Brief Answer: Can take once in three weeks Detailed Answer: Hi Thanks for posting your query on HealthcareMagic. I have read your query and I think there may be another reason as well for the symptoms of severe headache, difficulty in thinking and reasoning and memory loss. These symptoms are suggestive of frontal lobe getting affected. Do you have recurrent nose and throat infections? Since these infections transmit to the sinuses and to frontal lobe of the brain, they can cause these symptoms too. It is worthwhile to go to the neurologist and get checked for other causes of these symptoms. Anyways, I will answer your specific questions. 1)do i have to take b12 shot my all life. I am unable to control b12 deficiency with diet modification? A. You will not need it for the whole life. Vitamin B12 stores once replenished, last for sometime (2 - 4 years). 2)can i take b12 inj in pregnancy or how much time before baby planning i have to modify or leave b12 dosage? A. Yes you can take it in pregnancy. 3)can i shift to b12 inhalation inspite of inj..does both works in same intensity? A. B12 is inconsistently absorbed from nasal route, so both do not work in same intensity. You will need to take intranasaly to see if it works for you. 4)can you suggest me any further test for b12 because b12 blood test is showing high level of cobalamin because of recent loading ,in spite of that i get relief only when i take shot of rejunex 500 mcg on every alternate date? A. Serum MMA (methyl malonic acid) levels can also be used since the MMA level will be increased if B12 deficiency is there. But it can be costly. 5)can u relate reduced mch and increased esr with b12 deficiency? A. Reduced MCH means low hemoglobin levels in the red blood cells. It means that one of the following: iron, folate or B12 may be deficient. These are needed for the formation of hemoglobin. There can be some other cause as well like anemia of chronic disorders, thalassemia, etc. Thus I would suggest that you get investigated for causes of anemia. If anemic, level of hemoglobin will increase if all three (iron, folate and B12) are given together. ESR is usually increased if there is some inflammation somewhere. It is very non-specific test and does correlate with B12 deficiency. Nor does it point to any single condition. Hope it helps. Dr Vaishalee

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Brief Answer: It just temporarily makes you better Detailed Answer: Hi again The B12 injections are just temporarily making you better. Maybe by temporarily improving your immunity (through mechanism unknown - maybe by increasing RBC production temporarily). Anyways the B12 levels start to come down by third week after injection. I think you have already gotten the red blood cell indices done like MCH, MCHC etc. You can get the tests done like serum iron levels, serum folic acid levels. To test for Thalassemia they do electrophoresis. Throbbing headache can also be caused by raised blood pressure. Another way of keeping infections at bay is to drink cleaner water.It will help with digestion problems and sinusistis. Some digestion issues can also cause anemia by decreasing absorption of iron, folic acid and B12. Hope it helps. Dr Vaishalee

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Brief Answer: Hi again Detailed Answer: Hi 1)u said B12 levels start to come down by third week after injection is it after loading for more than one month or after single shot? A. After single shot 2)how many days before going for serum iron levels, serum folic acid levels and Thalassemia test i should stop taking b12 shot and corus tablets so that my body gets flushed out of supplements(folic or iron in corus tab). A. For thalassemia you can go any time. To test for iron deficiency and folic acid the timings are different. For iron, you can go after a week of stopping the iron supplements. For folic acid, the supplement stays in body for 8 weeks. And to get the correct values 40 weeks are required. Hope it helps. Dr Vaishalee

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