Vitamin B12 Deficiency

Question

Assalamualaikum! 
4 months ago, I got a horrible Panic Attack. Then, I was referred to a psychiatrist and he said that you have depression. I was not ready to accept it as I didn\'t even have a single worry. After researching through internet (based on my symptoms) I came to know that I have vitamin b12 deficiency. I got myself tested and the report came negative (134) (Normal Range 187-883). Now, I\'m on antidepressants for the past four months but my symptoms are as before, which include: Numbness, Tingling, Brain Fog, Forgetfulness, Severe Anxiety, Depression, Mood disorder, tension headache, Blurry Vision, Acid Reflux, Shortness of  Breath.
To cope b12 deficiency, I\'m taking Bevidox (B Complex Multivitamin) for last almost one month but there is not any improvement yet. According to my point of view, Either my intestine is not absorbing b12 (pernicious anemia) or my bones are not producing healthy red blood cells (megaloblastic anemia). 
Kindly help me (if there is any hematologist o

Dr. Mariam Salim · Answer

see hematologist

Dr. Jetender · Answer

Better to take IV B12 injections. And need physical assessment or further Hx to diagnose the cause.

Dr. Rais Burni · Answer

plz search Marham for haemotoligst.strong suggestion is dont discontinue anti dep,u may changa doctr

Dr. Homayoun Sheikh · Answer

it's a serious issue so need to be visited by a specialist physician soon to manage it

Dr. Shahid Ali · Answer

Get your (TFTs),thyroid function test done
and better to consult an endocrinologist.
repeat fresh baselines as well.

Dr. Fakhra Ayyub · Answer

First of all, Please don&rsquo;t Google your symptoms. This is very important to learn. Secondly 134 is not negative by any means. In the presence of symptoms it is clear deficiency for which you need deep IM injections of METHYCOBAL at regular intervals. Further you need to check complete blood count to see the number , size and picture of your blood cells to decide how severely this deficiency has affected your blood formation. Your symptoms are not due to single problem , you need to consult a trained family physician to see all the symptoms together in order to get the clear diagnosis. The proper diagnosis is must before the treatment. Avoid self medication please.

Dr. Sabah Malik · Answer

plz get yourself checked properly with all the previous record and labs plus meds you are taking so that proper diagnosis can be made to avoid further damage

Dr. Zunaira · Answer

share all you baslines esp. complete blood count. and get intramuscular neurobion. get your eye sight checked. and syp mucain 2+2+2 for reflux

Asst. Prof. Dr. Saadia Hussain · Answer

pl repeat vit b12 levels from a reputed lab and also intrinsic cell antibodies and ANA.
This is a medical dosorder and best investigated and trested by a medical specialist . If you B12 levels are still low . yoy need intravenous vitamin B 12

Dr. Aamir Javid · Answer

All ur symptoms are related to ur previous medications.u have no any type of deficiency. Mention ur drugs

Dr. Shabana Mehmood Malik · Answer

Better to Take IvB12 and
consult a heamotologist and endocrinologist

Dr. Ahmed Farhan Ghouri · Answer

take an appointment, for consultant opinion ,fees only 200 rupees

Dr. Nazish Shafi · Answer

Get yourself examined and investigated properly by qualified physician. proper history, and targeted investigation will help in diagnosis and getting rid 9f your current medicine

Dr. Amir Shahzad Joiya · Answer

Kindly consult a physician rather than searching on google. It will increase your worries.  You needs detail evaluation and work up.

Dr. Bisma Shahid · Answer

Share all your baseline inv , plus repeat your b12 level, in case of low b12 levels you need injectables of methycobalamine .

Dr. Mahnoor Hassan · Answer

Kindly send me your complete blood count , vitamin D, vitamin B12, thyroid profile, iron profile test report to reach the diagnosis.

Dr. Muhammad Naseem Sheikh · Answer

Pleas pay a visit to physician so he may take history and examination and then relevant labs to diagnose and treat acoordingly,

Dr. Faiz Naeem · Answer

get your fresh cbc and book online consultation

Dr. Muhammad Asghar · Answer

Can u share ur peripheral smear report? And TSH report?

Dr. Matiullah Hashimi · Answer

Repeat B12 by a well known lab if still decreased better take iv vitB12. Do intrinsic factor Ab .

Dr. Muhammad Waseem Abbas · Answer

The easiest way to check for B-12 deficiency is CBC with peripheral film showing anaemia and and raised MCV. If you will have B12 deficiency then you will have anemia on CBC. If your CBC is normal, you should not be worrying about b12 deficiency.

Muhammad Siddique Khan · Answer

You need to get work up from a good medical specialist who may or may not involve other specialists in your care. Once the cause of your Vitamin B12 deficiency is identifed, the medical specialist will continue with your treatment.

Dr Mariam Tariq, Internal Medicine Consultant is available through orladoc online platform and works in Islamabad. Good Luck.

Dr. Rumaisa Jamil · Answer

We need to evaluate ur case in the detail.. U need to tell the name of all the drugs you were taking for depression.. When did you get ur last test done for Vit B 12? The symptoms u have mentioned can be due to various reasons.. We need to get all the baseline tests(CP, Serum Ca++, Serum Vit D, Vit B 12 levels, Renal function tests, Liver function tests and ECG) done. Are you a smoker?? Did you take any recreational drug??

