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I have B12 deficiency as well, for a different reason - hemolytic anemia.
Many things have to be in balance when you get a B12 deficiency. First of all, did they test your ferritin? That is your iron stores. If your ferritin is low, it means you need to bump up your iron intake. (Most savvy drs want ferritin above 70, but anything above 10 is considered normal, so sometimes they gloss over it. This value is found in your iron studies, so you can look.)

When you're B12 deficient and you get an injection, your body gets busy using it. And when it sends the B12 to the necessary places, it uses up more potassium, folic acid and ferritin to get it there. So, if your folic acid was low before your B12 injection, your body won't be able to properly use the B12, and then you'll get even more folic acid deficiency, which is not good! And folic acid deficiency has the symptoms you describe as well. Pallor, fatigue, etc. So you may need not only the B12 injections, but prescription folic acid - I take 1mg - normal vitamins only have 400 mcg - so the prescription strength is way, way more.

B12 deficiency is a huge struggle for me. When I'm low I get tingly hands, exhaustion, foot pain, depression and a mental fog where I can't put words together. It is more debilitating than low hemoglobin to me.

My advice would be continue weekly injections, get proper folic acid levels, eat lots of bananas and from my experience, it takes a few months of B12 levels above 800 to feel normal. Good days happen, then bad, then good - it's not all forward progress. BTW - your level was *very* low - my hema says it's severe below 400 - neurological symptoms, so it will take time to get better especially since you're pregnant. Just consider yourself lucky they found it - because if left untreated, you can get nerve damage.

Hope this helps. Feel better!!!

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