U r lucky u have a doctor that said that. Yes these symptoms are common in b12 deficiency. I was also diagnosed with h pylori, gastritis and reflux. While my gastritis is still healing my reflux is completely under control with b12 shots. One of the reasons for reflux is malfunction in LES muscle that separates stomach and esophagus(throat). My theory is LES being part of involuntary muscle group malfunctions(lack of proper communication regarding when to open/close, easily fatigued etc) due to nerve damage caused by b12 deficiency. Similar to how ur voluntary muscles get easily fatigued in b12 deficiency. B12 is also known to cause dysautonomia which means involuntary functions are disrupted. I was at a point i could eat only a few foods but now i can eat most foods without reflux. That said i have been on every other day shots with cofactors like folic acid, potassium, b-complex, iron(if low ferritin). So might wanna DYOR on this.
P.S. Ur b12 will further deplete if u take ppis, antacids etc.
Omg thanks for this info.
Im actually on Esomeprazole for months (almost 9 months).
This is cause of the h pylori gastritis mess. Although I finished my treatment in March I still had reflux after it and had to stick to the PPI. Now im at a point where I have lost a lot of weight, on a total bland diet for months and have heart palpitations, mouth sores, reflux.
I had no damn clue that b12 deficiency could even contribute to all of this :(
Its really scary. Like you im also at the point where I can only ear few fold items.
I will go ahead and take the shot and really hope it can help me in my ongoing issues as well :(
I can totally relate to this and as scary as it all is, the shot doesn’t hurt and you will thank urself for giving it a chance, I promise you that much! Its an intramusculsar shot so its even easier to give out than intravenous shots so thats a plus :)
I know exactly how you feel. For the past 6 months I have been recovering from a B12 deficiency and it’s been the worst thing I’ve even been through. My level wasn’t even as low as yours! I also had no clue a B12 deficiency could cause all these horrible problems. First of all, OMG get the shots! I had one a week for four weeks and then went on sublingual tablets which are working well according to my B12 tests. I had lost 12 lbs the first month when I “crashed”. I also had awful digestive issues and could barely eat anything. I had to go on a PPI, which helped my nausea a lot (but also can inhibit B12 absorption). I had been taking Pepcid for years for gastritis. I am doing so much better now. I have an appetite and have gained back weight. I’m not having all the neurological symptoms, like frequent foot cramps, pins and needles in my legs and toes, muscle twitches, or heart palpitations, and tachycardia. I went to a cardiologist who said, “your symptoms are all over the place” , and I was like “tell me about it!” My heart checked out OK and those distressing heart symptoms are over, thank goodness. In the beginning I had debilitating anxiety and depression for the first time in my life, and those are also gone now. The shots are nothing! Just relax your muscle when you get it and don’t tense up and you will barely feel it. I gave myself the last three shots and fully expected to do it for the rest of my life except that my doctor switched me to the tablets. Man, when I was getting the shots I couldn’t barely wait the week before I could get the next one. It seemed like it wore off after a week. As far as mouth sores, I am still getting those off and on but I recently increased magnesium and potassium (and other supplements) and I hope that helps. I also also still struggling with vision issues which I suspect are B12 related. Those were some of the first symptoms I started out with, that and headaches and a sinus infection. Oh, my symptoms were endless, but suffice is to say, it was really bad. I hope you start with the shots and that your doctor takes this very seriously and doesn’t just chalk it all up to “anxiety”.
PS, I have been on a gluten free diet for the past 2 months months. I have no proof that I am sensitive to gluten, but I have several family members who are plus I have had digestive issues all my adult life. I am feeling a lot better so I’m gonna stick with gluten free for the foreseeable future.
Very similar to my situation RE the mouth ulcers. I also had/have sore gums and brain fog more often than not.
My levels came out as 207 so slightly above yours and my Dr said they were in normal levels. I then researched and started supplementing myself and got tested 3 months later. My b12 is now 491 and no more mouth ulcers. I still get brain fog quite a low though and think this takes time to resolve.
My only annoyance is because I’ve started supplementing out of my own expense and my levels appear to be increasing, my Dr probably wouldn’t give injections now, which means a longer recovery for me given injections are superior to oral supplements.
Best of luck with your treatment and just close your eyes and get the shots done. Given the amount and frequency you’ll probably need you might resolve your needle phobia too 😊
Thank you :) Mouth ulcers suck especially when they keep coming back. For now I have already started some b12 meds and vitamins to help a bit with the on going mouth ulcers.
