What kind of side effects might occur from taking Vitamin B12 vitamins?
Issue 1
For the last couple years, I've had terrible and frequent migraines, nearly every day. I couldn't find any trigger, and OTC medication did nothing.
Issue 2
I'd always had trouble with staying asleep - I had no trouble falling asleep, but once I was asleep, I'd wake up every 30-60 and fall back asleep relatively easily. I dealt with this for as long as I can remember. To be honest, I couldn't remember a night where I'd slept the entire night.
Issue 3
I'm unable to stay awake during the day. This has been going on at least 6 years (that I can remember). As hard as I try and as much caffeine as I have, I can't keep my eyes open and I find myself drifting off to sleep no matter what I am doing. More than once I've fallen asleep at restaurants, bars, work, etc. Through high school, I didn't go a day without sleeping in class. I was diagnosed with mono last year, and though it's effects seem very similar to what was going on all through high school, I can't find any sort of source as to whether it's possible to get mono repeatedly/for a long period of time or not. My doctor did not seem concerned with this.
I went to the doctor a few months ago about migraines, and they prescribed me with 20mg of amitriptyline before bed. It's also an antidepressant, so it came with the added benefit of helping me sleep. Since I started taking it, I've been able to sleep much better - I usually only wake up once or twice (if at all) which is a huge improvement to what I'm used to.
I returned to the doctor a few weeks ago with the problem of not being able to stay awake during the day. She swore it couldn't be related to mono, and refused to re-test for it, however, she ran other blood tests to check for some conditions I'm at risk for, and diseases that run in the family that I was worried about - they came up clean except for having very low levels of B12. She suggested this could solve my problem with OTC B12 Vitamins, so I got some regular 250mcg B12 vitamins from the pharmacy. These are supposed to give me more energy, and I'm to take them with dinner.
I've been taking them a couple weeks, and since, I've been feeling very strange.
I've almost completely lost my appetite, especially in the evening. This is VERY unusual for me.
In the evening (~4 hours after I've taken B12), I start to feel very sick - I get extremely nauseous (something that never happens to me either) and have to put all my thoughts into not throwing up.
I get a bad headaches (NOT a migraine), though with many of the side effects of a migraine like sound and light sensitivity. I also get hot flashes and I feel extremely shaky and weak.
I can't get to sleep. It's taken me several hours to fall asleep the last few nights. I'll be wide awake until 5am, unable to even get into bed.
I've always had asthma but it's so mild it usually doesn't affect me - the last few days I've been wheezing, coughing and trying to catch my breath with almost any physical activity
I wondering if it's possible I either have an allergy to B12 (sources seem to be conflicting whether it's possible or not) or there is some sort of conflict between the B12(for energy) and amitriptyline(for sleep).
I feel fine most of the day (other than the asthma), but at night I spend 8 hours unable to sleep and concentrating on not throwing up, but so energetic I can't even sit still. When I finally do fall asleep, I'm asleep for half the day.
I have no idea what's going on, but B12 is the only thing I can think of that might be causing it. I'm 20, female, and in good health other than what I've mentioned. Does anyone have ANY sort of idea whether this could be some sort of bad reaction to the B12, or bad drug interaction? A decently sourced answer or any knowledge on the topic would be appreciated.
Thanks Guys!
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M$10 Answers
(I’m not a doctor. I only know where to search for medical data.)
Let’s start from Vitamin B12.
B12 deficiency is big issue. B12 is not only for energy.
Vitamins B12
B12 deficiency can cause:
1. anemia:
“Symptoms of anemia are paleness, weakness, and fatigue. If severe, anemia causes shortness of breath, dizziness, and a rapid heart rate. Occasionally, the spleen and liver enlarge. Younger adults who have pernicious anemia (due to lack of intrinsic factor) are more likely to develop stomach and other gastrointestinal cancers.”
