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B12, Vitamin D Deficiency & Fatigue
I am a 30-year-old male with persistent fatigue and low energy. My recent blood tests show Vitamin B12 <148 pg/mL and Vitamin D 11.8 ng/mL. Hb is 15.1 g/dL and CBC is otherwise normal. Thyroid, HbA1c, kidney function and most liver parameters are normal. I am vegetarian. Please advise on the appropriate treatment for these deficiencies, including whether oral B12 or injections are preferable, dosage and duration. Also, should I get any further tests to identify the cause of the severe B12 deficiency or investigate my fatigue? I can share the complete blood report.
Answers (34)
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1 # Eat a balanced diet
Plenty of vegetables, fruits,
whole grains, pulses, nuts, and seeds.
Limit ultra-processed foods, excess sugar, and excessive salt.
Choose healthy protein sources and healthy fats.
2 # Stay physically active
Aim for at least 150 minutes of moderate exercise per week.
Include strength training 2–3 times weekly.
3 # Maintain a healthy weight
Excess body weight increases the risk of many chronic diseases.
4 # Get adequate sleep
Most adults need 7–9 hours of quality sleep each night.
5 # Stay hydrated
Drink enough water throughout the day.
6 # Avoid tobacco and limit alcohol
Smoking and tobacco use significantly increase disease risk.
7 #Manage stress
Meditation, yoga, hobbies, social connections, and relaxation techniques can help.
8 # Practice good hygiene
Wash hands regularly and follow food-safety practices
9 # Have regular health checkups
Monitor blood pressure, blood sugar, cholesterol, dental health, and vision as recommended.
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Hello dear, you have deficiany of both.
If there are neurological symptoms (tingling, numbness, imbalance, weakness) or significant deficiency, clinicians often use B12 injections initially, followed by oral maintenance depending on the cause.
And for vitamin D deficiency A common treatment for significant deficiency is cholecalciferol (Vitamin D3) 60,000 IU once weekly for ~6–8 weeks, followed by a maintenance dose.
You need detailed evaluation so you can consult we me
Next Steps
Consider checking CBC, folate, ferritin/iron studies, and evaluating dietary intake or causes of malabsorption.
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Take balanced diet which is mentioned below,
1/3 of food plate should contain bread, pasta, potato and rice.
1/3 of food plate should contain fruits and vegetables.
1/9 of plate should contain fish, meat, egg and beans.
1/9 of food plate should contain milk products.
1/9 of food plate should contain food rich in fat and sugar.
plus a glass of milk daily.
For prescription contact me at WhatsApp at +91959508739nine.
In future if consultations are required than contact me at WhatsApp at +91959508739nine.
Thanks.
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Hi sir
Your report shows Vit B12 deficiency but generally folic acid def can also show similar symptoms. I would advice you to consult directly through practo app, i can figure out thecause of your symptoms and also guide you through out treatmebt till recivery. You mentioning Vegeterian reminds me that Animals are the only source of dietary B12 and hence you should start Vit B12 supplementation and you can start with tablets as it is less painful.
Next Steps
serum Methyl Malonic acid
serum Homocysteine levels
Health Tips
Try to avoid tea cofee for an hour before and after taking tablets for better absorption
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Your B12 and Vitamin D levels are significantly low. Start Vitamin B12 supplementation (oral methylcobalamin 1500–2000 mcg daily for 8–12 weeks); injections may be preferred if neurological symptoms or malabsorption are present. For Vitamin D, 60,000 IU once weekly for 6–8 weeks, followed by maintenance therapy, can be considered under medical supervision.
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Pls consult me on 864 zero zero 205 6 zero for solution
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You can replenish your vitamin B12 with both oral and injectable forms depending on your comfort and preference.oral vitamin B12 requires longer course while injectable vitamin B12 requires shorter course starting from once a day for a week followed by once a week every week for 4 weeks and then once a month for 6 months. You can also take tab bendy plus for suspected deworming. For vitamin d3 you can take nano shots 60 k units once a week for 6-8 weeks or get a vitamin d injection 6 lac units single dose is enough
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tab albendazole 400 mg single tablet for deworming.
for vitamin replenishment can take any form depending on your preference and comfort
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I understood your concern and noted the problem as well .I need to ask few more details to make a diagnosis and start treatment and advice which suits you. You can discuss via whatsapp on 971*66*33*129 or book here on practo.
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Hello sir
Your results show significant Vitamin B12 deficiency (
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First of all don't be worried about it, these days it's so prevelent in Vegetarians and your reports can get back to normal within 1 month.
As per your levels of B12 Initially injections are mandatory and for vitamin D you can take oral medications followed by maintenance course of Oral Tablets for few months which will help you to avoid Vit D and B12 reports for the second time in your Life.