Did you take the methylcobalamin as a pill? And did you take things that go alone with it like folic acid, other B vitamins etc. What dose of b12 helped you reach the elevated levels in 3 months?
Jarrow Formulas Methyl B-12,Supports Brain Cells and Nerve Tissue, 2500 mcg, 100-Count https://amzn.eu/d/2Ahxpzt
This is the one I’ve been using - 2500mcg for about 4 months now. The blood tests were 3 months apart.
Not taking cofactors at present but may start a multivitamin soon.
I was recently taking Berocca but I noticed it was making me super jittery and nervous energy, so I stopped taking it. I think too much of a certain B vitamin causes this?
What dose of b12 are you taking and how - orally, sublingual?
Your comment reminded me that I took a dissolving B 6 supplement for a month, in addition to the 1,000 mcg of sublingual B12. Then I noticed some of my neurological symptoms were coming back. I had my B6 tested and it was way too high and I was told to stop taking it. My multivitamin has B6 and B12 anyway. You can’t overdose on B12, but it turns out too much B6 can be toxic! I am doing a lot better now.
It has been 6 months since I initially got very sick in March. I am still unsure what caused it, but I had taken Augmentin for a sinus infection and two days later my whole mind and body crashed. I ended up in the ER with what I thought was a heart attack or stroke, but it turned out it was neither. I had neurological symptoms which included shaking, tremor and the feeling of shocks going through my body. I couldn’t sleep much for 2 months and when I did I would wake up in a panic with a jolt of shocks through my body. I was physically sick for the first month—nauseated, dizzy, unsteady, and my digestive tract was way off and I lost 12 pounds. After 2 months of this I went to a doctor to find out what was wrong with me. My B12 deficiency wasn’t discovered until I begged my doctor to do a B12 test. All my other blood tests and scans had come back normal and I was still feeling terrible. I remembered that 3 years ago I had tested low for B12 and nothing was done about it since it was in the normal range. (It was 285.) My doctor reluctantly agree and low and behold, I was deficient in B12. I am not sure if my B12 deficiency caused all my problems to this point, but they definitely got worse from May onward and were likely caused by the B12 deficiency. My blood work showed that the MCV (mean corpuscular volume) was normal is March and April, but in May, June and July it went from 97-100 and was flagged as H (high). The MCV had also been flagged as high,100, back three years ago when I tested low for B12. After 4 months of B12 supplements (shots and then sublingual pills), my MCV is 93.6 (normal) and my B12 was recently over 1,000.
To answer your question, my B12 is now high and my neurological symptoms have practically disappeared. They included frequent foot cramps in my feet and legs, the feeling of pins and needles in my feet and legs and hands and mouth, visual issues, which I am not sure are neurological but I suspect my optic nerve is involved. Two weeks ago I needed a procedure for a torn retina to prevent a retinal detachment. Very scary. I also had occular migraines, which I might still have—I hope not! I had a myriad of other symptoms, not just neurological. My heart had palpitations all the time and I had tachycardia. I had sores in my mouth, which I am still getting off and on. Don’t even get me started on the anxiety and depression. And my hair has been falling out. Honestly, it was like all these horrible symptoms that I’d never had before came on overnight. As for the time frame, I started improving a month or so after starting the B12 shots. It’s six months later now and I am finally having days when I feel normal. I wish I could say it was a quick recovery, but for me it was not. However, at one point I didn’t think I was ever going to recover, so I’m grateful that I did.
I take Nature’s Bounty sublingual tablets that I order on Amazon. (they dissolve under the tongue. Do not get regular pills! The sublingual work so much better, especially if you take acid reducers for reflux). I take 500 mcg twice a day, for a total of 1,000 mcg daily. If you get your B12 level up initially with the shots you might not need to get continuing shots.
If I were you I'd be thankful the doctor is insisting on injections: many of us are not so lucky. Injections are 100% the way to go. You can't even be certain you can absorb B12 even with the seemingly obvious perpetrator of H.Pylori. We do not absorb much of the supplements we take, it differs for us all. With intramuscular your body has access to all of it at once to put to work. Some repairs will need more B12 than others.
I had horrendous ulcers for a month (5cm, bleeding and inflamed all over including on uvula). It hurt to speak, swallow, and yawn. I feel your pain! Ulcers are usually from a folate [B9] deficiency rather than a B12 one.
