# Low levels of B12



## DFaust (Sep 5, 2012)

Hello everyone. New member here. Very happy to discover this place with such wealth of information and support between the members.For the last four years, I have been dealing with symptoms indicating (according to the doctors) IBS and anxiety or GAD. Panic attacks, palpitations, bloating, cramps, constipation, abdominal pain, etc. All the typical symptoms. I had the basic tests done and came back clear, so it was assumed it was anxiety-related and IBS was part of it. I was on various SSRIs and SNRIs (Cymbalta for the last 2 years) for the duration of this time, it seemed to keep IBS-related pain relatively in-check but the side effects were quite bad so I decided to discontinue, which I did after few hard months of weaning. However, recently, I started having pains in my lower right abdomen area again that progressively got more severe almost to the point of rushing to ER one night, with shivers, cold sweat, almost passing out. I went to my GI the day after and after prescribing a spasmolytic and advising to restrict my diet for now (my diet was terrible for an IBS patient to be honest)things look better for the last 10 days or so. A lot less pain and generally the whole situation is a lot more manageable. He ordered blood tests however and today I got the results. The results look normal but B12 levels are low. I never had B12 done before so I don't know what it was in the past. I am seeing my doctor tomorrow so I don't know what to make of this. I read that low levels of B12 could be a sign of IBDs and probably my doctor will follow up with further tests and colonoscopy too.So, I am quite worried as of now, dealing with IBS is one thing but having to deal with Crohn's will be more difficult. Is it possible to have low levels of B12 with IBS but not Crohn's? Having low levels of B12 and IBS independently? Or low B12 means almost invariably Crohn's disease?Thank you very much in advance and looking forward to participate in the discussion in this wonderful place.


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## BQ (May 22, 2000)

There are a myraid of reasons why your B12 could be low. I think worrying about Crohn's is a bit premature. SOooo many things besides Crohn's could be responsible. Go over your concerns with your Dr.Let us know how you make out.


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## DFaust (Sep 5, 2012)

BQ said:


> There are a myraid of reasons why your B12 could be low. I think worrying about Crohn's is a bit premature. SOooo many things besides Crohn's could be responsible. Go over your concerns with your Dr.Let us know how you make out.


Thanks a lot. I am nervous about it to be honest, I haven't been eating for some time now, I was in lots of pain and now that. I can't help it. Hope things turn out ok.


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## BQ (May 22, 2000)

> I haven't been eating for some time now


 That could be your problem right there.... Try to eat...please.. And definitely tell your Dr you haven't been.


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## rhonalomey (Aug 15, 2005)

I also had a blood test and they found lack of vitamin B12. It wasnt a symptom of anything else and the dr said I had to have B12 by injection because I wasnt absorbing it in food. This is years ago and I have the injection every month, no futher problems


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## Freud (Mar 22, 2012)

*Common SIBO symptoms* While symptoms tend to be patterned and chronic, they may also come and go; sometimes they persist for years before signs of malnutrition present. Severity depends upon the type of bacteria present as well as the extent of overgrowth, and not all of the symptoms occur for everyone:•Abdominal bloating and/or belching soon after eating•Abdominal cramps, discomfort, and pain•Bulky, floating, frothy, loose, smelly stools•Loud rumbling noises in the belly soon after eating •Nausea and vomiting, especially after meals•Weight loss Rather than diarrhea, some SIBO sufferers complain of chronic constipation. Others report symptoms seemingly unrelated to the gastrointestinal tract, such as body aches and/or fatigue. *Other problems created by SIBO* When the overgrowth is severe and prolonged, damage to the absorptive surface of the small intestine can interfere with the absorption of fats, proteins, sugars, and vitamins:•Poor digestion of fats results in weight loss and steatorrhea (stools that have excess amounts of fat, and characterized by a foul smell, and a loose, floating, and greasy appearance).•Poor digestion of proteins results in increased susceptibility to infections and hair and weight loss.•Poor digestion of sugars - Symptoms vary in intensity depending on sugar consumption: belching, bloating, cramping, gas, and watery diarrhea.*•Vitamin B12 deficiency may result from bacteria utilizing B12, and rendering it unavailable for absorption: causes anemia.*


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## DFaust (Sep 5, 2012)

