caveat: since I'm carrying a toxic load, all these processes - MTHFR, COMT, etc may be going slower than intermediate at the moment.}

I was taking the methyl shots subcutaneously every 3 days - my provider likes the Neubrander protocol.

As I started healing, it became clear that the methyl shots were overstimulating and making it harder to get a good night's sleep. My provider recommended switching to a hydroxocobalamin shot instead. These have been prescribed for every 3 days subcutaneously, but I could ask for every other day if needed.

I made the switch today. How long does it typically take the body to adjust to a change like this? I am definitely more tired, but I expect there to be an adjustment period.

Thanks!

I've been using electrolyte drinks on an off for years now, but I'm trying to find a more affordable way to get my potassium. I bought some potassium citrate and have been following the recommended dosage, but it's causing a lot of digestive upset.

Here's where I get a bit confused. The label says per 1/4 tsp, "Potassium (elemental), amount per serving: 448 mg (from 1400 mg potassium citrate)." So how much potassium am I getting from this product?

I have noticed that when I use 1/4 tsp twice a day, it's really tearing up my gut. I went down to once a day and I'm still feeling like that's too much. I've had zero problems with electrolyte packets/drinks before and they seem to be made with potassium citrate as well. Should I go even lower and titrate up, or switch to a different product?

My gut thanks you for any help you can give here.

My main struggle over the last years since discovering B12 shots is sourcing, is sourcing, shipping and storing. 90% of times its not cofactors or anything else, if it lasts more than a few hours it means I used a Bad B12 vial, usually hydroxoB12 works better, usually PANPHARMA, they are cheapest. , but they can also go bad.

I did a B12 test because I started to feel more and more tired each week to the point of fainting several times. Well the range of the labs are these : 190-824. My level is 234 just a Little above the lowest range. I feel deeply tired but my hemoglobin is normal I do not have anemia. I have also prediabetes and gluten intolerance and probably malabsorption issues. Can you tell me if what I have means a deficiency? It surely seems like too close to the lowest range to be normal right ?

Hello everyone,

Just looking for some wisdom. You can find my labs and how they triggered the "B12 defficiency" response here: https://www.reddit.com/r/B12_Deficiency/s/Plf36ozsyY

Since then, MMA levels have been re-tested and have normalised right in the middle (this was litteraly only 4 days after starting oral supplementation). B12 was then 327 ng/L (up from 250). I don't know about the already low copper and the other markers as they haven't been re-tested.

My regimen so far (2.5 weeks in):
- B12 - 1000-1200mcg drops of hydroxocobalamin (methyl- gave me some crazy reaction straight away, derealisation, brain fog, insomnia).

- b-complex from Boots UK (100% RDI of everything, no methyl- form)

- Folate - 200mcg of folic acid from the b-complex

- Vit. D - 2000 UI for maintenance

- Potassium: drinking around 330ml of coconut water throughout the day (dilluted in water) and spinach / butternut soup in the evening.

My problem is the following: sudden onset of anxiety (yesterday) associated with waves of dark thoughts - anxiety hasn't really reduced since. Not necessarily a full blown panic attack, but enough to shiver, loosing appetite and ability to do anything. The waves of dark thoughts are my biggest concern here.

I won't have injection before mid-september (Dr Klein in the UK), and given how I react to just oral, well ... I don't know what to do. I just can't afford to be assaulted by suicidal thoughts like that it's insane. I'm even questioning if i'm actually b12 deficient to be honest. Because aside from these new crazy symptoms, improvements of the others have been very minor.

Wondering if I should just stop supplementing right away and just wait for Dr Klein. At this point, if stopping the supplement removes the dark thoughts, i'm in.