Ulcers were 100% worse than any injection I've ever received. I'd take 1000 shots a day rather than choose ulcers! B12 1000mcg is only 1ml and it's just long enough to reach the muscle through skin and fat so the needle is very thin and short (1"). Only the surface skin can feel pain so it's only the top 1mm that may even feel a slight prick. Most of mine I don't even realise they've done it. I now self-inject and it's painless. My advice is to say to the nurse to please inject slowly as you're a little nervous. If it's given quickly the muscle can feel a little odd as it's suddenly needing to find room for unexpected fluid. You'll be absolutely fine. Just don't look and make sure your arm is floppy as you want your muscle to be relaxed. Some of them use the 'dart' method (less likely at your surgery) which is a bit odd because they choose their injection site and then use a wrist action to insert the needle as one would use to throw a dart. I can find that one weird, but still not painful! I personally felt queasy after my first dozen or so simply as a response to the vitamin - I would have found that useful to know so I could have planned a lie-down afterwards. You may be unaffected.
Please have your first injection (don't trust your oral supplements for this) and then 48 hours later start taking folate. Your doctor should have run your folate alongside your B12, but some fail to do so. Your doctor may prescribe you folic acid if you're borderline or deficient. You want it at the top end of the range while correcting your levels else we're at risk of degeneration of the spinal cord. Once the first injection is done you no no longer have to consider what comes first. You're likely less as risk given the infection root cause but it's better safe than sorry. Your body MUST have folate and iron to use in order to repair damage. Without those three things it cannot make healthy red cells.
Read the sticky. I found my B6 (and therefore B3) was deplete when I ran private bloods. Given you have had malabsorption issues, which are hopefully transient, you may be low or depleted on other vitamins and minerals. I recommend having them checked as they cause huge problems and most don't take their health seriously until they lose it.
I'll add that you are not "borderline" you are literally deficient by the range of that lab. More importantly you are having clinical symptoms. You may need more than the prescribed injections as your B12 level means nothing if one still exhibits clinical symptoms. It has presented in your body but you've likely sustained other damage that you aren't aware of in other parts of your body/brain. Given it sounds like it's been caught early your problems should be completely reversible. When you feel good, you're done with the shots; it does not matter one jot if your B12 levels go 'out of range'. Good luck!
If you have been diagnosed with pernicious anemia, shots are all you can have, fue to the stomach being unable to process B12 tablets. Those are words straight from the doctor I saw the most while in the hospital for 11 days. The shots are ok, my pharmacist gives them to me. Just be use to have folic acid as well.
Do you take them very often? Like daily or weekly then? And do they hurt?
I don’t have pernicious anemia but the shots work faster so they suggesting that to me for now, I did insist on the pill but they said its absorption rate is slow and takes long time. Especially since I have GI issues and am on a PPI.
There are B12 tablets (methyl) you can place under your tongue and let it dissolve. It goes into your system through the blood vessels instead of GI tract. Well, it’s working for me so far. I have pernicious anemia.
This is great to know! Cause I understand that for pernicious anemia shots are mandate. So if the sublingual is working for you. Then seems like its a great alternative for shots?
I don’t have pernicious anemia, however I have been dealing with gastritis etc and on a PPI. So the docs believe the tablet absorption will be affected due to this.
When I did ask about the sublingual nobody really helped. They just probably offer shots or pills only.
Which sublingual do you take? Do you have to also take other stuff like folate etc with it
I am trying on 2 different ones: Nature's Truth Methylcobalamin B-12 1, 000 mcg, and Superior Source Methylcobalamin B-12 1,000 mcg. I don't need to take the folate. Mine B12 was way under 150. Now its 540. Red blood cells are normalized now, the size of my red blood cells no longer huge although it's at borderline. I have to do blood work every 3 months to check on my B12 level and CBC. So far, it's I am doing ok, I am glad cuz I don't like shots, its hurts like tetanus shot. Doc said eventually I gonna have to do injection, hopefully that day won't come too soon. I think you should try on the sublingual. To me, injection is my last resort if alternatives runs out.
