Your first B-12 shot serves as both a therapeutic and a diagnostic tool. It allows your doctor to determine whether you are B-12 deficient, and how often therapy should be administered if you are deficient. There are 4 major types of reactions to a B-12 shot: a no deficiency reaction, a moderate deficiency reaction, a severe deficiency reaction, and a severe deficiency reaction with “feeling worse.” The general framework is that there is a minimal level of B-12 the body needs to function.
No Deficiency Reaction:
If you “feel the shot”— that is, you have a positive sense of more energy, clarity of thought, etc. — and this feeling dissipates without any adverse reaction, you already had the needed minimal level of B-12 to function and the shot provided just a fun boost. It is like having a “Naturopathic cup of coffee” without the side effects of coffee!
Moderate Deficiency:
You “feel the shot,” therefore obtaining a minimal level of improved functioning. The body does not know that you are not going to continue to provide that level of B12, and therefore rapidly uses the B-12 up for all the things it has needed B12 to accomplish. This results in a B-12 “crash”. This crash can occur as early as the day after the shot or as late as a week after the shot. The crash can manifest in subtle symptoms (e.g., lack of energy, fatigue), in total exacerbation of the original symptoms, or in some malaise that is in between these two extremes.
Severe Deficiency:
You do not “feel the shot” at all. The recommended treatment then is daily shots for 4-5 days or perhaps longer until you feel a “lift”. You then attempt to spread the shots out to every 48 hours at which time your doctor may advise you about further shots.
Severe Deficiency with Feeling Worse after the shot:
If the shot made you feel worse without any high then two things have occurred. The first is that you are severely deficient, and secondly your liver was taxed. The liver is responsible for the metabolism of B-12 and it had a difficult time. The antidote to this situation is still a trial of B-12 shots and to drink lots of water at the time of the shot. Other liver support would include such foods as beets, fresh artichokes, turmeric, and dark foliage.
Special Cases and Considerations:
- Another possibility if the shot made you worse is an allergy to the material the shot is made with. Your doctor will consider alternatives to supply you with B12.
- Some people taste the B-12 or B-vitamins. Sometimes tasting the vitamins is a sign that you have adequate amounts. You should report tasting to your doctor.
- If you need frequent shots we advise that you bring someone in who can learn to give you the shots. This is more convenient and less expensive. We will dispense the medication and the syringes needed for self administration.