Do I need my vitamin B12 injection more often?

Roxie, 41

A The issue of vitamin B12 is a very thorny topic, and a low B12, particularly if it is only slightly lower than the normal, may not be the cause or at least not the entire reason behind tiredness and fatigue.

After B12 injections, your levels often rise to the higher end of the scale, and once you commence injections they often stay there.

Hence there would be no need to increase the frequency of injections, and it may be that there is something else causing your fatigue.

We also lead very busy lifestyles and it is sometimes difficult to recognise if you need to slow down.

Q I’ve just found out that I’m pregnant. I’m very pleased but I’m worried as I am on Sertraline, which was started for post-natal depression after my last pregnancy 18 months ago. What should I do?

Annabel, 29

A There is always an increased risk to the unborn child when mum is on a medication.

Some medications should not be used at all during pregnancy, while others including Sertraline, fall into the category of “do the risks outweigh the benefits”.

It is always preferable not to be on medication during pregnancy, however we also know that if mum’s mental health during this time is bad, this is also a risk for a poor outcome.

If you feel you would like to come off your sertraline, it would be worth discussing this with your GP, with the plan that if your mood were to drop, you could always go back on it.

IF you have a question for Dr Zak, you can email him at askdoctorzak@gmail.com, visit his website, doctorzak.co.uk or find him on Twitter @AskDoctorZak.

DR Uddin’s advice is provided in good faith and in accordance with currently accepted evidence.

However, this content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

You should always seek the advice of a GP, or other qualified health provider, regarding a medical condition.