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Vitamin b12 and vitamin D deficiency
I am getting constipation since two months
The constipation is like some days ok and other days it comes like thorn( starting mai chubta hai kante ki tarah) and because of that after 4-5 days I got blood in the stool, I consulted to gastroenterologist he said due to constipation I got feissure and gave me tube to apply
Blood got stopped but constipation is still there
Gas, heartburn if i eat anything...
My weight reduced to 3 kg in 20 days.. thyroid is normal but I m having severe weakness and heartburn
But i have vitamin b12 deficiency and vitamin D deficiency
My vitamin b12 is 170 and vitamin D is 27
Yesterday I consulted to general physician and he suggested to take multivitamin for a month
But I got call from the dietician from where I had done blood test
She said to take vitamin b12 supplement for 3 months
She said pehle multivitamin complete kar lo fir vitamin b12 start karna
I asked to doc she said to take neurobion alpha d but I m already started vitamin d for 4 weeks,
Answers (42)
Hello
I’ve carefully gone through your symptoms — constipation for two months, occasional blood in stool, fissure, weakness, heartburn, and confirmed Vitamin B12 and D deficiency. You’ve explained your condition very clearly, and I must say — you’re already on the right track.
Here’s what’s likely happening:
Constipation & Fissure:
The fissure pain (the “thorn-like” sensation) and bleeding are due to hard stools. Even after bleeding stops, the fissure takes time to heal completely — if constipation persists, it can reopen.
Vitamin Deficiencies:
Low B12 (170 pg/ml) and Vitamin D (27 ng/ml) can cause fatigue, nerve tingling, mood changes, and delayed recovery. These deficiencies often coexist with poor gut absorption and diet imbalance.
Weight loss (3 kg in 20 days) with persistent heartburn and gas needs further evaluation — especially to rule out gastritis, malabsorption, or stress-related gut dysfunction.
Here’s what I recommend:
Continue Vitamin D for 8 weeks (weekly dose if prescribed).
Start Vitamin B12 supplement (Neurobion Alpha D or methylcobalamin) for at least 3 months — no need to wait for multivitamin completion.
Take a soft stool regimen:
Isabgol husk or lactulose syrup at night
Plenty of water (2.5–3 L/day)
Fruits like papaya, soaked raisins, and vegetables daily
Avoid spicy food, caffeine, and heavy meals to ease acidity.
If weight continues to fall or fatigue worsens, we may need a stool test, Hb, and ferritin to assess nutrition and gut function.
You’re dealing with a treatable combination of issues — once constipation and deficiencies are corrected, energy and digestion improve quickly.
If you’d like me to review your complete reports and guide you step-by-step with diet, medicines, and recovery tracking, you can message me directly on WhatsApp —nine three two six zero two zero five three six — for a private consultation.
I’ll personally help you correct the deficiencies and heal your gut naturally and safely.
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Hello, I am Dr. Romain Rajan, General Physician. Your case has been allotted to me.
I understand your concern. Constipation with fissure pain, gas, and weakness can become distressing, especially when associated with vitamin deficiencies. These symptoms are quite common when digestion slows down and nutritional absorption is affected.
â
Advices
Drink 3 to 3.5 liters of water daily, include warm water after waking up and before sleeping.
Add high-fiber foods such as papaya, soaked raisins, banana, oats, and vegetables daily. Avoid spicy or fried food that worsens fissure pain and acidity.
As an expert suggestion, take 1 tablespoon of isabgol (psyllium husk) with warm water at night; it helps regulate bowel movement naturally.
What to Monitor
Note your stool pattern, any recurrence of bleeding, or pain during defecation.
Watch for persistent heartburn, bloating, or fatigue despite taking supplements.
Management
You may continue your Vitamin D course and start Vitamin B12 supplementation (like Neurobion Alpha D) as advised. It can be taken together safely with Vitamin D. Do not wait for one course to finish. Continue multivitamin if prescribed. For constipation, you can use a stool softener such as Cremaffin Plus at bedtime for a few days. Avoid overuse.