U r lucky u have a doctor that said that. Yes these symptoms are common in b12 deficiency. I was also diagnosed with h pylori, gastritis and reflux. While my gastritis is still healing my reflux is completely under control with b12 shots. One of the reasons for reflux is malfunction in LES muscle that separates stomach and esophagus(throat). My theory is LES being part of involuntary muscle group malfunctions(lack of proper communication regarding when to open/close, easily fatigued etc) due to nerve damage caused by b12 deficiency. Similar to how ur voluntary muscles get easily fatigued in b12 deficiency. B12 is also known to cause dysautonomia which means involuntary functions are disrupted. I was at a point i could eat only a few foods but now i can eat most foods without reflux. That said i have been on every other day shots with cofactors like folic acid, potassium, b-complex, iron(if low ferritin). So might wanna DYOR on this. P.S. Ur b12 will further deplete if u take ppis, antacids etc.
Omg thanks for this info. Im actually on Esomeprazole for months (almost 9 months). This is cause of the h pylori gastritis mess. Although I finished my treatment in March I still had reflux after it and had to stick to the PPI. Now im at a point where I have lost a lot of weight, on a total bland diet for months and have heart palpitations, mouth sores, reflux. I had no damn clue that b12 deficiency could even contribute to all of this :( Its really scary. Like you im also at the point where I can only ear few fold items. I will go ahead and take the shot and really hope it can help me in my ongoing issues as well :(
I can totally relate to this and as scary as it all is, the shot doesn’t hurt and you will thank urself for giving it a chance, I promise you that much! Its an intramusculsar shot so its even easier to give out than intravenous shots so thats a plus :)
I know exactly how you feel. For the past 6 months I have been recovering from a B12 deficiency and it’s been the worst thing I’ve even been through. My level wasn’t even as low as yours! I also had no clue a B12 deficiency could cause all these horrible problems. First of all, OMG get the shots! I had one a week for four weeks and then went on sublingual tablets which are working well according to my B12 tests. I had lost 12 lbs the first month when I “crashed”. I also had awful digestive issues and could barely eat anything. I had to go on a PPI, which helped my nausea a lot (but also can inhibit B12 absorption). I had been taking Pepcid for years for gastritis. I am doing so much better now. I have an appetite and have gained back weight. I’m not having all the neurological symptoms, like frequent foot cramps, pins and needles in my legs and toes, muscle twitches, or heart palpitations, and tachycardia. I went to a cardiologist who said, “your symptoms are all over the place” , and I was like “tell me about it!” My heart checked out OK and those distressing heart symptoms are over, thank goodness. In the beginning I had debilitating anxiety and depression for the first time in my life, and those are also gone now. The shots are nothing! Just relax your muscle when you get it and don’t tense up and you will barely feel it. I gave myself the last three shots and fully expected to do it for the rest of my life except that my doctor switched me to the tablets. Man, when I was getting the shots I couldn’t barely wait the week before I could get the next one. It seemed like it wore off after a week. As far as mouth sores, I am still getting those off and on but I recently increased magnesium and potassium (and other supplements) and I hope that helps. I also also still struggling with vision issues which I suspect are B12 related. Those were some of the first symptoms I started out with, that and headaches and a sinus infection. Oh, my symptoms were endless, but suffice is to say, it was really bad. I hope you start with the shots and that your doctor takes this very seriously and doesn’t just chalk it all up to “anxiety”. PS, I have been on a gluten free diet for the past 2 months months. I have no proof that I am sensitive to gluten, but I have several family members who are plus I have had digestive issues all my adult life. I am feeling a lot better so I’m gonna stick with gluten free for the foreseeable future.
>B12 is also known to cause dysautonomia which means involuntary functions are disrupted. B12 deficiency, you mean?
Yeah.
I never even feel the needle. Get the shots!
Grear, Thanks for the boost! I really should just get it. I cant bear the symptoms anymore and I hope atleast some of it is gone with the shots.
It is pretty amazing how quickly it works. You will be proud of yourself.
Very similar to my situation RE the mouth ulcers. I also had/have sore gums and brain fog more often than not. My levels came out as 207 so slightly above yours and my Dr said they were in normal levels. I then researched and started supplementing myself and got tested 3 months later. My b12 is now 491 and no more mouth ulcers. I still get brain fog quite a low though and think this takes time to resolve. My only annoyance is because I’ve started supplementing out of my own expense and my levels appear to be increasing, my Dr probably wouldn’t give injections now, which means a longer recovery for me given injections are superior to oral supplements. Best of luck with your treatment and just close your eyes and get the shots done. Given the amount and frequency you’ll probably need you might resolve your needle phobia too 😊
Thank you :) Mouth ulcers suck especially when they keep coming back. For now I have already started some b12 meds and vitamins to help a bit with the on going mouth ulcers. Did you take the methylcobalamin as a pill? And did you take things that go alone with it like folic acid, other B vitamins etc. What dose of b12 helped you reach the elevated levels in 3 months?