Thank you everyone for your considerate and informative answers.To be honest as soon as I saw the law levels of B12 in corelation with the symptoms I though Crohn's. The doctor wants to have a colonoscopy asap to have an acurate view of the situation.He said it is a pretty accurate way,together with biopsies taken to have a good view of the situation. Another thing he said is that B12 normally takes a few years to drop to low levels so in his opinion I may have this for a while now. However the rest of the test seems normal,with a normal sed rate and i understand not any apparent sign of anemia. The problem is,ever since,my stress and anxiety has returned full force and I get severe pain at the lower right quadrant a couple of hours after almost every meal.this makes me unable to sleep,and the pain which is normally piercing in nature causes me to shiver,have cold sweats and generally make me even sicker and exhausted.if i eat i get pain after a while-if i dont i get weaker.How am I going to take the colonoscopy in such a bad state?I really dont know what to do with the pain,my doctor prescribed me Flagyl,an antibiotic and otilax a spasmolytic.i dont see much difference to be honest.i find peace only when i havent eaten for some time. I am thinking maybe the discontinuation of antidepressant and anxiolytic medicines I was taking until recently(Cymbalta and Xanax)may have played a role in the return of the anxiety bit at least. But the intense pain after eating makes me very worried.Is it typical IBS? I mean, even if it is how long will it go like this or what can I do about the pain? What can I take to soothe the pains at least because like I said neither otilax or flegyl seem to be doing a great deal. And why do I get this almost panic attack response when the pain becomes severe? Sorry for the bulky format,I am typing this from my phone in bed. Thanks to everyone again for their contribution.


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## Kathleen M. (Nov 16, 1999)

Pain after eating is common with IBS. The colon is told by the stomach when you eat and it increases it's activity.Unfortunately if you skip meals when you do eat the colon activity will have an even bigger bump in activity. So while not eating meals or even not eating for a day or two may be a short term solution, you will pay for it later in that when you finally do give in and eat you will typically have more pain that if you ate small frequent meals regularly.Do you take the antispasmodic before meals, about 20 minutes before you eat? That tends to be more effective than waiting to see how bad the pain will be then trying to calm it down.Flagyl isn't really for the pain, more for any bacterial problems in there, so I wouldn't expect it to help, and it is something you would take regularly, not just if the pain hits.Discontinuing the medications you were on could very easily make the anxiety worse, and they can sometimes blunt IBS pain so it may have been less when you are taking it.As to why the pain sets off your anxiety? Most of the time pain is a warning signal and when you have pain it is going to do things like increase your adrenaline and all that can up the anxiety. Unfortunately with chronically painful conditions you can still set of the "danger, danger" system that is really only helpful for acute pain. Being constantly on alert isn't good for the mind or mood.Sometimes a heating pad can help for the pain, I don't know if you can get them where you are , but here they make thermacare for menstrual pain that you can wear under clothes and they warm up the intestines just as well as the uterus. So easier if you need to be up and about than something you have to plug in.Are they going to test you, or have they tested you for celiac disease? It can also mess with B-12 levels.


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## DFaust (Sep 5, 2012)

Another thing I would like to add, if it is of any help, I dont recall myself having any notable diarhea or constipation throughout all this time (4+ years) I am dealing with this. I would get the occasional rush to the toilet,especially when sleeping,with stomach cramps etc especially after a heavy meal but that was happening like once a month or so and for a long time,a lot longer than these 4 years.likewise with constipation.I may had constipation for about two months couple of years ago but ever since i seem to be reasonably frequent and my bowel habit and shape kinda corresponds to what i eat.i really cannot recall much diarhea to be honest. Neither blood,particularly foul smelling stool, unusual colour or particularly painful defecation.It mostly seem to correspond to the type of food I am having.Even though the symptoms in total,coupled with those of anxiety and depression have literally rendered me incapacitate to function at a normal everyday level.also,my energy levels are really low for as long as im battling this and B12 might be playing a role in this. Looks I will also need the shots.


