B-12 Levels

[NURSELPN]

Dr Mark,
Seeing normal B-12 range is so broad (200-1200 I think). Could you tell me what a good level would be to shoot for. I am still symptomatic @ 348 and I know this can happen between 200-400. I also have heard it takes 8-9yrs to deplete your B-12 is that true? I have no idea how long this has been present because I have been symptomatic for awhile. If tested for PernicIous Anemia & it's positive is there any other treatments besides
B-12 injections?
I have also been doing some research on Celiac Sprue, which you mentioned. Could this be the cause of my low B-12 and why would it be remaining low when I'm taking bi-weekly injections. Hx: My low B-12 was found after my family physican sent me to a neurologist due to numbness in my hands, feet & intermittently in my face. Thanks for your advice.

[Mark Lupo, M.D.]

With bi-weekly injections the level should be 800+ in most cases.  There is no additional treatment for Pernicious Anemia that I know of other than B-12.  Sprue can cause low B-12.

Would dose 1000mcg each week IM for six weeks then usually can go to once a month but may need every 2 weeks for another 2 months then monthly.  

I don't do a lot of B-12 injections in the office as I have left that to the primary once the diagnosis is made, thus my experience is limited on the details.

[ciaoana]

A related discussion, symptoms include: dizziness, numbness, lightheaded B-12 level 222 was started.

[gienka]

I take b-12 shots monthly symptoms from slightly low level were severe. Bone pain that took me to the floor to the exclusion of the world around me it hurt that bad. Also muscle spasums all over all the time. None of these symptioms since starting shots. Dr's thought my levels werent low enough to warent shots but gave it a try thank God I highly recomend getting shots or whatever it takes as soon as possible. IT can cause unstable spines ect..

[NURSELPN]

I appreciate your suggestion. But if I'm having an absorption problem I'd better stick with the injections.  Jean

[lietchi]

There are sublingual tablets for B12 too. A lot less hassle than injections...

[NURSELPN]

I have been taking 1000 mcg 2x's wkly. since July. At first Dr. started me on 1000mcg's wkly.. I took that for 2 mos. & my lab increased from 89 to 224, so he increased the dose to 2x's-wkly which I give myself sub-q. My last level was 348. He is concerned a little & just wonders why it is not going up like he thought it would. Even if I was positive for Celiac Sprue (God forbid) that should not effect my absorption of sub-q B-12 should it? Maybe I need to be giving it IM instead of sub-q although that is an available route according to the drug literature.

[NURSELPN]

Sorry about the bi-wkly thing my brain still isn't working right. I meant 2x's wkly. :-).