Self-injecting vitamin B12
Quick and painless jabs after a B12 deficiency diagnosis 2 years ago
I was diagnosed with B12 deficiency two years ago, at the start of COVID-19 lockdown in the UK. I urgently needed B12 injections and had to learn to self-inject, but I struggled to find clear and sensible information on how to do it.
I am not a medical doctor, and I am not writing this article to replace doctor’s recommendations or to suggest that you inject B12 as I do. This is simply how I do it.
A few points on Vitamin B12 deficiency:
- Vitamin B12 (cobalamin) is important for cellular metabolism (DNA synthesis), mitochondrial metabolism as well as neuronal health.
- Vitamin B12 (cobalamin) is a water-soluble vitamin. This means that the body will remove excess B12 and it cannot reach toxic levels.
- Vitamin B12 deficiency can occur through insufficient diet (e.g., un-supplemented veganism or absorption issues (e.g., pernicious anaemia)
- Treatment for B12 deficiency is regular intramuscular injections until symptoms improve. For many, it is life-long injections.
- I am lucky enough to get B12 on prescription from my GP.
When I first needed to self-inject, it was really challenging. I was scared that it would hurt and I needed over an hour alone in the bathroom to pluck-up the courage. When I finally did, I clutched the syringe, almost with white knuckles, and jabbed it into my leg. There was no care of kindness. I was upset that my body was broken and that I needed to inject myself for the rest of my life.
Things have got A LOT better since then. Now it takes me mere minutes, and I do it with care and kindness.
Equipment for Self-injecting B12
I have a prescription for B12 and the GP surgery provides me with the equipment needed:
- 1ml ampoules of B12 (cobalamin).
- 2ml syringe
- A drawing-up needle (these are red and thick in the UK)
- 25mm (1") needle, gauge 23g (blue in the UK)
- Yellow sharps box
How I self-inject B12
I often inject after a warm shower. This way, I am clean and my muscles are relaxed and warm, which means the the injection is less painful or totally pain-free.
- Prepare. I have established a habit that helps me do my injections quickly and easily. I inject in the bathroom because I can lock the kids out and take my time, if needed. I get out everything I need, open the needle packaging and attach the syringe to it and put it on the side (note that the GP rarely gives me drawing-up needles, but ideally they should be used).
2. Where to inject. Advised by my doctor, I inject into my thigh. It is important to get the right position. It should be in the middle third of the top, outside portion of your thigh. Medically speaking, this is the vastus lateralis site (give that a google if you are unsure). I find this position by putting my elbow on the side of my hip. Where my hand lays on the top, outside of my thigh is where I need to inject.
3. Wash hands and clean the injection site with ethanol wipe or surgical spirit. Let it evaporate before injecting (it stings otherwise).
4. Open the B12 ampoule. I used to really worry about this, as you have to break glass with your hand. It’s actually easy to do. I use some folded loo roll over the top of the ampoule, just in case it breaks (only one break in 2 years of injecting 2–3 times per week). The key here is confidence. Face the dot towards you and place your thumb on it. Then push the top of the ampuole away from you and it should snap off easily. Put the top straight in the sharps box.
5. Draw-up the B12. Holding the open ampuole at an angle in one hand, use the other hand to carefully place the needle near the bottom and draw-up the B12.
6. Remove air from the syringe. Turn the needle and syringe upside down and carefully press the plunger until a small droplet of B12 appears at the end of the needle. Sometimes a small bubble of air gets trapped in the main part of the syringe. If this happens, I pull the plunger out a little to draw in more air. I then slowly push it in until there is a small air bubble near the mouth of the syringe (see first image below). I know the syringe and the bubble moves up into the nose of the syringe. You can then press the plunger carefully again and push the air out.
7. Injecting B12. Find the correct place (point 2): the middle third of the top, outside portion of the thigh. I using one hand to pinch (or grab, perhaps!) the muscle and skin of my thigh, pulling it slightly away from the bone. The needle should go straight into the skin and muscle at 90 degrees. I push the needle into my thigh for its full length, slowly and firmly. I find it helps to give a long breath out as I am inserting the needle.
Once it is in position, I tend to let go of the muscle and then slowly press the plunger. I take my time. When all of the B12 has gone, I pull the needle out swiftly and confidently, using another breath if needed.
And that’s it!
Things that have happened:
Sometimes I hit a vein, in which case I bleed a bit once the needle is removed. Sometimes it’s quite big drops, but it soon stops. If this happens I tend to bruise.
Once, in the hundreds of times I have done it, I hit a nerve. This was painful and caused my leg to jerk and I pulled out the needle without thinking. I needed a few minutes to pluck-up the courage to try again, and I chose the other leg. It hasn’t happened since.
By self-injecting B12, I now have my energy back and freedom to look after my own health. I know that I am lucky to have a supportive doctor who is happy to prescribe me B12 and that other’s aren’t so fortunate.
If you’re struggling, I suggest you contact your doctor and B12 deficiency support forums.
All the best!
Caroline
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