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## DFaust (Sep 5, 2012)

My eating habits used to be terrible for someone who is dealing with IBS or any GI related problem. I was working nights hence my whole life schedule was upside down. Bad diet,only one, usually big meal per day,terrible really.But still I dont recall that bad levels of pain and discomfort.Whether it is a coincidence or not,since I discontinued cymbalta the gut pain seemed to get progressively worse.cymbalta is supposedly helping with fibromyalgia among other psychosomatic disorders and pains but I am not certain about its eficacy on IBS related conditions. Is it really prescribed for IBS? Never the less I can clearly feel not only a change for the worse in the level of gut pain pro and post cymbalta but my anxiety levels have upped significantly too. Im trying to take my meds as you suggest,spasmolytic before meal and flagyl after the meal.but sometimes i miss the time or take them earlier or later.its not easy to follow p a tight schedule when ur suffering. I have read about heat pads and was always about to look for one, are they really working?Are they only suitable for IBS only or they are good for other gut conditions too? With regards to coeliac,I will try and aware my doctor into as many possible conditions to look for as possible though I am sure he is aware. My concern is how I will be able to deal with the prep if I am exhausted already.Im trying to eat small and relatively frequently now like I said it mostly causes me greatr pain soon after. Im mostly eating yogurt,juice,chicken soup and a little bread on the side.nothing beyond thatb,no appetite and the thought of yet more pain and shivering terrifies me. I mean I have also convinced myself that that much pain coupled with panick attack like responses cannot be just IBS and it has to be something more serious. Hence my anxiety levels have increased also. What can be done for the pain in that case therefore?If spasmolytics are not very efficient and normal painkillers dont seem to work either what is a medication that can potently stop these kinds of pains? i am conscious now about strictly dieting if and when symptoms recede but till then I am desperate for a potent pain relief at the time of need.one more thing to add, pain is usually preceded by significant mobility,cramps,noises-watery some times and movement on the part of the bowel affected. When I have this starting it is isually a good indication that pain will follow. Is this typical IBS or is it something even more severe? Many thanks again and sorry for the bulky appearance of the text for now!


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## Kathleen M. (Nov 16, 1999)

All the antidepressants can be prescribed for IBS, but which one will help (if any) is idiosyncratic so you need to find the right one for the right person. I believe I've heard IBS was one of the things they looked at when they were developing it, but depression is a lot easier to get approved for.95% of the serotonin in your body is in the gut nerves.Heating pads are a generalized pain thing, not for any specific disorder.Pain with IBS ranges from very mild to extremely severe and can be more severe than whatever other conditions your anxiety is sure you must have. Anxiety is not specific to any disease, so it isn't more likely in crohn's than IBS. It can be made worse and can be triggered by every symptom of every disease.Usually if antispamsodics don't work for pain they try antidepressants.Sounds like you have the kinds of pains that are pretty common for IBSers in pattern and what comes with them.


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## DFaust (Sep 5, 2012)

Another couple of questions, are to your knowledge and experience benzodiazepines such as Xanax, Tranxene, Lexotanil, etc effective in pain relieving/calming IBS and other gut related pains? Since they are not pain relief medications do/can they actually work for these pains? Also,in my case, applying pressure on the lower right part of my abdomen returns stabbing pains, and they are there for as long as I can remember.where do these come from?it feels as if my gut is permanently injured or I have swallowed a bag of pins and needles in there.


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## Kathleen M. (Nov 16, 1999)

They do seem to for some people, but hard to know how much is just effecting IBS pain vs helping to calm down the body's reaction to pain that is similar chemically to what happens if you just have anxiety.Some pain meds have a bit of an anti-anxiety drug like Xanax in it. There is in the USA a combo antispasmodic with a benzo in it. My migraine pills have a bit of a benzo in it just because it helps calm down that reaction to the pain.But they usually don't do just a benzo for pain, but they do sometimes add it to a pain formulation because it helps a bit.The pain from IBS isn't from any damage to the colon, it is more like the nerve pain you get from diabetes. The nerves are just overly sensitive and reporting sensations they shouldn't be and usually the brain interprets all that as pain. So even the colon just doing what it is supposed to be doing can be painful.


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## DFaust (Sep 5, 2012)

Kathleen M. said:


> All the antidepressants can be prescribed for IBS, but which one will help (if any) is idiosyncratic so you need to find the right one for the right person. I believe I've heard IBS was one of the things they looked at when they were developing it, but depression is a lot easier to get approved for.95% of the serotonin in your body is in the gut nerves.Heating pads are a generalized pain thing, not for any specific disorder.Pain with IBS ranges from very mild to extremely severe and can be more severe than whatever other conditions your anxiety is sure you must have. Anxiety is not specific to any disease, so it isn't more likely in crohn's than IBS. It can be made worse and can be triggered by every symptom of every disease.Usually if antispamsodics don't work for pain they try antidepressants.Sounds like you have the kinds of pains that are pretty common for IBSers in pattern and what comes with them.


