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Suffering with spondylosis, have back and leg pain, feel tired on exercising. B12 injection required?

Feb 2014
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 2004
Answered : 5930 Questions
My Vitamin B12 levels are in the range of 155-170 and i also suffer from spondylolysis. I get tired whenever i take up any exercise (walking and swimming as other activities are banned due to spondylolysis). I always need a break of 2 days after 2-3 days of walking/swimming. Also there is a pain in lower right back and right leg.

Should i take B12 injection and if yes, what should be the dosage. Also, can i take up any other sport other than walking and swimming after your consultation.
Posted Fri, 17 May 2013 in Bones, Muscles and Joints
Answered by Dr. Saurabh Gupta 1 hour later
Thanks for posting your query

It is not neccessary to take vit b12 injection for these level of vit b12. It can be managed by taking oral methylcobalamin (b12) supplements and taking diet XXXXXXX in vit b12.
I also suggest you to do back strengthening exercises to strengthen back muscles so that you can participate in other sports. Continue doing swimming. It is a good exercises for back problems.

Hope this will helps you. Let me know if you have any more concern.

Wishing you good health.
Dr Saurabh Gupta
Orthopaedic Surgeon

Above answer was peer-reviewed by
Follow-up: Suffering with spondylosis, have back and leg pain, feel tired on exercising. B12 injection required? 1 hour later
Please suggest the Oral B12 Supplement and also dosage and time for taking that. I am a vegetarian so what specifically do you suggest in my diet other than milk and dahi, which i take in sufficient quantity already.

Is a D3 test required/helpful. More than my back pain on exertion, i am worried out the general fatigue and possible nerve damage. Another important point i forgot was that i feel lot of tightness in chest at times on jogging or when i swim a little more than normal. Is it related. I had a full body checkup in January and everything was normal (BP, Echo, Sugar etc.).

Do you need to see my X-ray to see the extent of my back problem and suggest if i can play other sports (especially badminton) after taking the oral B12 as suggested by you. If yes, how can i do that. I am already doing some back strengthening exercises.
Answered by Dr. Saurabh Gupta 5 hours later
Thanks for writing back.

You can take oral vit b12 supplement 500 microgram daily. Before taking this get it prescribed by your treating doctor.
Natural source of vit b12 comes from animal products. For vegetarian milk and its products are only source.
General weakness and nerve symptoms seems to be related to vit b12 deficiency.

Vit d3 test seems to be helpful in your case.
Lot of tightness in your chest after exertion seems to be due to muscle spasm and not related to this.

It is better , if you can upload xray images.

Hope this will helps you.

Wishing you good health.
Orthopaedic Surgeon

Above answer was peer-reviewed by
Follow-up: Suffering with spondylosis, have back and leg pain, feel tired on exercising. B12 injection required? 19 hours later
Hello Doctor,

I have uploaded my back xray for you to see. A scan was not clear so i took a picture with my camera and have uploaded it for you to see.

Please see and recommend how bad is it and will i be able to take up any other sport other than walking or swimming now or in future.

Also is there any test/way to find out if B12 deficiency is really due to diet or because the body is not able absorb/exctract B12 from the food. If it is due to diet, i can at most compromise upto the extent that i can eat eggs. If it is the other reason, what is the way out.
Await your reply.
Answered by Dr. Saurabh Gupta 9 hours later
Thanks for writing back.

I have gone through the xray picture uploaded by you.It doesn't seems so bad.
Do not worry, you will be able to take part in sport activities.

Beside deficiency in diet you can develop this when the digestive system is not able to absorb the vitamin. This can happen if:
You have pernicious anemia. In this anemia, your body destroys the cells in your stomach that help you absorb vitamin B12.
You have problems with the way your body digests food, such as sprue (also called celiac disease), Crohn's disease, bacteria growth in the small intestine, or a parasite.

If you are not suffering from this, the cause of deficiency seems to be due to diet. You can increase this in your diet by eating breads, cereals, or other grains that have been fortified with vitamin B12.

Hope this will helps you.If you have any questions I will be happy to answer.
Please close the query if you have no other questions.

Wishing you speedy recovery..

Orthopaedic Surgeon.
Above answer was peer-reviewed by
Follow-up: Suffering with spondylosis, have back and leg pain, feel tired on exercising. B12 injection required? 9 hours later
Thank you doctor XXXXXXX

I have started with Methycobal 500 mcg from Wockhardt since yesterday. Most of my queries are answered and thank you for the important fact/possibility of problem with the way my body may be digesting the food.

What do you suggest I do to confirm that I am suffering from pernicious anemia / sprue / crohns disease. Are there any tests for these and do I have to consult some other kind of specialist for that please suggest. I can take it further from there once the above is confirmed or ruled out. My blood, stool and urine tests were normal during my last full health checkup in January.

I have also given my blood sample for D3 today but report will come after 5-6 days by when the discussion will be closed. Is there an option to just show you the D3 report when it comes?
Answered by Dr. Saurabh Gupta 8 hours later
I am glad to know that I could address your concern.

For diagnosis of these conditions thorough clinical evaluation is required.
For pernicious anemia blood test like complete blood count, reticulocyte count and bone marrow test are required.
For sprue and Crohn's disease blood protein and mineral levels, blood sedimentation rates, red and white blood cell counts, stool test and some imaging tests like barium xray and CT scans are required.
I suggest you to consult gastroentrologist (digestive tract specialist) for this.
When your reports are ready,you can consult me again directly through me profile .

Hope I have answered your query.
I will appreciate your reviews about the service.

Wishing you healthy life.

Warm regards
Orthopaedic Surgeon.
Above answer was peer-reviewed by
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