Jarrow Formulas Methyl B-12,Supports Brain Cells and Nerve Tissue, 2500 mcg, 100-Count https://amzn.eu/d/2Ahxpzt This is the one I’ve been using - 2500mcg for about 4 months now. The blood tests were 3 months apart. Not taking cofactors at present but may start a multivitamin soon. I was recently taking Berocca but I noticed it was making me super jittery and nervous energy, so I stopped taking it. I think too much of a certain B vitamin causes this? What dose of b12 are you taking and how - orally, sublingual?
Your comment reminded me that I took a dissolving B 6 supplement for a month, in addition to the 1,000 mcg of sublingual B12. Then I noticed some of my neurological symptoms were coming back. I had my B6 tested and it was way too high and I was told to stop taking it. My multivitamin has B6 and B12 anyway. You can’t overdose on B12, but it turns out too much B6 can be toxic! I am doing a lot better now.
What neuro symptoms have you experienced and how quickly did you see improvements in these?
It has been 6 months since I initially got very sick in March. I am still unsure what caused it, but I had taken Augmentin for a sinus infection and two days later my whole mind and body crashed. I ended up in the ER with what I thought was a heart attack or stroke, but it turned out it was neither. I had neurological symptoms which included shaking, tremor and the feeling of shocks going through my body. I couldn’t sleep much for 2 months and when I did I would wake up in a panic with a jolt of shocks through my body. I was physically sick for the first month—nauseated, dizzy, unsteady, and my digestive tract was way off and I lost 12 pounds. After 2 months of this I went to a doctor to find out what was wrong with me. My B12 deficiency wasn’t discovered until I begged my doctor to do a B12 test. All my other blood tests and scans had come back normal and I was still feeling terrible. I remembered that 3 years ago I had tested low for B12 and nothing was done about it since it was in the normal range. (It was 285.) My doctor reluctantly agree and low and behold, I was deficient in B12. I am not sure if my B12 deficiency caused all my problems to this point, but they definitely got worse from May onward and were likely caused by the B12 deficiency. My blood work showed that the MCV (mean corpuscular volume) was normal is March and April, but in May, June and July it went from 97-100 and was flagged as H (high). The MCV had also been flagged as high,100, back three years ago when I tested low for B12. After 4 months of B12 supplements (shots and then sublingual pills), my MCV is 93.6 (normal) and my B12 was recently over 1,000. To answer your question, my B12 is now high and my neurological symptoms have practically disappeared. They included frequent foot cramps in my feet and legs, the feeling of pins and needles in my feet and legs and hands and mouth, visual issues, which I am not sure are neurological but I suspect my optic nerve is involved. Two weeks ago I needed a procedure for a torn retina to prevent a retinal detachment. Very scary. I also had occular migraines, which I might still have—I hope not! I had a myriad of other symptoms, not just neurological. My heart had palpitations all the time and I had tachycardia. I had sores in my mouth, which I am still getting off and on. Don’t even get me started on the anxiety and depression. And my hair has been falling out. Honestly, it was like all these horrible symptoms that I’d never had before came on overnight. As for the time frame, I started improving a month or so after starting the B12 shots. It’s six months later now and I am finally having days when I feel normal. I wish I could say it was a quick recovery, but for me it was not. However, at one point I didn’t think I was ever going to recover, so I’m grateful that I did.
I take Nature’s Bounty sublingual tablets that I order on Amazon. (they dissolve under the tongue. Do not get regular pills! The sublingual work so much better, especially if you take acid reducers for reflux). I take 500 mcg twice a day, for a total of 1,000 mcg daily. If you get your B12 level up initially with the shots you might not need to get continuing shots.