Thanks again for the reply. It is the severity of the pain and it triggering this almost panic attack reaction that have me worried plus the B12 findings. I think I will try Xanax when I feel anxiety due to pain becomes uncontrollable. It took a while and lots of effort to get off antidepressants so the thought of having to go back to them for IBS is not very pleasing. I would prefer if something else could work rather than having to go back to SSRI/SNRIs. But I also realise my diet all this time was absolutely terrible and this is the first thing I will work on.


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## DFaust (Sep 5, 2012)

My biggest fear is what really happens if pain relief medication,whether it is a spasmolytic or antidepressant not seem to work. You cant really go on your life in such pain so what other potentially more potent medicines are there for dealing with these? I really do hope GIs have a lot more at their disposal for IBS related pain than just antispasmotics. I just cant imagine life when you are in severe pain after even the slightiest meal every day. At this point Im really willing to try anything as long as it produces results and comforts me. I know I am late with my diet but at this point I literally dont eat anything but a couple cases of yogurt,a couple of bananas and some juce. Even this little food still produces great pain after some time,usually after 2 or more hours. So, can I really blame it on the diet at the moment? A month ago I was just eating without care-so wrongly-but now I barely eat. So whats wrong with me? Another thing, is the prep for colonoscopy demanding? I know you really have to have the large intestine completely empty taking a cathartic so is this process dehydrating and exhausting assuming you cannot eat anything for a day? Also, does it require to spend the night at the clinic/hospital? Many thanks already!!! You help me so much!


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## Kathleen M. (Nov 16, 1999)

Unfortunately they tend not to go with potent narcotic pain medications as for some people over time they make the gut nerves even more sensitive and the pain much harder to control, and they treat narcotic bowel syndrome pain with antispasmodics and antidepressants.Most people do the colonoscopy prep at home. You can have fluids and should drink what you need to in order to keep yourself hydrated and functioning. Usually the only limit on liquid diet is no red food coloring as it can stain the colon lining red, not that you may only have water and nothing else (they should be able to give you a list of allowable liquids and broths). The point isn't to end up needing IV fluids to stay alive, after all. Most people are way more bothered by the wiping (so baby wipes and diaper creams are helpful) than not being able to drink enough carbs, electrolytes, and broth to say upright.Usually they give mostly osmotic laxatives rather than relying only on stimulatory cathartic laxatives (although some people do give a combination).


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## DFaust (Sep 5, 2012)

OK this is good to know,I was under the impression you are not allowed to have any solid or liquid intake during colonoscopy prep. And having mentioned that, in my case, since I cant properly eat at the moment, is there anything I can take to supplement my diet in preferably liquid form? Can I even have IV fluids administered at home for as long as I cant properly eat?I really need some serious boost in my nuitritional levels hopefully either in liquid form or without having to go through the GI tract at the moment. Another thing, how deep is the sedation for colonoscopy typically and how soon are you discharged? How long does it take for the results/biopsies to come back normally? So many thanks!!!


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## Kathleen M. (Nov 16, 1999)

No solid food once you start (as you don't want to make new poop) but I've never seen a no fluids at all for a day or two before the colonoscopy. Usually no fluids the day *of* the colonoscopy because of the sedation.Generally you can't do IV fluids at home unless you have a home health nurse taking care of you. You have to be in really bad shape for them to put in an IV feeding thing. That you can feed yourself at home, but like I said that isn't commmon if you can get food in and keep it down. Usually that is when you throw up everything you eat for too long.Do you have something like Ensure where you live? There are usually some kind of liquid high-nutrient food replacements in the pharmacies here for people who have a hard time eating enough. Usually for a colonoscopy they do "twilight" sedation so you aren't completely under to where you are complete dead weight, but are able to roll over and comply with some simple orders that allows you be be easier to work with than being completely out and under.Most of the time you should be discharged within a few hours of when it is over, but you will have to be driven home by someone else. Basically once you are back up and functional even if still sleepy they will send you home.The visible results (what it looked like) is usually available the same day. Biopsies will take a couple of weeks on average.


