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Dr. Bob
Dr. Bob, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5118
Experience:  Neurology & Int Medicine (US Trained): 20 yrs experience
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I was diagnosed with very low B12 recently. I have been on

Customer Question

Hi,I was diagnosed with very low B12 recently. I have been on prescribed injections now for 6 weeks and will continue to do so.My initial symptoms were slight tingling in the hands, muscle twitches all over the body including calves thighs, arms, shoulder, buttocks etc. I also felt fatigued.Some of the symptoms have improved however, my thighs are now aching partularly when elevated and still have some of the twitches although reduced. I also feel very distant but this could be because of the worry.I have had a whole host of bloods done, CT scan and several physical neurological exams done and nothing so far has been uncovered.I have also had some slight cooling sensations in the legs recently which i didn't have before the injections.My questionsDoes it sound like B12 symptoms and do I just need to be patient?
How long does recovery take?
Should I be concerned about it being something else?
Is it usual for symptoms to get worse during treatment?I'm really worried and any advice would be appreciated.Dean
Submitted: 4 months ago.
Category: Neurology
Expert:  Dr. Bob replied 4 months ago.

Hi Dean. The normal exams, blood tests and CT scan are very reassuring. The symptoms you are having may actually be a good sign, as the nerves that have been deprived of B12 (and damaged as a result) are now recovering and reparing themselves. This often results in intermittent, sporadic firing that creates abnormal sensation without actually representing any pathology. Recovery can take 3-6 months as nerves regenerate rather slowly. If you are working closely with your family doctor or a neurologist you should not be concerned about it being something else. They should be monitoring you for other possible conditions.

Customer: replied 4 months ago.
Hi Bob,Thank you so much for your response. I've seen your reviews and I was hoping to get a response from you!Do you mind if ask you just a couple more questions:I have also developed a deep ache in my thighs which I didn't have before but I did have twitching there. Is this likely to be a sign of recovery?Finally, would you recommend any other suppliments whilst on the injections such as potasium or magnesium as I have read the injections can depleat these which can also cause twitching?Thank you again.
Expert:  Dr. Bob replied 4 months ago.

This could be part of the recovery process of the neuromuscular units affected by the B12 defiicency, or it could represent strain from increased activity now that you are getting better. This would be especially true if you recently took up a regular exercise program, are weight lifting, or doing more of some activity around the house such as going up and down stairs. Either way, monitor this deep ache and let your doctor know if it progresses. As for supplements, the only would you might need would be a multivitamin. This would certainly be the case if recent blood tests indicated that your sodium and potassium levels were within the normal range. You could also have your GP check your calcium, magnesium and phosphorous levels just to be sure.

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