When to Consult a Doctor Immediately
If you notice fresh blood again or severe anal pain.
If constipation persists despite dietary changes and stool softener use.
If weakness increases or you feel dizzy, faint, or have black stools.
Every patientâs situation is unique. For accurate diagnosis and lasting relief, itâs important to discuss your medical history and symptoms in detail.
ð You can reach out to me directly for this case, and also connect with me in future for any medical consultation.
I am available on Practo or on WhatsApp at 85271646 seven seven for a one on one consultation, where youâll receive
A personalized treatment plan
Safe medicine adjustments (if required)
Quick follow ups to track your recovery
Take care, wishing you good health.
Best regards,
Dr. Romain Rajan
General Physician
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Hi,
The best way ahead would be a detailed clinical interview to understand the symptoms and your comprehensive history.
For a personalized plan, find me by searching "Dr Abhinav Tewari Neuropsychiatrist Lucknow" on Google Maps — my details are listed there.
ẄĤÃŤŠÅPP available on nine four one five three nine four three seven nine
Kind Regards,
Dr Abhinav Tewari
Consultant Neuro-Psychiatrist
MBBS (A.I.I.M.S., New Delhi)
MD (Psychiatry) (A.I.I.M.S., New Delhi)
DNB (NBEMS)
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For constipation - Take high fibre diet. Add salads to your meal. You can take 1 heaped spoon of Psyllium Husk mixed with a glass of water in the morning.
For Vit B12 and Vit D deficiency - Continue the vitamin supplements. If you're not strictly vegetarian, add meat to your diet.
Health Tips
For now, try to avoid spicy foods as they can aggravate the fissure.
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I still didn't understand what is your query. U started medicines like multivitamin which already has Vit B12 components, also u started vit d, ur blood stopped. But constipation is there. So take water water water, and fibres. Ya aap likh nhi paayi apki prob, I think apka constipation hi issue hai. Kindly consult with me on 94 two six eight six 78 nine six.
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The chronic constipation and passage of hard stools have caused fissure. Bleeding stopped means mostly the fissure would have healed but has high probability that it can reccur if constipation is not dealt with.
Since you are already on another vit d supplements, take tab. Neurobion alpha only (note that it is without vit d in content).
Next Steps
Have a diet with fruits, vegetables. Avoid meat.
Stool softeners: Syp. Lactulose 15ml HS x 1 week
Stay hydrated
Health Tips
Consult for detailed evaluation
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hello,
it looks like chronic constipation which led to fissures and nutritional deficiencies. constipation requires lifestyle modifications and for vitamin deficiencies since you are weak have multivitamin tablets and you also need b12 and d in higher doses since their levels in your body are less
Next Steps
-cremaffin plus 5ml once daily post dinner for 3 days
-stop cremaffin after 3 days and switch to isphagula once daily post dinner…it is a natural medication which has fibre that helps to reduce constipation
-zincovitt once daily post dinner
-uprise d3 60k iu once a week post lunch for 3 months
-neurobin once a day post lunch for 30 days
-xylocaine gel 2% only when there is painful/ thorn like sensation during stool
Health Tips
lifestyle changes are very important for constipation. eat high fibre content food such as chia seeds, greens…drink plenty of water and few steps post lunch makes a lot of difference
for nutritional deficiencies add nuts, fish and stand under sun at early morning for vit d
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You can take Multivitamin and b12 tab, need not to wait ,
But don't take both together,
Take neurobion once daily in the afternoon and continue Multivitamin as prescribed or in the morning
For more queries connect with me on practo
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It looks like your constipation and fissure are linked to vitamin deficiencies and mild digestive slowdown. The fissure causes pain and bleeding when stools are hard or irregular, which often leads to fear of passing stool and worsens constipation.
Your vitamin B12 level of 170 is quite low and can cause weakness, fatigue, and even digestive issues. Vitamin D at 27 is also below the ideal range and may add to muscle tiredness and low energy. The gas and heartburn suggest slow digestion, often worsened by low fiber intake or irregular meals.