2. nerve damage
“the legs are affected earlier and more often than the arms. Tingling is felt in the feet and hands, and sensation in the legs, feet, and hands is lost. People become less able to tell where their arms and legs are (position sense) and to feel vibrations. Mild to moderate muscle weakness develops, and reflexes may be lost. Walking becomes difficult. Some people become confused, irritable, and mildly depressed. Advanced vitamin B12 deficiency may lead to delirium, paranoia, and impaired mental function, including dementia.”
3. B12 deficiency can also cause Toxic amblyopia (nutritional amblyopia), damage to optic nerve cell. Read the symptoms there.
Highlights:
“can cause other serious symptoms such as coma, difficulty breathing, vomiting, and abdominal pain.”
4. A paper that says B12 affects sleep. B12 deficiency may cause sleep disturbance.
Wikipedia has good info too.
insomnia
migraine
Read the cause portion. One of the causes for migraine is insomnia.
B12 deficiency may be the root cause of your many problems. It causes sleep disturbance, then insomnia.
Information about B12
http://www.drugs.com/ppa/cyanocobalamin-vitamin-b12.html
Scroll until drug interaction, adverse reactions. Read.. the symptoms you mentioned seems to be in the adverse reactions. How you administer B12 ? Do you take the drug listed there that can interact with B12 ?
It seems there isn’t overdosage for B12
Now scroll to end: patient information… It says: Instruct patient to report the following symptoms to health care provider: irregular heartbeat, muscle weakness, shortness of breath, vision disturbances.
I think you better go and see doctor now.
Info on amitriptyline
Overdose symptoms:
“flushing, fast or irregular heartbeat, dry mouth, drowsiness, confusion, agitation, enlarged pupils, seizures, loss of consciousness, hallucinations, stupor, mydriasis, hyperpyrexia, paralytic ileus, urinary retention, decreased GI motility, cardiovascular toxicity, rhabdomyolysis, renal failure, respiratory depression, cyanosis, shock, diaphoresis, aspiration, ARDS, hyperthermia, hypothermia, polyradiculoneuropathy, muscle rigidity, disorders of ocular motility, vomiting.”
Seek medical attention right away if any of these SEVERE side effects occur:
“evere allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; confusion; dark urine; delusions; difficulty speaking or swallowing; fainting; fast or irregular heartbeat; fever, chills, or sore throat; hallucinations; new or worsening agitation, anxiety, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, or inability to sit still; numbness or tingling in an arm or leg; one-sided weakness; seizures; severe or persistent dizziness or headache; severe or persistent trouble sleeping; slurred speech; suicidal thoughts or actions; tremor; trouble urinating; uncontrolled muscle movements (eg, of face, tongue, arms, legs); unusual bleeding or bruising; unusual or severe mental or mood changes; vision problems; yellowing of the skin or eyes.”
I think you better go and see doctor ASAP. Tell him/her your symptoms and you take B12, amitriptyline.
After the symptoms subside, you may need to do tests to find out whether you still have B12 deficiency and root cause of it. Refer to link above on B12 deficiency.
Are you a vegetarian ?
Hope this helps.
websites mentioned in text
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M$"*Mild diarrhea
*Anxiety attack or panic attack
*Insomnia
*Heart palpitation
*Breathing problem
*Chest pain
*rash, hives or itchy skin" This information was taken from http://www.bodybuildingforyou.com/vitamins-minerals/vitamin-b12-cobalamin-benefit.html
Also, Vitamin B12 deficiency is usually come with anemia. So taking folic acid along with B12 can correct some of the problems associated with anemia. If you are taking any other medication, it can interact with the B12 supplement.
Side effects to B12 vitamin is a rare case. Since you have rare kind of illnesses and situations, probably, you may be allergic to the supplements.
Another website suggests the side effect can be constipation; darkened or green stools; diarrhea; nausea; stomach upset and vomiting. From reading all the information, I think, you got many of the symptoms of allergic reaction to B12. But I am not a doctor. So I cannot tell you what is going on exactly.
I had constipation when I took the B12. I didn't experience other symptoms you mentioned.
I was having lack of energy for some time. I read somewhere to have soaked almonds. I soak 10-15 almonds over the night and eat them after removing the skin in the morning. I just took it as a kind of snack. It is working for me.