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## DFaust (Sep 5, 2012)

I do have heard of Ensure, I am not sure if its readily available at the pharmacies here or need to be ordered etc, but I will discuss with my doctor how to supplement my diet with liquids for as long as I cant eat properly. Is Ensure particularly for IBS or it is a general nutritional supplement? Not having to go through much solid food for now would help me a great deal I think at least my with regards to my anxiety since the thought of having a meal terrifies me. Are liquids affecting IBS and bowel motility as much as solid food btw?


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## Kathleen M. (Nov 16, 1999)

Some people find liquids easier, but it just really varies.Ensure is what is commonly used here by people with ulcerative colitis when they can't eat solid food. So it generally tends to be as well tolerated as anything. It is designed, from what I understand, to offer complete nutrition if you can do nothing but drink it and can't have any solid food. When my Dad's throat was really irritated from radiation treatment that is what they had him supplement his diet with.


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## DFaust (Sep 5, 2012)

I see, I will discuss about all this with my doctor, if we can come with a liquid supplement to help me for now. Something else I wanted to ask is,what kind of findings do you expect to see during a colonoscopy,especially in Crohns disease, I understand Crohns inflamation could regularly be in the ileum hence will a colonoscopy (which typically examines the large intestine) be able to identify potential signs? Does IBS have its own set of sights or it is actually the abscence of sights that may lead the doctor it is IBS instead of IBD. Really, thank you so much for taking the time to answer my questions.


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## Kathleen M. (Nov 16, 1999)

The colonoscopy goes into the last little bit of the small intestine (the ileum) so can see Crohns.Crohns can also occur in the large intestine and in parts of the small intestine you can't see with a scope. If your blood tests indicate inflammation and they can't see it with the scope they may do a barium swallow test (drink barium and get X-rays as it goes through the small intestine) or capsule endoscopy (swallow a mini camera that takes pictures). IBS the colon will appear normal, so nothing specific that they will see, it will look healthy.


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## DFaust (Sep 5, 2012)

Ι see. On the pain side,is it possible or even normal that every single meal irrespectively of type and size to still produce this kind of pain invariably day in and out as it happens with me right now? Nothing seems to affect it-I know IBS pain often depends on type of food intake-as long as I have eaten something, pain will invariably follow. In my case it usually appears 2 to 4 hours after my last meal and can last for a while especially if the spasmolytic doesnt seem to control it. Is there a typical duration for this kind of pains,how soon after a meal they usually appear and how long do they last? And also, does Crohns diagnosis require a biopsy?


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## Kathleen M. (Nov 16, 1999)

IBS can cause pain after every single meal, and it doesn't always depend on what kind of food. IBS pain can also be more sporadic, but it can be every single meal regardless of food just from colon activity like it was for me.The act of eating causes the colon to become more active (normal humans, typically 1 hour or so later, but in IBS the timing can be faster or slower than that).There is no duration or quality of pain that is specific for IBS so other than "you have pain" there isn't much else you can do with this kind of chronic pain. I think even when the visual evidence is pretty clear they still do biopsies to confirm as you can't always tell the full picture without checking the tissues under the microscope.The timing does tend to be a bit long for IBS, so I might even think SIBO but does a meal of just plain boiled/broiled chicken cause the same pain as a meal with carbs in it?


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## DFaust (Sep 5, 2012)

So far all the pain feels similar. Whether it is some yogurt or a portion of chicken soup the pain is the same,both in extent and largely in duration. It can feel intermittent but it is always one pinch away from flaring up again. The only time I feel relatively better is when there is a good few hours since my last meal. I am usually in no or very little pain if 8 or more hours have passed since my last meal. I also try to monitor Otylax(spasmolytic) activity. Last night it felt like it helped somewhat , 15-20 mins or so after I took it. I am not knowlegable about SIBO, I will alert my GI about this possibility too.


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## Kathleen M. (Nov 16, 1999)

Here is a recent paper done with Dr. Pimentel who started the research into SIBO in IBS thing that also has some Greek authors (and was done in Greece), so may be helpful to show your doctor.http://www.ncbi.nlm.nih.gov/pubmed/22262197 That may be a lead toward seeing if you can be tested or talk to someone who might see if you are a good candidate for testing.