You should continue your vitamin D course as prescribed. You can safely start a vitamin B12 supplement like Neurobion Alpha D now; there is no need to wait for a month. Drink plenty of water, add fiber from fruits, vegetables, and a teaspoon of isabgol at night. Avoid spicy or fried food for a few weeks.
Once your digestion settles and vitamin levels improve, the weakness and constipation should ease. For clarity and proper management, an online consultation with me will help.
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You can take neurobion forte once daily after finishing your vitamin d.
Try eating fibre rich diet.
Drink 2-3 litres water daily.
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You can consult me directly on Practo, or reach out via WhatsApp:
Eight Seven Six Two Seven Four Nine Nine Seven Four
I’ll guide you step-by-step with easy-to-follow treatment plans.
Early consultation helps avoid complications — feel free to connect.
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Continue vit d3 and start neurobion once daily.., don’t take these tablets together.., Don’t worry.., Take fibre rich food.., avoid spicy and oily foods and avoid maida .,
Next Steps
Sitz bath regularly
Take fibre diet
Health Tips
For any queries , kindly contact me on Practo … thankyou
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Vit d3
Uprise d60k once a week for eight weeks followed by one per month for six months a complete therapy by WHO.
Deficiency cause constipation.
Softovac powder two tsf two times for two weeks.
A non habit forming isabgol.for constipation.
Change life style n diet plan drastically first.
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Take vitamin D weekly dose 60k aiU units
Take tablet neurobion forte daily
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3 kg in 20 days with constipation I can’t co-relate clinically although your vitamin D, b-12 is not that much low you need to for full body check up and consult good physician .
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Usually multivitamins tab are b complex tabs which has all vit B including Vit B12 so need not to take multivitamin and separate B12 tabs.
Either u take b complex with vit D or just take neurobion d ,which has D and B both.
Next Steps
use laxative proper dose,overuse cause weightloss,under use will result in constipation
use ppis for gastritis continously for 1 month
ask ur dietician diet plan to reduce gastritis
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Vitamin B12 & Vitamin D : continue taking the multivitamins for 3 months.
Heartburns : symptoms lean towards a condition called “GERD”
Take frequent meals, with little to no spicy flavour.
Avoid Meat for a few days.
Constipation: eat fibre rich fruits with every meal.
Drink lots of water after meals and throughout the day.
Next Steps
TAB.D-RISE 60k - one tablet once a week for 12weeks (for vitamin d)
TAB.NEUROBION FORTE 1 every morning with meal for 12 weeks (for vitamin b)
TAB.RANITIDINE 150mg 1-0-1 30mins before food for 15 days
(For heartburns)
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1. For Constipation:
Lactulose syrup 15–30 mL at bedtime × 10 days → then as needed
Isabgol husk 1–2 teaspoons with warm water at nigh
High-fiber diet, adequate fluids, regular exercise
2. For Anal Fissure (if discomfort persists): Lignocaine + Nifedipine ointment — apply locally twice daily after warm sitz bath
3. Heartburn:Tab Pantoprazole 40 mg — once daily 30 min before breakfast × 4 weeks
4. Vitamin Supplementation: Tab Methylcobalamin 1500 mcg (Neurobion-OD / Methylcobalamin) — once daily after breakfast × 3 months
Cap Vitamin D3 60,000 IU — one capsule weekly × 4 weeks, then once monthly × 6 months
Tab Multivitamin — once daily × 1 month
5. Diet Advice:
Add fruits (papaya, banana), green vegetables, whole grains
Avoid spicy/oily foods, caffeine, and late-night meals, mints
Next Steps
Repeat Vit D and Vit B12 level after 3 months. CBC as well. , If constipation persists, bleeding per rectum persists, review after 4 weeks
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Most multivitamin tablets already contain Vitamin B complex So you don’t need to take a separate B12 tablet and
If you want both Vitamin B and Vitamin D together, you can simply take Neurobion D. This already has both vitamins, so you don’t need extra tablets.
Next Steps
drink plenty of water 8-12 glass per day
fiber rich food,
try 1tsp isabgol with lukewarm water before sleeping
you can contact me directly for further evaluation
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