If you have sleep apnea, then you will get troubled sleep at night and will be tired during the day. Just mentioning, because this was the cause of tiredness to my husband. If you snore at night, tell that to the doctor too.
May be your body is working against the Vitamin B12 by not digesting the food you eat properly.
If you can talk to pharmacist sooner, then do so. If you cannot reach your doctor sooner then this can be the best next alternative.
If the symptoms are bothering you much, then I guess, you can call the tele health Ontario on
1-866-797-0000. It doesn't hurt to make a call. A registered nurse will give you some answers. (I just think that, you said some time before, you live in Ontario. Am I correct?)
Gel well soon. Happy new year!
http://www.bodybuildingforyou.com/vitamins-minerals/vitamin-b12-cobalamin-b...
http://www.publix.com/wellness/notes/Display.do?id=Supp&childId=Vitamin...
http://www.drugs.com/sfx/iron-side-effects.html
http://www.living-foods.com/articles/b12issue.html
http://www.health.gov.on.ca/en/public/programs/telehealth/
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M$
Vitamin B12 (or Cobalamin as is its proper name) is non-toxic, however, occasionally one of the other added ingredients in the preparation can cause problems for those sensitive to it. As you have already been told you have a very low level of B12, it is crucial that you are given 1000mcg B12 injections to build up the store in your liver and then be put on a maintenance injection certainly no less than three-monthly for Hydroxocobalamin or monthly for Cyanocobalamin, but more frequently if you feel a return of the symptoms before this.
It is also quite likely that you are also deficient in folate and so daily folic acid supplements (5mg) should also be given along with the B12 to ensure proper absorbtion. Before commencing treatment, it is vital that you have your potassium level checked as you risk a potentially fatal condition called Hypokalemia if your level is already low as it would dip further once aggressive B12 treatment is commenced. It would also be to your benefit to have your Homocysteine level checked. This is often raised in those with a B12 deficiency and is very toxic and damaging to the body.
The B12 supplements you are on are nowhere near enough to correct a deficiency and it may be that you are taking enough to stimulate your system but not enough to make repair to the red blood cells and this may be why you are feeling so rough. You really need to get this problem sorted as soon as you can as you risk serious permanent nerve damage to the central nervous system (believe me, I know as I have this!).
I hope you are able to get effectively treated for this but you are probably in for a fight! Do a search for "Pernicious Anaemia Society" and you will find their website where there is a vast amount of information and help.
All the best,
Andrea
thanks @pellrider , definitely the type of answer I was looking for - I'm not sure my doctors could do a much better of a job to be honest, considering the info I've managed to talk out of them so far.
I would agree with the trouble sleeping = trouble staying awake, but that problem has been fixed for some time which is what makes me think it's something bigger.
Maybe the smart thing to do would be to just stop taking it. I mean, it IS just a vitamin, I doubt there are any withdrawal symptoms.
Thanks for the help!
Call the telehealth ontario, if you can. It is really easy and fast. I did this couple of times when my daughter got sick. One time they said to just give the generic medicines. Another time they said to take her to the emergency. She was having real trouble with appendicitis.
Thanks again for the answer.. .I could only pick one BA so I sent you a tip.
I will say that the problem with B12 is absorption. It is usually given as an injection because it requires something called "intrinsic factor" to absorb it in the stomach. People with true B12 deficiency (something called "Pernicious Anemia") can also have specific problems with their stomach (a type of gastritis that can be serious). If you are truly B12 deficient, you should discuss this with your doctor.
Medical school, 15 years of being a doctor
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M$- Dermatologic: Itching, rash, transitory exanthema, and urticaria have been reported. Vitamin B12 (20 micrograms/day) and pyridoxine (80 mg/day) has been associated with cases of rosacea fulminans, characterized by intense erythema with nodules, papules, and pustules. Symptoms may persist for up to 4 months after the supplement is stopped, and may require treatment with systemic corticosteroids and topical therapy.
- Gastrointestinal: Diarrhea has been reported.