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## DFaust (Sep 5, 2012)

Hello again. I saw both my psychiatrist and GI today. It was obvious to my psychiatrist that I was in pretty bad state,extremely anxious, stressed and agitated.We will rely on Xanax for now untill we have the colonoscopy results then we will probably return to a comprehensible antidepressant and antianxiety treatment. It might be that discontinuing it,even as gradually as I did could be part of the problem in her opinion. My GI booked me for a colonoscopy for Wednesday,so tomorrow is prep day. He seems pretty relaxed about how I will handle it all and also quite convinced that we will get a good picture of what is going on. He said he will be able to go to the ileum too and take biopsies as necessary. According to his experience a number of IBS patients do show signs of improvement soon after a "good" colonoscopy,possibly due to a change in their psychological state. Is there anything in particular that I should be aware about the procedure? Many thanks!


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## DFaust (Sep 5, 2012)

I am now on prep day. Its ok so far,I have drank the first two litres of the liquid and there is two more to go.its not the easiest thing to drink,it reminds me of saltwater so i have a sip of chamomile ot mint tea before every glass.It does work although from a point onward its only fluids that come out.interestingly enough my GI said Im allowed to have watery noodle soup,together with some other drinks.the information leaflet states even coffee or tea is ok. But definitely nothing even remotely solid. I can feel my bowel markedly emptier and the pains have recedeed. Xanax also helps calming me during this process. I checked my blood pressure last night and it was between 10-11 and 8. is that normal?bpm was above 100, this is also something I have noticed since some time now,could it be related to the fatigue,stress or B12 levels again? Many thanks,I ll keep updating about how things go,it gives me strength and solace and I can assist other members of the forum from my own experiences.


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## Kathleen M. (Nov 16, 1999)

I think you measure blood pressure differently, so I don't know what that means.If you are a bit stressed, and if the B-12 has made you a bit anemic that can make your heart beat a bit fast.Good luck with the prep!


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## DFaust (Sep 5, 2012)

Thank you very much.I guess I meant 110 for systolic and 80 for diastolic? Actually I measured a couple of times, systolic was between 100 and 110 and diastolic at 80. Been a while I have measured my blood pressure so I dont remember what is what. Bpm was certainly over 100 though.


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## Kathleen M. (Nov 16, 1999)

Unless you normally run high I wouldn't worry about 110 over 80 or even 100 over 80110 over 70 to 120 over 80 is usually the optimal range, and anything over 100 on the top is still in the normal range. And some people routinely run lower than that and as long as you don't faint when you stand up too fast they usually don't worry about low. I used to run about 105 over 65 when I was younger and since that was my usual and I didn't have any symptoms then it was just fine. I did sometimes get a question if I was donating blood as they wanted to be sure that was my usual as if I was normally higher than that they would have me wait until it went back up. If you are normally running high a drop to normal range can be too much of a change (and may you light-headed), but if you've never had high blood pressure issues this is just fine.


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## DFaust (Sep 5, 2012)

I am 35 years old male. I dont recall having blood pressure lower than 110 before last night to be honest. When I started monitoring my blood pressure four or so years back I would usually be between 115-130 and 75-90 which seemed to be ok with the docs. I was on antidepressants at the time too so they suspected this might have played a role in raising blood pressure somewhat. However I had higher than normal average bpm in almost all EKGs and a 24 Holter I did. They said sinus tachychardia so I think they atributed it to stress and anxiety. I also had ultrasound scans that came back ok. So it was mainly high bpm at the time but no one talked to me about B12 or some sort of vitamin deficiency. Just stress. I was prescribed a medication for it (Ivabradine) that indeed worked well in lowering BPMs by about 20% with no significant side effects which I took for about a year and a half. It looked like the cardio doctors thought my high BPM was stemming from my anxiety issues. Anyway,after a stress test a year and a half later I was told to stop taking Ivabradine because I did not need it. However, I do feel my BPM has been up to its usual high levels ever since and I can confirm that I get tired easier,dizzy,often when I stand up or taking a flight of stairs. I can feel all these symptoms one would categorise under say "fatigue". The problem is where do I look for them too? Another round of heart tests with a heart specialist and mentioning my B12 results to them? Thanks.


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## DFaust (Sep 5, 2012)

By the way, have you heard of Inderal (Propanolol) and its use and effects both in treating anxiety-related conditions and tachycardias? Thanks.


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## Kathleen M. (Nov 16, 1999)

I use it for tachycardia but I only have it once in awhile, not all the time. I also have high blood pressure now, so it helps with that as well.I don't have anxiety so I can't speak to that, but it is also supposed to help reduce the frequency of my migraines.


