Vit B12 and Vit D deficiency.

Vitamin D: continue weekly × 4 more weeks → then maintenance. B12: Neurobion Forte daily × 8 weeks → then 2–3×/week. Iron: Prefer medical iron supplement; Siddha medicine can be taken along for support.

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Continue with dietary modifications and lifestyle modifications.

Continue  vitd3  for eight weeks followed by one per month for six months a complete therapy by WHO. Tab neurokind od one at night for 2 months for 2 mo you.   The original  b12. Haem up or rb tone syr10 ml after dinner for two months after dinner.  Note stool  color will be changed to Grey or another., don't worry.

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Hello, I am Dr Romain Rajan, General Physician. Your case has been allotted to me. I understand your concern. Your July report shows three deficiencies that commonly occur together and cause fatigue, headaches, body pain and weakness • Vitamin B12 = 177 pg/ml (low) • Vitamin D = 11.1 ng/ml (severely low) • Serum Iron = 41.5 mcg/dl (low) Let me guide you step by step on how to correct each one safely. Advices 1 Maintain a fixed meal pattern with enough protein, as this helps all three deficiencies recover faster. 2 Sunlight exposure for ten to fifteen minutes daily will support Vitamin D improvement. 3 Avoid tea or coffee one hour before and after iron-rich foods to boost absorption. What to Monitor 1 Fatigue, hair fall or breathlessness. 2 Tingling or numbness which indicates B12 deficiency. 3 Body pain which is common in low vitamin D. Management Vitamin D You have already taken one D-Rise capsule per week for four weeks, which is good. Now your maintenance plan should be • One capsule every two weeks for the next two to three months, then • One capsule every month as long-term maintenance This is the safest and most commonly used schedule. Vitamin B12 Neurobion Forte is appropriate for mild to moderate B12 deficiency. Usual dosage • One tablet daily after food for four to six weeks Then • One tablet three times per week for another four weeks If symptoms like numbness, fatigue or tongue soreness continue, B12 injections may be needed. Serum Iron Your value is low but not dangerously low. It can be corrected with • Diet (spinach, beetroot, jaggery, dates, eggs, meat) • Vitamin C rich foods to improve absorption • Iron supplements only if symptoms persist Regarding Siddha medicine (Madhulai Manapagu) This is a mild natural iron-rich syrup made mainly from pomegranate, jaggery and honey. It is safe to use along with Vitamin D and B12 supplements. However, it may not be enough alone to correct iron deficiency if symptoms are significant. If you experience fatigue, hair fall or low stamina, we may need to add an iron tablet temporarily. When to Consult a Doctor Immediately 1 Severe dizziness or palpitations 2 Tingling that worsens 3 Persistent fatigue despite supplements Every patient’s situation is unique. For accurate diagnosis and lasting relief, it is important to discuss your symptoms, lifestyle and medical history in detail. 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 you will receive 1 A personalised treatment plan 2 Safe medicine adjustments if required 3 Quick follow ups to track your recovery Take care, wishing you good health. Dr Romain Rajan General Physician

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