A woman taking a vitamin D supplement and getting a B12 injection

Investigating Possible Causes of Fatigue for Cancer Patients

Last updated: June 2021

As a person who is in remission from bladder cancer, I find that even now two years later I can still suffer from quite severe fatigue. I also seem to easily pick up any "bug" that is going around. In fact, it's felt like as soon as I get rid of one virus, I'm then down with another.

We all have fatigue in common

When talking to fellow cancer patients, I found that we all pretty much suffered from similar problems: fatigue and ongoing bugs and viruses. And when reading people's cancer journeys, they pretty all mention FATIGUE as a problem that they can't seem to shake off.

So, I'm not alone, which makes me feel somewhat better. I was beginning to think, "I must just be lazy, I should be "fighting fit" and "full of beans," after all my cancer has been taken away..."

So, I started to investigate the subject of fatigue and cancer patients. It doesn't seem to matter which cancer you have or have had, fatigue is always mentioned as a chronic symptom.

Vitamin B12 deficiency and fatigue

However, I did uncover some interesting reading regarding B12 deficiency and those patients who have had their bladders removed. It seems that quite a number of patients who have undergone a cystectomy, in fact, end up B12 deficient.1,2 And, what are the symptoms of a low Vitamin 12? Surprise, surprise - fatigue, along with weakness, lethargy, lightheadedness, constipation or diarrhea, even depression.

So, why are bladder cancer patients, in particular, likely to suffer from low Vitamin B12? Well, the term "ileum" is widely used for the construction of the lower urinary tract. As the "terminal ileum's" primary function is to absorb vitamin B12, removal of the ileum may make you more likely to have a Vitamin B12 deficiency.1,2

With this information in hand, I went to get my B12 levels checked (just a simple blood test), and guess what? My vitamin B12 levels were all but nonexistent. So, I then started weekly B12 injections. I have to say, improvement in my energy levels was noticeable within 24 hours of the injection. I have been receiving them weekly for the last 3 months, and I can honestly say that my fatigue has lessened immensely.

Vitamin D deficiency and bladder cancer

The next vitamin deficiency I identified that can cause fatigue is Vitamin D. Vitamin D in foods is primarily found in fatty fish such as salmon, mackerel or tuna. Small amounts can be found in dairy products like cheese and also egg yolks and beef liver. And, of course, the SUN! It's thought that we only get around 10% of our required intake of vitamin D through food. 90% is received through sunlight.3

Note: Overconsumption of sugary drinks and links to low Vitamin D are also currently being investigated in contributing to low levels of Vitamin D.4

One recent report conducted in 2016 by the Society for Endocrinology actually associated low levels of Vitamin D with an increased risk of bladder cancer.5 More studies are being conducted.

Symptoms of a vitamin D deficiency

So, what can be the symptoms of low Vitamin D? Number one is fatigue, and also getting sick more often, intense sweating especially through the head, joint pain, generalized weakness, depression or anxiety, muscle cramps and weakness, blood sugar problems, low calcium, and low bone density.6

So again, I get the blood test to check my Vitamin D levels, and yes, you've guessed it - they were extremely low, too. I was prescribed by my doctor a "high dose" vitamin D to start, which would be gradually reduced over the coming months until satisfactory Vitamin D levels were attained. (Please do seek medical advice before taking supplements high in Vitamin D as this can be detrimental to your health!)

Dramatic improvement

Overall, I feel that getting my Vitamin B12 and Vitamin D levels checked has been extremely beneficial for me. I was found to be extremely low in both of the vitamins, and the subsequent regular B12 injections and Vitamin D supplements have improved by fatigue dramatically.

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