Family, Internal Medicine, General Medical Questions/Vitamin B12


QUESTION: I just found out my Vitamin B12 is 169. They said they prefer it to be in the 400's (this was a phone conversation so I haven't had a chance to ask questions yet). Anyway, I was wondering what could have caused it to drop so low? They want me to start taking B12 shots, is this the best way to replace it? Will I be able to administer them myself? Do I need to start receiving them right away?


ANSWER: that is low, you do need replacement.... people this low cannot absorb it well so taking oral vitamins doesn't typically work.  You have pernicious anemia where you are lacking a transport protein to carry B12 across your intestinal wall.

Get the shots.... (400 is the low side of normal)

You can eventually give them yourself with your doctor's blessing.... usually we give a lot initially (weekly) then go to monthly.   

Yes, start right away.   

---------- FOLLOW-UP ----------

QUESTION: Is this something that develops over time or can happen quickly. From what I read I will have to take this for the rest of my life and I'm only 40 so I'm curious to what would have could have cause it to happen.

Also, I am having some other medical issues right now. Could this be the cause of that? I am having problems with my stomach. I was literally prepped and ready for surgery on Monday to have my appendix removed when the surgeon viewed the CT and decided that my bowels are inflamed and they sent me home instead.

I've made my appointment and will start receiving the replacement shots Monday. I can't begin to say how excited I am to start feeling normal again!!

Thanks for helping me understand what it is.

the onset is usually slow and progressive and tough to notice until it is bad.... the "inflamed bowels" may have something to do with it.....  but whatever the cause, B12 is absolutely essential to good function of the body so you need the replacement....

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Robert Borucki


I am an expert in Family Medicine and Emergency Medicine.


I am trained and boarded in Family Medicine and have also worked extensively in emergency medicine for over 10 years.

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