What are the reasons for dizziness, brain fog, and migraine following B12 shots for panic disorder?

Question

Hello doctor,

First, let me start by saying that I was diagnosed with panic disorder 10 years back. I do not think this is an anxiety or depression problem. Seven weeks back, I started getting B12 injections. The first shot took five days to start working but once it did, 90 % of my anxiety went away. This was naturally life-changing for me. I have not missed my B12 shots except once when the person who gave the shots was out of town. I have had six B12 shots in total and I took my last shot four days back. I am now experiencing (and have been experiencing even before my last shot) dizziness and brain fog. These are two things that I associate with having anxiety, and I can feel that the anxiety is gone, but my body being in this type of state is making me feel worried.

But I will not panic, and I shall focus on finding a solution. The other problem that may be contributing to my anxiety is migraine. Eight days back, I got a migraine that lasted for three days (with reduced headache in between). I have been known to have migraines without headache before and last night I decided to take Imitrex before bed in case this was a silent migraine. I woke up in the middle of the night with a pounding head and I took another tablet of Imitrex. This morning I woke up and my headache was gone but I still felt dizzy and had brain fog.

Also, last night, I experienced restless legs and for the past one week, I have had a dry mouth. Sometimes, I experience breathing issues. I am not sure if I have some MTHFR gene mutation (getting tested is very difficult to find) whether taking the B12 shots without taking Folinic acid put me into this situation or if it is a migraine problem. I am unsure whether I have some other type of ongoing deficiency (potassium) or have a B12 overdose. I would like to note that a week after my first B12 shot, my blood levels came back to a range of 500 pg/mL.

So, I do not know if I had only a B12 deficiency that helped me cure my anxiety. I am not sure if I should try taking Folinic acid to see if that helps or if I should take potassium or if I should concentrate on migraine (which I honestly cannot tell if it is present or not). I cannot get the blood tests and genetic testing done immediately since my doctor is out of town. I need help with this now since the longer it persists the more, I feel like how I was when I had anxiety previously and I do not want to experience the same again. I took my shot of Depo last week and I regularly take Ibuprofen for headaches and muscle aches. Please help.

Answer 1

Hello,

Welcome to icliniq.com.

We are elated to have you onboard at icliniq.

The first possible reason for your uncontrollable anxiety is vitamin B12 deficiency. Though there is no direct relationship, a lot of individuals with anxiety have associated B12 deficiency. Folate deficiency is also a contributing factor to uncontrollable anxiety. So, if your symptoms improved after taking doses of B12, then most likely you were having anxiety due to B12 deficiency. The reason for experiencing migraine is not due to B12 overdose since your levels are not very high. But since you woke up at night with a pulsatile headache, this should be evaluated properly. MRI (magnetic resonance imaging) should be done to rule out any serious issues.

Right now, if you have a prescription then take medicines to control headaches like Naproxen. For severe pain, you can take the tablet Sumatriptan. You can take your regular medicines for anxiety. Once you get an appointment with your GP, then ask for a referral to a neuropsychiatrist for evaluation.

I wish you good health.

Thank you.