Question: I am a female with 38 years of age. Last year on 11/7/2012, after feeling extremely fatigued and excruciating pain in legs, I was diagnosed with vitamin B12 deficiency 154pg/ml (reference range 180-914). I was prescribed methyl cobalmin injections course for a year along with ultranuron tablet OD and folvite tab OD. I felt better but not fully better with the symptoms. My vitamin B12 touched normal levels in September. But I did not feel robust. I was prescribed coenzyme Q10 but it did not benefit much.
Again in the month of Feb. 2013, I got all test done. My CBC was normal, urine analysis was normal, lipid profile was normal, KFT, LFT was normal thyroid profile was normal, my glycosylated haemoglobin, EDTA whole blood, HBA1C-5% (non diabetic <5.7%) and mean plasma glucose 96.8 <116.0mg/dl, vitamin b12 was normal, vitamin D3 was insufficient for that I was prescribed Uprise capsule. I felt little better with the energy levels but still not upto the XXXXXXX
On 23-06-2013 I had a full blood test done, all test were normal, with normal total protein, urea, potassium, phosphorus, calcium total, haemoglobin. Chest xray was normal. And vitamin d3 was in normal range.
My concern is: My vitamin B12 injection course is ending this month, despite my blood profile is normal, my vitamin D3 is normal I am still not feeling upto the XXXXXXX My energy levels are not in proportion to my good diet. I feel fatigued, I have generalised pain in both my legs. Pain and energy levels don’t get better with rest or consuming more nutritious food. It is more of a muscular pain in legs. It is hindering my day to day activities. I am resting most of the time. Combiflame makes it slightly better. I wake up feeling tired in the morning. My left leg is slightly jerky at night. It was jerkier before I was diagnosed with vitamin b12 deficiency. I don’t know what to do. Two years ago I was rigorously gymming, now it’s painful to do even regular chores. I am not over weight. My MC is normal. Please advice.

Thank for replying Dr. XXXXXXX

Except for muscular pain in both the legs i have no other associated symptoms of fibromyalgia. i have no head aches, no sleeping issues as informed above. infact i am sleeping a lot to relax my muscles. all these symptoms resemble my state before i was diagnosed with vit b12 deficiency. there are spells when i feel normal. but currently i am in a bad shape. i need to know who would be a best consultant : an orthopedic or a rheumatologist for muscular evaluation?

secondly is there a chance , i am approaching menopause? although i have regular MC right now. is there any test to confirm this? please advise.

thirdly though my Vit D levels have touched the normal range. i have taken it once a week for 4 months followed by once a month, for 2 months. i was advised to take once a month for 12 months . should i continue for next 10months or discontinue now?

Thanks