- Hematologic: Peripheral vascular thrombosis has been reported. Treatment of vitamin B12 deficiency can unmask polycythemia vera, which is characterized by an increase in blood volume and the number of red blood cells. The correction of megaloblastic anemia with vitamin B12 can result in fatal hypokalemia and gout in susceptible individuals, and it can obscure folate deficiency in megaloblastic anemia. Caution is warranted.
- Leber's disease: Vitamin B12 in the form of cyanocobalamin is contraindicated in early Leber's disease, which is hereditary optic nerve atrophy. Cyanocobalamin can cause severe and swift optic atrophy, but other forms of vitamin B12 are available.However, the sources of this statement are not clear, while an opposing view concludes: "The clinical picture of optic neuropathy associated with vitamin B12 deficiency shows similarity to that of Leber's disease optic neuropathy. Both involve the nerve fibres of the papillomacular bundle. The present case reports suggest that optic neuropathy in patients carrying a primary LHON mtDNA mutation may be precipitated by vitamin B12 deficiency. Therefore, known carriers should take care to have an adequate dietary intake of vitamin B12 and malabsorption syndromes like those occurring in familial pernicious anaemia or after gastric surgery should be excluded."
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M$
Thanks for the attempt, but I'm looking for a little more than a C&P from wikipedia here - I've read most of those sites so I'm looking for more of a personal experience or some sort of study that I've missed. Preferably something to do with the possible problems between the two drugs - but I haven't found anything like that yet. Was just hoping someone else could :)
http://chronicfatigue.about.com/od/exercisenutrition/p/B12.htm
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M$
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M$
I have a question about your question, if you don't mind: could you please describe the B12 supplement you're taking? Was it a prescription or an OTC brand? According to the label, is it *just* vitamin B12, or is it a B-complex or multivitamin that has lots of other vitamins in it?
I ask because I've noticed that 'energy shots' like 5-Hour Energy sometimes make me shaky, headachy, and (later) jittery and unable to sleep. I can't drink 'em all at once--it has to be spread out in 2 or 3 doses over the course of the day, and even then I have trouble sleeping. (I figure coffee's cheaper anyway.) 5HE contains high doses of not just B12, but also B3, B6, and folic acid, in addition to caffeine and amino acids and so on (1).
I know this is really going out on a limb, but are you getting high doses of other vitamins besides B12?
I hope the mystery gets solved and that you feel better soon. :)
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M$You can leave an optional "tip" with Mahalo's virtual currency, Mahalo Dollars. If you are asking a difficult question that might require some research, or if you'd like a wide variety of feedback, a higher tip often leads to more answers to your question.
M$
Vitamin B supplements are great for when you are feeling a bit tired, assuming it's not contraindicated (such as an allergy), but if you are having possible side effects, it's not a bad idea to try a lower dose (split the tabs, for example, or take a daily multivitamin with a lower amount of vitamin B, and some other vitamins in there as a bonus). Take it in the morning too (you said you take it in the evening) so that by the time you are ready for sleep, it's metabolized and out of your system.
Vitaming B12 can cause sleep disturbances because it's believed to be part of the regulation of the sleep/wake cycle by the pineal gland.
Here are some other side effects that are possible: Itching, red skin flush, and diarrhea.
Why don't you ask your doctor about taking melatonin before bed to help with sleep? Maybe the B12 in the morning and the melatonin before bed will be just what you need.
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M$
1. Caffeine. The first step is to cut caffeine out of your diet completely. This is really not optional. Caffeine affects several things: It causes unstable blood sugar, which can lead to your headaches, digestive problems, loss of appetite, and insomnia. Expect some withdrawal symptoms for a few days, including the symptoms you're trying to get rid of (headache and such). But I have personally eliminated a lot of similar problems by taking a week or two long break from caffeine to allow my body time to reset. You don't have to give it up forever, just break the cycle and then reintroduce it slowly. I drink tea and coffee all the time, but now I know my limits and can avoid the unpleasant side effects.