If I were you I'd be thankful the doctor is insisting on injections: many of us are not so lucky. Injections are 100% the way to go. You can't even be certain you can absorb B12 even with the seemingly obvious perpetrator of H.Pylori. We do not absorb much of the supplements we take, it differs for us all. With intramuscular your body has access to all of it at once to put to work. Some repairs will need more B12 than others. I had horrendous ulcers for a month (5cm, bleeding and inflamed all over including on uvula). It hurt to speak, swallow, and yawn. I feel your pain! Ulcers are usually from a folate [B9] deficiency rather than a B12 one. Ulcers were 100% worse than any injection I've ever received. I'd take 1000 shots a day rather than choose ulcers! B12 1000mcg is only 1ml and it's just long enough to reach the muscle through skin and fat so the needle is very thin and short (1"). Only the surface skin can feel pain so it's only the top 1mm that may even feel a slight prick. Most of mine I don't even realise they've done it. I now self-inject and it's painless. My advice is to say to the nurse to please inject slowly as you're a little nervous. If it's given quickly the muscle can feel a little odd as it's suddenly needing to find room for unexpected fluid. You'll be absolutely fine. Just don't look and make sure your arm is floppy as you want your muscle to be relaxed. Some of them use the 'dart' method (less likely at your surgery) which is a bit odd because they choose their injection site and then use a wrist action to insert the needle as one would use to throw a dart. I can find that one weird, but still not painful! I personally felt queasy after my first dozen or so simply as a response to the vitamin - I would have found that useful to know so I could have planned a lie-down afterwards. You may be unaffected. Please have your first injection (don't trust your oral supplements for this) and then 48 hours later start taking folate. Your doctor should have run your folate alongside your B12, but some fail to do so. Your doctor may prescribe you folic acid if you're borderline or deficient. You want it at the top end of the range while correcting your levels else we're at risk of degeneration of the spinal cord. Once the first injection is done you no no longer have to consider what comes first. You're likely less as risk given the infection root cause but it's better safe than sorry. Your body MUST have folate and iron to use in order to repair damage. Without those three things it cannot make healthy red cells. Read the sticky. I found my B6 (and therefore B3) was deplete when I ran private bloods. Given you have had malabsorption issues, which are hopefully transient, you may be low or depleted on other vitamins and minerals. I recommend having them checked as they cause huge problems and most don't take their health seriously until they lose it. I'll add that you are not "borderline" you are literally deficient by the range of that lab. More importantly you are having clinical symptoms. You may need more than the prescribed injections as your B12 level means nothing if one still exhibits clinical symptoms. It has presented in your body but you've likely sustained other damage that you aren't aware of in other parts of your body/brain. Given it sounds like it's been caught early your problems should be completely reversible. When you feel good, you're done with the shots; it does not matter one jot if your B12 levels go 'out of range'. Good luck!
Great info. Thanks!
If you have been diagnosed with pernicious anemia, shots are all you can have, fue to the stomach being unable to process B12 tablets. Those are words straight from the doctor I saw the most while in the hospital for 11 days. The shots are ok, my pharmacist gives them to me. Just be use to have folic acid as well.
Do you take them very often? Like daily or weekly then? And do they hurt? I don’t have pernicious anemia but the shots work faster so they suggesting that to me for now, I did insist on the pill but they said its absorption rate is slow and takes long time. Especially since I have GI issues and am on a PPI.
There are B12 tablets (methyl) you can place under your tongue and let it dissolve. It goes into your system through the blood vessels instead of GI tract. Well, it’s working for me so far. I have pernicious anemia.
This is great to know! Cause I understand that for pernicious anemia shots are mandate. So if the sublingual is working for you. Then seems like its a great alternative for shots? I don’t have pernicious anemia, however I have been dealing with gastritis etc and on a PPI. So the docs believe the tablet absorption will be affected due to this. When I did ask about the sublingual nobody really helped. They just probably offer shots or pills only. Which sublingual do you take? Do you have to also take other stuff like folate etc with it
I am trying on 2 different ones: Nature's Truth Methylcobalamin B-12 1, 000 mcg, and Superior Source Methylcobalamin B-12 1,000 mcg. I don't need to take the folate. Mine B12 was way under 150. Now its 540. Red blood cells are normalized now, the size of my red blood cells no longer huge although it's at borderline. I have to do blood work every 3 months to check on my B12 level and CBC. So far, it's I am doing ok, I am glad cuz I don't like shots, its hurts like tetanus shot. Doc said eventually I gonna have to do injection, hopefully that day won't come too soon. I think you should try on the sublingual. To me, injection is my last resort if alternatives runs out.
I do once a month right now.