Q. I have a tingling sensation even after taking two injections for Vitamin B12 deficiency. Kindly help.

Answered by
Dr. Upendra Kumar Shah
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jul 04, 2021 and last reviewed on: Aug 10, 2021

Hi doctor,

I was diagnosed with Vitamin B12 deficiency two weeks ago (level was 112 pg/mL). I had pins and needles, burning and tingling sensation in my hands and feet. I visited a local doctor here, and the doctor advised me to take weekly injections (1000 mcg) for three weeks and then oral supplements. I have taken two injections to date the symptoms still exist. I feel better for the initial two to three days, and then the symptoms return. Oral supplements make me itchy and tingle even further. My MCV is 82.7 fL, and my MCH is 25.80 pg. Slightly lower. My Hb is 14.9. Is the injection therapy correct, and do I need to increase the dosage of injections? Are sublingual better than oral supplements? I have heard sublingual have a better capacity to absorb. I never had such problems in the past. After acute gastritis, my problems started. This is having a very debilitating effect on my work. I hope with the appropriate medications, my conditions can be reversed. Please give your opinion.



Welcome to

The diagnosis of a Vitamin B12 deficiency following gastritis with neuropathy is compatible with this clinical scenario. I would like to know the nerve conduction study report. Here the Vitamin B12 deficiency is due to decreased secretion of intrinsic factor from the stomach, which is important for absorption. Anti-parietal cell antibodies should be checked. The injection is the only treatment option in this condition. Oral will not help at all because it will not be absorbed. The usual prescribed dose is 1500 to 2000 microgram weekly for eight weeks, intravenous or intramuscular. Then monthly for three months. As of now, I am not aware of any sublingual preparation. As far as I know, there is no sublingual preparation for Vitamin B12, well I have to check that, but the standard treatment is injection only. Symptoms will not go in days. It may take up to three to six months, medicines for neuropathy can be taken. I hope this was helpful.

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