Introduction Some individuals with Crohn’s Disease who take long term three monthly Vitamin B12 injections complain of lack of energy and tiredness prior to their next B12 injection. Some have persuaded their General Practitioners to give the B12 injection more frequently than 3 monthly.
Methods We wanted to determine if this was a common experience,and also if seen in other causes of B12 deficiency besides Crohn’s Disease.
453 patients on long term B12 in the community were invited to complete a questionnaire, 148 agreed. Most of these patients were elderly with a history of pernicious anaemia. 445 patients completed the questionnaire online. Most of these patients had Crohn’s disease. 593 questionnaires were analysed.
Results In the period prior to Vitamin B12 injection, the majority reported tiredness, lack of energy, poor concentration and mood. Selected control symptoms were only seen in 1/4, figure 1. Of those noticing fatigue, 65% noticed this in the week prior to B12 injection. The community recruited group and the online group showed a similar pattern of complaints, but the incidence was lower in the Community group.
Following B12 injection there was an improvement in the majority, in energy, concentration, fatigue and mood.
Multivariate analysis to identify factors differing between high and low symptom sufferer, showed only age and treatment interval which predicted greater symptom burden but this only explained a very small proportion of the variation seen (less than 9%)
A small proportion reported worsening of symptoms following B12 injection; the most common symptom was feeling cold in 7%.
Conclusions In summary, fatigue, lack of energy, poor mood, and difficulty in concentration are seen frequently as individuals approach the 3 monthly B12 injection both in Crohn’s Disease and pernicious anemia. These improve following injection
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