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## DFaust (Sep 5, 2012)

Hello again dear  Today I had my colonoscopy as planned. First time I had this procedure but it was really painless and generally I found it suprisingly tolerable. I really did not feel it. Mild sedative(I dont recall the exact mix, I will check and update later) that made me sleepy but pretty communicative. The doc seemed happy with what he saw, he thought my bowel looked good and healthy. He went some 25cm inside the terminal ileum too and said it looks good too. However he took biopsies from that area just in case because of the B12, even though he said possibilities of Crohns are small. No further biopsies were needed apparently. Generally he was very happy with his findings and advised me to start thinking things differently,reorganise my life and priorities and dont think back. At the moment,it looks like IBS, of course we cant be 100% certain till the biopsies are out but looks like this is what I will have to battle with now-and even harder from now than I ever did. I feel like starting to make a few conscious decisions about my life already. So what do you think? Does this sound pretty good or should I still be worried? I am waiting to see how my gut will react to food now,according to the doctor a positive outlook colonoscopy often helps people see a positive change and aleveate symptoms very quickly. Possible through this not very well understood brain-gut connection mechanism. On a related note, you mentioned ocassional use of Inderal for tachycardia. When exactly do you need to take it? Periods of high physical stress and exercise or there are other medical reasons? Having all this B12 scare made me link it to my tachycardia, my doctor though still said that B12 shots might be needed only if levels consistently drop below 100. For now he thinks we wait and see.


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## Kathleen M. (Nov 16, 1999)

I take it daily for high blood pressure, but one of the reasons for that particular BP med is that it also controls tachycardia. I have infrequent but severe bouts (when it goes off my heart rate is over 240 and sometimes trained professionals are just estimating as they can barely count that fast). When I take medication I have no bouts of it.The biggest triggers for me are 1. Lack of sleep the night before, and 2. As they say in the South "fixin" to go do something. I'll be sitting for awhile and the signal from the brain that says "I'm about to get moving, get ready" seems to set off, on occasion, the racing heart rather than just a small bump in heart rate. When I am anemic (so actually fewer blood cells rather than just a bit low on iron) that seems to make it a bit more likely to happen as well. I probably have SVT which means I actually have two pacemakers in the heart rather than just one bundle of nerves that does that. So sometimes I get twice as many signals as I should when they are both going rather than just one running the show and the other resting. If it ever got bad they could go in and fry the extra "circuit".But back to your results, I think the trust the doctor and don't worry unless something pops in the biopsies is the best bet. If you can. Dumping more anxiety into the situation will not make the symptoms better. It would be nice if the treatment for anything was get really stressed up and freak out about something, but that never seems to be what helps.As long as eating properly and maybe a multivitamin or B vitamin supplement keeps your level up you should be fine. Doesn't sound like you have a severe deficiency from what your doctor seems to be saying.


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## DFaust (Sep 5, 2012)

I see. I hope Inderal works well for you. Over here it is quite commonly prescribed I think, for tachycardias, abnormal heart rate and more generic stress and anxiety related issues. I wonder why my cardio put me on Procolaralan (Ivabradine)instead. This is a newer drug and apparently does not have many side effects, there is only one really somewhat annoying and thats seeing weird illuminative patterns during the night. I think this is because it acts on the same If channel inhibitor in the sinus as well as in the retina. It was pretty expensive though, probably near $100 per month per box. I used it for a year and a half then was told to stop it so I did. But now I started thinking again about maybe going back to a heart rate control medication, obviously after seeing a specialist.Does Inderal work on a 24h-basis? Is it something you need to take continuously for some time or only strictly as needed? Any unpleasant side effects? How often do you feel you need it and how quickly and effectively manages to put your symptoms under control?With regards to anaemia, what kind of of indicators in the blood test could point towards it? Hematocrite, number of red, whites, ferritine? One of the things I get constantly annoyed with blood tests is when I am prescribed with some I may have to go back again at a later time for some extra indicators that werent included in the first test. Probably there is a reason for that, since doctors wants to see the basic indicators first but it is still annoying to have to go back for things that could have been included from the beginning. Like the B-group of vitamins, I read now you might need to have the whole B-group tested as they usually go up and down in relation. Is that correct?


