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PHARMACIST-REVIEWED GUIDE · PAKISTAN
Tiredness, tingling hands and feet, a sore tongue: how to tell if it's B12, and what mecobalamin tablets and injections cost.
✓ Reviewed by Arhum Nadeem, Pharm-D · ✓ Prices checked Oct 2026 · ✓ 3–4 hr delivery in Lahore
Medically reviewed by Arhum Nadeem, Pharm-D (8 years’ experience as a pharmacist) · Last reviewed: 17 October 2026
The most common symptoms of vitamin B12 deficiency are extreme tiredness, pins and needles or numbness in the hands and feet, a sore red tongue, mouth ulcers, muscle weakness, pale skin and problems with memory or mood. Symptoms usually develop slowly. B12 deficiency is easily confirmed with a blood test and treated with tablets or injections, but nerve damage can become permanent if it’s left untreated for too long.
Key points
| Area | Symptoms |
|---|---|
| Energy and blood | Extreme tiredness, breathlessness, pale or slightly yellow skin, fast heartbeat (from anaemia) |
| Nerves | Pins and needles, numbness or burning in the hands and feet, poor balance, muscle weakness |
| Mouth | Sore, red, smooth tongue (glossitis) and mouth ulcers |
| Mind and mood | Poor memory, confusion, irritability, low mood |
| Eyes | Disturbed or blurred vision (in more severe cases) |
A blood test measures your B12 level, often with a full blood count to check for anaemia. Labs in Pakistan usually report B12 in pg/mL. Many treat a level below about 200 pg/mL as low, but ranges vary between labs. Your doctor may also check folate, iron and thyroid levels, because they cause similar symptoms.
Divine Medicines prices, checked in October 2026.
| Product | Form | Price |
|---|---|---|
| Axicobal 500 mcg | Mecobalamin tablets | About Rs 62 per strip of 10 |
| Mecobal 500 mcg | Mecobalamin tablets, 30 | About Rs 644 per pack |
| Cobolmin 500 mcg | Mecobalamin tablets, 50 | About Rs 855 per pack |
| Methycobal 500 mcg | Mecobalamin tablets | About Rs 299 per strip of 10 |
| Neurobion | Vitamins B1 + B6 + B12 tablets | About Rs 136 per strip of 10 |
| Nutrifactor Vitamin B12 500 mcg | Tablets, 60 | About Rs 941 |
| Mecobal injection 500 mcg | 10 ampoules | About Rs 945 per pack |
| Methycobal injection 500 mcg | 10 ampoules | About Rs 1,824 per pack |
Tablets or injections? Tablets work well for mild deficiency and for people who eat little B12. If the deficiency is caused by poor absorption (pernicious anaemia, gut surgery) or there are nerve symptoms, doctors usually start with injections. The dose and schedule should come from your doctor.
Plant foods such as daal and vegetables contain almost no B12. If you’re vegetarian, a supplement is usually needed.
B12 supplements are very safe. Occasional side effects include mild stomach upset, diarrhoea or headache. Injections may cause pain or redness at the injection site. Allergic reactions are rare.
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Vitamin B12 ki kami ki alamat mein bohat thakawat, hathon pairon mein sunn hona ya jhunjhunahat, zuban ka laal aur dard wala hona, munh ke chhale, kamzori aur yaadasht ki kami shamil hain. Sugar ke mareez jo metformin lete hain, sabzi khor log aur buzurg zyada khatre mein hain. Khoon ke test se tasdeeq hoti hai. Ilaaj mecobalamin goliyon ya injection se hota hai. Pakistan mein Axicobal ki ek patti taqreeban Rs 62 aur Mecobal 30 goliyan taqreeban Rs 644 ki hain (October 2026).
Tiredness and lack of energy are often first, followed by pins and needles in the hands or feet, a sore tongue or mouth ulcers.
Mecobalamin is a form of vitamin B12 used to treat and prevent B12 deficiency and, on a doctor’s advice, nerve problems linked to low B12, such as tingling and numbness.
Energy often improves within a few weeks of treatment. Nerve symptoms can take months to improve, and some may not fully recover if treatment was delayed.
Yes. Long-term metformin use can lower B12 levels. People taking it should have their B12 checked regularly, as advised by their doctor.
Injections are needed when the gut can’t absorb B12 or when deficiency is severe. For mild deficiency due to diet, tablets are usually enough.
Yes, at the dose on the label or as advised. Excess B12 is usually removed in urine, but follow your doctor’s advice on how long to take it.
This article is for general information and does not replace advice from your doctor or pharmacist. Always read the pack leaflet and follow the dose on the label or prescription.
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