2. B12. It's extremely unlikely that this is causing any problems. B12 is in a lot of things you already eat, and it's a water soluble vitamin meaning that it doesn't hang around in your body for very long. I have personally experienced the same nausea and awakening in the middle of the night and trying not to throw up. Every single time I have been able to trace this back to drinking strong tea or coffee before going to bed. It's not just the caffeine; the acids in tea and coffee irritate the lining of the stomach and even your intestines (if it gets that far, which can easily happen when your metabolism is in hyperdrive due to caffeine consumption), leading to a tight or nauseous feeling.
3. Sleepiness during the day. This is actually normal especially considering your mono. It is also caused by your insomnia and hence indirectly by the caffeine. Don't try to treat this as it's actually quite normal considering everything else you've described. I once had a doctor give me samples of a drug called Provigil for this, which I never took and later found out has some serious side-effects.
4. Mono. It's quite common for some symptoms of mono to recur every so often. Once you contract the virus that causes mono (the Epstein-Barr virus or EBV), you never lose it. There is some speculation that EBV is a cause of chronic fatigue syndrome. Your doctor probably didn't act concerned because, frankly, the doctor can't do anything about it.
5. The antidepressant. I won't advise you on what to do. But if I were in your shoes, I would follow the above steps and stop using the drug.
personal experience
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M$
Thanks, this is really great info - I actually have quite a few of the symptoms listed with amitriptyline, but only since I've started taking the B12. I'm also having *mild* hallucinations, but I figured that was just due to being awake so late. I've actually now got about 1/2 the symptoms on that list in some form or another - gah, what is this craziness, it's like B12 is giving me an amitripltyline reaction or something.
One thing I realized, though, is that these are the exact same reactions I have to taking Neocitran.
I take B12 in the tablet form like this ->
Thanks, this really is a great answer - I can see I'm not going to figure this out without a ton of time with a doctor though (given I can find one that knows what they're talking about)
You mention neocitran too.
http://www.neocitran.ca/en/content.shtml?products
http://www.neocitran.ca/en/content.shtml?faq
It contains lots of medications inside (from 1st website). You may need to search 1-by-1 in the drug website. It’s better to ask doctor. :-)
You’re welcomed.
Some opinions:
1. It’s still not good to jump to any conclusion yet. Seek medical advice and test.
Many possibilities/guesses:
a. If B12 deficiency worsens, it may cause severe anaemia: shortness of breath, dizziness, and a rapid heart rate. This is still possible as B12 pill taken does not mean B12 absorbed. You may check B12 level to confirm.
b. amitriptyline overdose
could it be you unknowingly take more pills ? or you forget you have taken one and take another in a short span of time ?
c. combination effect
the side effects add on and aggravate each other (?)
d. Previously amitriptyline may treat your sleep symptom of B12 deficiency, now if B12 pills settles your B12 deficiency, you will be like a new, more healthy you taking amitriptyline. I wonder whether doctor has a way to determine suitable amitriptyline dosage.
2. After you settle the B12, amitriptyline, you may need to find out the root cause of B12 deficiency. Check the root cause portion. Some of the causes are as serious too.
3. May need to evaluate B12 deficiency effect on nerve damage, especially optic nerve cell. See what can be done about it. Blindness is serious.
4. Some good sources of info are: Merck manual (for medical info), drugs website, Mayo clinic website..
Objectively evaluate all your symptoms, jot down.
Tell doctor, pharmacist all the medicines you are currently taking before he prescribes new medicine. Let him judge whether it’s OK. Read the instructions, precautions sheets come with the medicine (or search for drugs website) so that you know what to do if adverse reactions.
Word of caution : these websites should be used as a guide and cannot replace a doctor. Sometimes websites are outdated, with old findings refuted by new data. Doctor may know more.
Sometimes I think a patient has no choice but takes a more active role for his own health. Doctor only has limited time/resources for a patient. Help him to help you..
You mentioned “I don't have a doctor to ask for a couple of weeks so it's worth a try”. You may need better medical care.
Wish you speedy recovery.. Having sleep problem since day one is no joke.