Dr. Mahum Bushra Tariq · Answer

So your case seems to be at the junction of psychogenic vs organic cause for your symptoms.1st we ll havto rule out all the organic causes which,yes include but are not limited to vit.B12 deficiency.We ll havto undergo a detailed history including mood and social behaviour changes and family history and also need to check all the meds you are currently on and carry out some baseline tests to start from somewhere. Dr.Omar Farooq(int.medicine) at Farooq hosp. Lhr is an excellent physician.I can get in touch and rule in or out some causes via history and medicine review and recommending lab tests to start us somewhere and we can take it from there.I hope you recover soon,InshaaAllah.

Dr. Tahira Naqvi · Answer

wsalam.. I am a consultant physician .. your b12 levels are low and that can lead to your psychiatric symptoms aswell ... even you are not taking b12 in a proper dose... first thing is to rule out the causes of b12 to appropriately treat the disease and to take a proper history of your associated symptoms.. you can take my online consultation to have a detailed discussion regarding your problems and their treatment.. thankyou

Assoc. Prof. Dr. Dr Muhammad Farooq · Answer

It is not possible to satisfy your query with the data available.More clinical and lab data is required to reach a proper diagnosis.You need a detailed consultation either online (if sufficient evaluation is already done) or physical if proper evaluation is not done previously.Best of luck

Dr. Haris Majeed · Answer

u need a proper check up   and then some tests will b advised to rule out the disease  when u search on internet there are many irrelevant topic that's not supposed to b read  ND self treatment  is dangerous ... so book an appointment with Dr.  online or physically visit the clanic for proper evaluation of your condition and  for diagnosis . thanks!

Dr. Naeem Ullah · Answer

Wsalam, being a medical specialist, i would say that you have gathered valuable knowledge about your complaints. Vitamin B12 deficiency is one of cause of all of your reported symptoms. But if you are not responding to oral vitamin b12 supplements then you are quite right that there is some problem with absorption of vitmain b12. In undeveloped countries, malnutrition and infections like intestinal tb are major causes, while autoimmune diseases like pernicious anemia is major cause of vitamin b12 deficiency in developed world. In addition to vitamin b12, gut problems also cause deficiency of other minerals (calcium) and vitamins. U need extensive evaluation & work up to check the underlying cause of this deficiency. Initial tests are cbc, Esr, Lfts, Rfts, stool r/e, S. Electrolytes, S. Calcium, Ultrasound abdomen. Then more specific investigations are vitamin b12 and D, antibodies tests like antiparietal cells abs, upper GI endoscopy/enteroscopy and biopsy. If the cause is pernicious anemia then u will need lifelong parental vitamin b12, otherwise treating the underlying cause along with parental vitamin b12 till healing takes place is way forward. Despite treatment, some neurological symptoms often persist despite treatment. I hope, u will find this helpful. Feel free to ask anything about your diease.

Dr. Nargis Tasleem · Answer

ur symptoms show ur stomach is not working properly..plus ur vit b was very low.when got it done??it needed i/v or I/M replacement. plus ur serum TSH also should be done.

Dr. Akmal Shahzad · Answer

Hi dear! You need to be assessed properly and councelled. I am afraid that you might have been mistreated as your symptoms and treatment history do not match. Feel free to contact me and fix a time for consultation. Thank you.

Dr. Shahab Ahmad Siddiqui · Answer

A detailed history n few labs needed . You were treated wrong.
Try to take B12 tablets. Feel free to consult me

Dr. Ukasha Ejaz · Answer

Aoa kindly done your proper labs and work up thank you

Hafiz Muhammad Yasir Rehman · Answer

if vitamin b12 is being taken properly and symptoms are not improving. u should get anti helminthic medication ( vermox 2 tablet stat)
and injection neurobian should be started .
u can get my appointment so v can discuss in details and sought it out

Dr. Haider Kazmi · Answer

you are most likely just overthinking. best book online consultation to dig deeper into the problem.

Asst. Prof. Dr. Hadi Hussain · Answer

Your symptoms are suggestive of Vit B12 deficiency and you require comprehensive nutritional and supplemental support to cope. up with your symptoms and may require injections of Vit B12 weekly for some time

Asst. Prof. Dr. Hadi Hussain · Answer

Your symptoms are suggestive of Vit B12 deficiency and you require comprehensive nutritional and supplemental support to cope. up with your symptoms and may require injections of Vit B12 weekly for some time

Dr. Sadaqat Ali · Answer

Need proper history so book online appointment .

Dr. Rana Ahsan Javed · Answer

For detailed assessment and proper prescription take appointment using the following link!
Regards!
https://www.marham.pk/online-consultation/internal-medicine/islamabad/dr-rana-ahsan-javed-042-32591427,

Dr. Aaqil Anwar · Answer

Bevidox is not enough to resolve your problm kindly book your appointment and share your test report so i can find a best way to treat your problem

Dr. Syed Sardar Ali · Answer

take Motival 1 bd

Dr. Naveed Babar · Answer

take vit D cap. continue psychiatric medicine

Dr. Shane Kumar · Answer

need to see some of your reports

Dr. Muhammad Farhan Liaqat · Answer

daily dietary requirement of vitamin b12 is 3-4micrigrams and our liver storage of vitamin is 4-5mg which is enough storage for 3 years even if you don't take any food that contains b12.
so if you still have b12 deficiency that means there is something wrong with absorption, one of which is pernicious anemia .... there are other absorption related causes as well....
tablet won't do you any good if you have any of these reasons , you need parenteral b12

Dr. Adnan Khan · Answer

Why are you on antidepressants. I think you need to taper off from that. The best supplement for vitamin B is moringa powder. You can also take vitamin B12 injections once a week to increase levels. Start exercising, eat healthy, have vitamin D tablets once a week for a month , improve your digestive health and work on your mindset.

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