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## Kathleen M. (Nov 16, 1999)

Since I take it for high blood pressure I take it every day.It can make me a bit tired.The effect on the tachycardia events seems to have been immediate, but since I can go a couple of months without one it is hard to know if it really kicked in right away, or I just wouldn't have had one anyway the first couple of weeks.I'm sure when they did the B-12 test they also did a complete blood count. They count the red blood cells, if you don't have enough you are anemic. They also measure how much hemoglobin you have in the cells. So you can have enough cells, but they don't have enough hemoglobin in them.Usually if you are anemic the first couple of things they look at (often just test at the same time) is how much iron and how much B-12. If you are low on either of those, that is why you are anemic. If you have more than enough of both of those then they gotta look for something else. Anemia is kind of like fever. There are a lot of things that end up there.I don't know about how the other B's relate or not, but they could go up and down in some relation as a lot of foods have more than one B in them. There are a few diets that can be very low in a specific B, but it is more common for a food to have several in them, not be lacking in just one.Now B-12 only comes from animal sources (and a few specific yeast extracts that may not be common in a lot of diets). So you can be very low in B-12 and fine on everything else. Usually if you are significantly low in B-12 they will just give you a shot. If they haven't given you a shot or put you on supplements it probably isn't low enough to worry the doctors. Often something can be low, but not clinically significant.


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## DFaust (Sep 5, 2012)

I am glad you see reasonable and manageable results with Inderal. I hope, together with any other meditation you may be taking to really help. My tachycardia was observed at the same time when I started having my first full-fledged panic and anxiety attacks four years ago so I suppose my heart specialists attributed it to this. Like every other specialist I saw at the time, they all attributed what I was experiencing to stress, anxiety, perhaps some form of GAD. My tachycardia was sinus tachycardia so I was prescribed Procoralan(Ivabradine). It seemed to work, when I was measuring my bpm while on it, most of the time it would come back fairly normal, around 80-82 bpm. Since I stopped it however I suspect my bpm probably got back to higher levels. Not sure how much as I have stopped checking regularly (I was doing it several times a day at the worst of my anxiety, becoming fixated on the process) so i try to avoid doing this anymore but I feel a re-check is on the cards. I just wonder what could be causing it. Like we said, could it be low B12, could it be prolonged periods of stress or some other reason? It looks it goes together with my energy levels too, which are pretty low, especially at periods of major stress.


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## DFaust (Sep 5, 2012)

Regarding my current situation, I have definitely seen some improvement when it comes to my anxiety levels (my anxiety was sky-high last week especially between when I received the blood tests and performed the colonoscopy - I was experiencing dread!)though I'm taking Xanax three times a day which probably playes a major role in keeping it in check. I don't know what would happen without it. There are still times during the day that I hit emotional bottom but they are not that often since I started Xanax. Only downside is Xanax makes me drowsy most of the day and my sleep while not bad by any means can get disrupted by weird sensations and reactions(I'm sure people on Xanax can relate). The bowel pain and discomfort is still there but feels a bit more moderate now and I can eat somewhat better. For example, yesterday I had my lunch at around 17:00 and I only really started having some discomfort and pain between 22:00-00:00 then it progressively soothed down. Today I had my last meal at around 19:00 and it is only now around 01:30 that I feel some discomfort but it is still tolerable.


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## Kathleen M. (Nov 16, 1999)

Glad you are feeling a little better. Even though anxiety is considered mental/emotional it certainly is experienced in the whole body and it can really cause and effect a number of symptoms so it may be something you need to be treating.


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## DFaust (Sep 5, 2012)

I can say, since I had my test and started with Xanax I am more calm and relaxed so it is an improvement compared to last week. However what really worries and drives my anxiety up still is food and eating, since all this time even after the test anything I eat produces pain after few hours. However little, or much, whether it is pasta, yogurt, fish or some boiled vegetable or juice I will still get the pain after 4-6 hours. Which is my real problem, how to stop this from happening and when it does how to relieve the pain when it's on.


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## DFaust (Sep 5, 2012)

Hello again. I saw my GI doctor today about the biopsies as planned. Apparently they came back ok so I should not be worrying too much according to my doctor. Both colonoscopy and biopsies were good. He prescribed me with a probiotic medication too so I'll wait and see how it works with eating. I guess all this has helped with my anxiety, which had badly taken over me, especially the last few days. Now, I am also seeing my psychotherapist for a comprehensive treatment plan concerning my anxiety and underlying depression, so we'll see how it goes.


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