woman runner hold sports injured leg on tropical park trail

My B12 Deficiency Experience

This happened one Saturday morning. I woke up as usual and went to the washroom, and on my way back, I found myself in excruciating pain that suddenly started from my lower back and traveled down to the back of my right thigh, and to my calf muscles, and heels.

I was going through lower back pain for about two weeks; it was mild, but persistent. Having had a long history with back pain, for over 10 years on and off, I assumed I would be fine after some stretching and posture corrections, but what I experienced was not something I was prepared for.
When I attempted to walk, I felt an electric shock-like sensation in my hamstring and calf muscles, and they felt being pulled to the extreme. I was afraid the muscles might tear if I moved my legs. My heels burned, too. I was frozen on the spot, pondering how to walk back to my bed, when I just happened to cough, and it brought on a pain that surpassed all levels of physical pains that I had experienced so far. It was like being stabbed precisely and brutally on the very painful and tender areas.

I dragged my feet as slowly and with as little movement as possible and finally reached my bed. But, lying down had become a tricky issue by then. I literally had to crawl on my hands and arms to lie down. That night, I lay down on my back with both legs stretched out, as turning to either side and bending the knees were unbearably painful. I used hot water bags under my hamstring and calf muscles, which provided great relief. But, the moment I tried to move, turn to the sides, sit up, or walk, the pain started all over again.

I was completely in bed the first three days. Sleeping was painful and uneasy. The pain in the lower back gradually subsided after a few days, but the hamstring, calf muscles, and heels were still very taut, and it was painful to sit on the chair, or sit up in bed. It felt worse while coughing, bending at the waist, and climbing the stairs. I couldn’t stand or walk more than a few minutes before I needed to sit down. I noticed that my two toes were numb, too.

A week later, I consulted an ortho surgeon, who is also my neighbor. He prescribed me naproxen and muscle relaxants for a week, and told me that if there was no change in my condition, I should run an x-ray, or I may have to do an MRI after a few weeks. The painkillers did help with inflammation, but as soon as I went off the medicine, the pain returned. I started walking differently too. I was dragging my foot and using a cane to move around, and my activities around the house got limited, as I was mostly lying in the bed.

In the following week, I went to see the doctor who I had previously visited for my back pain. I told him I was diagnosed with severe vitamin D deficiency in 2019, and I had also been a vegetarian for the last two years. After hearing this, he asked me to get my vitamin D and vitamin B12 tests first.

When the reports came, as he suspected, my vitamin B12 and vitamin D levels were extremely low. My vitamin B12 count was 68 pg/mL, when the normal range is between 200-900 pg/mL, and vitamin D was 15.2 pg/ml, when the normal rage is between 25-80. He then prescribed me five doses of Methamin (500 mcg) injections on alternate days and put me on a course of Methamin (1500 mcg), Shelcal CT, and DV 60K for three months, and asked me to use hot compress regularly and return in six weeks.

Only a month after I took my first shot, there were some changes in my condition. The hamstring muscles were less tense. Sleeping was not as painful, though certain movements still irritated the nerves. I could bend my knees and move around. I could sit up in the bed and sit on the chair with some support. The numbness in one of the toes faded a little.Walking or standing for longer, however, was still painful. In the following week, the pain in the calf muscles and the heels lessened, too.

What has helped me?
Since the first day, I have been using both hot and cold compresses regularly, and it has provided great relief, even if temporarily.

As I’m still a vegetarian, I’m eating a lot of dairy products like milk, cottage cheese, and yogurt. I’ve also included some fortified food like fortified milk and fortified cereals in my diet.

Seven weeks from the day I first experienced the pain, things are looking up, but I’m yet to fully recover. Standing or walking for longer, taking the stairs, and walking a little faster are still painful, and I must sit down till the pain goes away. As I have been wondering when I could start to walk normally again, I decided to reach out to Dr. Pravin Nepal, Consultant Orthopedic Surgeon, Norvic International Hospital, to get some answers on my own recovery, and the symptoms and treatments of vitamin B12 deficiency.






Q & A with Dr. Pravin Nepal,

Consultant Orthopedic Surgeon,

Norvic International Hospital

What is vitamin B12, and why is it important?
Vitamin B12 is also known as cobalamin. It has a special role in red blood cell (RBC) formation, nerve function, cell metabolism, and formation of DNA, which carries our genetic function.

What are some of the signs that can tell you are low on vitamin B12?
Fatigue, lack of energy, mouth ulcers, light headedness followed by headache, feeling of pins and needles in the limbs, depression, constipation, diarrhea, and loss of appetite.

What causes this deficiency, and which groups of people are at the highest risk?
This deficiency is mainly seen in a person who cannot absorb vitamin. Factors that cause the deficiency include age and history of weight loss surgery or any part of stomach removed. Other conditions in which the deficiency is caused are:
a. Pernicious anemia
b. Atrophic gastritis
c. Certain drugs like proton pump inhibitors (PPI), H2 blockers, and metformin
d. Heavy alcohol consumption
e. Immune system disorders like Graves or Lupus

What are the dangers of B12 deficiency?
Anemia, depression, fatigue, etc.

Can it be treated? What are the medications?
Yes. Medicines to supplement vitamin B12 like methylcobalamin or cynocobal.

Who needs vitamin B12 shots and why?
Vitamin B12 shots are given to a person whose vitamin level is very low. Shots are generally given for quicker action in the body to absorb and function.

How long does it take to feel better after starting the B12 shots?
It solely depends on the level of deficiency. For neurological symptoms to disappear, it will take six-eight weeks. Muscular fatigue may get resolved after one week.

Does vitamin B12 deficiency affect walking?
It will affect walking, as deficiency causes muscle weakness, and supplementation helps improve it. But, people who have cognitive dysfunction do not have any room for improvement even after the supplements are taken.

Can B12 deficiency cause sciatica and tight hamstring?
No. This is mainly caused by compression of nerve, and not by deficiency. However, the symptoms might mimic each other.

Can you get enough B12 with fortified food?
No. Several cereals and flour are fortified with vitamin B12, but these fortified foods alone are not enough for the deficient person.

How long does it take to recover from the deficiency?
Generally, six-eight weeks.

What are the sources for vitamin B12, particularly for vegetarians and vegans?
Vegetables like beans, broccoli, asparagus, etc. are known to have traces of vitamin B12. An Italian study has shown that even selected types of oyster mushrooms grown in the southern areas of Italy have a range of concentrations of vitamin B12, from 0.44 to 1.93 μg/100 g. Shiitake mushrooms, which are popular among vegetarians, and widely edible seaweed called Nori, also contain significant amounts of the vitamin.

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