With this your further treatment is dependent upon your clinical condition and symptoms
Next Steps
start treatment to avoid complications
Health Tips
taking a walk or exercise session in early morning sunlight will help to increase vitamin D levels and it will give you a better Life habit.
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Need proper evaluation please consult for assessment and treatment
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Kindly consult with me on 94 two six eight six 78 nine six for proper guidance and treatment.
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You need to consult as proper history is needed .you need supplements but only after consultation you can start
Health Tips
take 15 min morning sunlight add curd milk spinach beetroot amla walnut almonds in your diet
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Consult
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Despite B12 deficiency, hemoglobin is currently normal, suggesting early-stage deficiency. Vitamin D deficiency may also contribute to fatigue.
Next Steps
1. Initiate B12 and vitamin D supplementation.
2. Monitor response over the next few months.
3. If fatigue persists, re-evaluate with iron studies, inflammatory markers, or thyroid function.
Health Tips
In your case, there’s no clear malabsorption or gastrointestinal issue, oral B12 supplementation can be effective because the body can absorb it in large doses. If you don’t see improvement in a few months, then switching to injections would be warranted.
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Injections will provide results sooner than tablets, that is the only difference.
Please share details of your symptoms, get blood sugar done and share results. Then I can guide you further.
Start tab neurobion one morning and one evening for for 6 weeks.
Tab uprise 60,000 units once a week for 6 weeks. Repeat tests after that.
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Complete your deficiency via supplements
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Consult me asap
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Kindly consult and give proper detailed history along with symptoms for evaluation and take proper timely treatment with relevant investigations as required.
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You have a significantly low vitamin b 12, vitamin d deficiency.If you have symptoms ,you can consider vitamin b 12 injections 1000 mcg weekly once for 4 weeks ,then follow with oral tablets.you may need further tests if only you have lower hemoglobin level
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kindly do connect and consult with me for better treatment plan and advice on your case via PRACTO app
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Hello.It's better for you to make a teleconsultation through practo by booking for your concern with all detailed report analysis and proper medication.
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You have vitamin B12 and vitamin D deficiency,
Vitamin B12 might be due to vegetarian diet and to follow up the reason beyond vitamin D deficiency, I need more details regarding your work , lifestyle .
Next Steps
i think you don't need any further investigations regarding vitamin B12 deficiency right now,,
you need to take vitamin B12 and vitamin D medication,
To decide oral/injectable vitamin B12 , it depends on your neurological symptoms , which you didn't mention
Health Tips
even after the treatment you should follow some changes in lifestyle and (diet habits if possible) to make sure it don't reoccur
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Uprise d60k once a week for eight weeks followed by one per month for six months a complete therapy by WHO. Neurokind od one after dinner for two months b12
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If you would like to discuss your concern in more detail, please feel free to contact me on WhatsApp at eight six one nine six six nine nine zero six. Alternatively, you can connect with me through the Practo app for a detailed consultation
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Next Steps
You should start with oral vitamin B12 and Vitamin D
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Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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Your B12 and vitamin D levels are clearly deficient and can contribute to fatigue. If there are no neurological symptoms or absorption problems, oral B12 is often effective; injections are preferred for numbness, weakness, anemia, malabsorption, or poor response.
Vitamin D replacement should be taken in a clinician-guided doseâavoid prolonged high-dose self-medication.
Please review the complete CBC/MCV, ferritin, TSH and diet history to look for other causes of fatigue.
You may share the reports in a Practo consult or meet me at Synergy Multispeciality Hospital, Miraj.
Next Steps
Arrange an in-person evaluation with your complete reports; recheck B12 and vitamin D after treatment and return sooner for numbness, weakness, or worsening fatigue.
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Dr. Lekha Rajeevan
General Physician
40 yrs exp
Ernakulam
Check ferritin and iron levels .Take vit b12 and vit D supplements for 2 months and recheck levels.check folate levels.if you have malabsorption problems check for that also.any drug intake like phenytoin sodium
Next Steps
Vcheese milk yoghurt egg yolk etc and morning sunlight improve vit D levels
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Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
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Dr. Suraj Sharma
General Practitioner
4 yrs exp
Jaipur
Do consult for proper medications
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Dr. Gaurav Jaiswal
General Physician
7 yrs exp
Jhansi
Avoid fried and spicy food
Water intake more
Green leafy vegetables more
Fiber meal
Walk
Do connect and consult
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Dr. Ankita Gahlot
Obstetrician
12 yrs exp
Bangalore
Both oral and injectable B12 are used for a deficiency this low, but which one, the dose, and how long depends on your full picture, not something to decide from a report alone.
Next Steps
Please see a physician in person, mainly since a B12 this low in a vegetarian diet sometimes needs a specific cause identified rather than just correcting the number.
Health Tips
Don't start a fixed dose or schedule yourself based on general information online.
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