Anyone had Vit. B12 deficiency with Crohns?

[coachvee]

Hi all,

I know it's a very common thing, but at the same time it's quite hard to find specific answers regarding b12 deficiency, considering that it is triggered by Crohn's.

A little background - I had a resection operation last February, ~15cm of ileum was removed. Since then I've had problems on and off - had another inflammation and ridiculous pain, culminating in a hypomania episode in July 09 which was associated with prednisolone, and lingering depression, tiredness and anxiety ever since.

I have been seeing a mental health nurse recently, and she was concerned that I was still very tired all the time, despite my Crohn's being pretty well in check compared to before, and despite my starting a course of Sertraline. I just assumed it was because of family issues and perhaps the Crohns being dicky, and because of the depression, but she wanted to make sure. So she asked me to get a blood test done.

Apparently my b12 levels were around 130. (I had the same test done in April 08 and they were 330) Doctor thought that was severely deficient, along with my folate levels, and from what I've found out it's ridiculously low. So basically I've had 3 of my b12 injections so far (ouch) and 3 more this week.

Just a little thing here... I can't understand why the hell I wasn't tested for this automatically following my operation. I was sure that I was, but my memory of last year is rather patchy thanks to the hypomanic spell. The blood tests from last year were only to check my reaction to infliximab. But b12 deficiency is apparently REALLY common for people with Crohns, and especially for those who have resections. I could have avoided all of this - grrr!

Anyway, from what I understand, b12 deficiency can affect all sorts of things including moods and I am certain that's what is causing my mental health issues right now. What I am wondering, that I can't seem to get an answer to.. when is it that I will feel more normal? The only thing I've noticed so far is that I get very hyper occasionally - a little like the Prednisolone "buzz" (which brings back some very unpleasant memories for me, after my hypomania last year).

I've also read that it can take about 20 injections for the liver's stores of b12 to get back to normal. Some people seem to get them every day for 2 weeks or so, then once every week, but what I don't get is that the doctor said I have 6 over the next 2wks, then once every 3 months. Surely that isn't enough?

So I know this is rambling, I'll try and summarise...
- When having b12 injections to combat a deficiency, how long does it usually take to feel "normal" again? (p.s. I know that it will take longer than 1 week... i've only had 3 injections so far, the first of which was on the 18th )
- Is 6 injections over 2 weeks as an initial "loading" dose really enough? Each injection is 1mg i think.

Thanks in advance

 

[DustyKat]

Hey coachvee, :bigwave:

Since you have had a resection at the terminal ileum you should have been receiving B12 injections all along and perhaps a Folic Acid supplement, unless you are consuming high amounts in your diet, and maybe even Iron.

Everyone is different but as a general rule you should be able to get onto 3 monthly injections, after a number of loading doses, and that is quite normal for many people and maintains their blood levels quite nicely. I think another thing you should have checked is your Iron Stores, which will show as Ferritin on a blood test. You can have a normal haemaglobin and still have depleted iron stores, this coupled with a low Folate reading may also be contributing to your malaise and moods.

I am also surprised this wasn't followed up from the word go. You can't have extensive damage or removal of your Terminal Ileum and not require B12 injections for the rest of your life 'cause this is where B12 is absorbed.

Good luck and keep us posted!

Dusty.

 

[georgiegirl]

Hi, I too have to have some loading doses of b12 pretty recently. But same as you, I didn't really notice much in the way of mood changes or increases in energy. However, the next time I saw my GI (only the second time since the colonoscopy), he was annoyed that I hadn't been taking all the other vitamins he'd suggested. Now I had no recollection of any of those being spoken about (I was still in a dream land after being told I had Crohn's!). But almost as soon as I started taking them, I noticed a MASSIVE difference in my energy levels and mood. These vitamins include iron, calcium, C and D. I don't know which is responsible for the change, or maybe it's all of them.

Have you been checked out for all these things? Maybe a full blood workup will be able to tell your doc what you need...

 

[Seeingangels]

Hi, i have vit b12 every 4-6 weeks, as you can only store so much any excess your body gets ride of it anyway.but i was only precribed this over the past 2 years with my new specialst,as most crohns patients have this as the norm.we cannot fully absorb all the necessary nutiants from our foood. I.e poor absorbtion, which in part makes us tied and have enemia etc etc .

 

[auntee_steph]

For about 5 years now, I have had to get B12 shots once a month

 

[Seeingangels]

Hi There, i dont know if this will reach you i am a new member ?

 

[auntee_steph]

Hey.....I just joined myself.

 

[Arby]

My Crohn's has caused me to become anemic (which is no fun). My Hematologist has me on Iron, B12 and Folic acid supplements. He told me if the B12 is not up by my next appointment next month he will start B12 injections.

The Crohn's / Anemia connection has landed me in the Hospital twice in the last year.

 

[Jennjenn]

Hey coachvee, :bigwave:

Since you have had a resection at the terminal ileum you should have been receiving B12 injections all along and perhaps a Folic Acid supplement, unless you are consuming high amounts in your diet, and maybe even Iron.

Everyone is different but as a general rule you should be able to get onto 3 monthly injections, after a number of loading doses, and that is quite normal for many people and maintains their blood levels quite nicely. I think another thing you should have checked is your Iron Stores, which will show as Ferritin on a blood test. You can have a normal haemaglobin and still have depleted iron stores, this coupled with a low Folate reading may also be contributing to your malaise and moods.

I am also surprised this wasn't followed up from the word go. You can't have extensive damage or removal of your Terminal Ileum and not require B12 injections for the rest of your life 'cause this is where B12 is absorbed.



Dusty.

Dusty is right.....I had a resection and it took a while for them to finally give me injections and infusions instead of orally. When they checked the ferritin levels mine were almost depleted. I am still exhausted and fatigued even with the infusions but i still go and get the iron infusions and the B12 shot.....The specialist stated that iron pills can cause inflamation because they are not easily digested and that people with any IBD who needs iron should get it through infusions.