Hello mrsd, theresej and rose,
Part of the reason for my decision to use oral B12 rather than injections was the risk of fatal hypokalaemia. I have ventricular tachycardia, a potentially fatal cardiac arrhythmia. Using the oral dose did not completely protect me because I still suffered a very frightening episode of hypokalaemia after taking my first oral dose of 1000µg cyanocobalamin, when my serum B12 level was 100 pmol/l; I did not take Slow K until after this episode. This is how my then GP reacted to my hypokalaemia:
Quote:
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If you are really sick, call an ambulance.
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Here are quotes from reputable sources (I added the bold):
This is from Cyanocobalamin, Hazardous Substances Data Bank, TOXNET, NLM, reference J6 in the
References page of my web site:
Quote:
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Serum potassium concn should be monitored during early vitamin B12 therapy & potassium admin is necessary, since fatal hypokalaemia could occur upon conversion of megaloblastic anemia to normal erythropoesis with vitamin B12 as a result of increased erythrocyte potassium requirements.
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This is from Medsafe NEO-CYTAMEN Data Sheet, reference J6:
Quote:
Hydroxocobalamin should only be used in properly diagnosed cases of deficiency.
The dosage schemes given above are usually satisfactory, but regular examination of the blood is advisable. If megaloblastic anaemia fails to respond to NEO-CYTAMEN, folate metabolism should be investigated. Doses in excess of 10 micrograms daily may produce a haematological response in patients with folate deficiency. Indiscriminate administration may mask the true diagnosis.Before commencing treatment of pernicious anaemia it is important to establish base line levels for haematological parameters and plasma levels of cobalamin and to monitor response at frequent intervals particularly in the first few weeks of treatment and thereafter at less frequent intervals.
Cardiac arrhythmias secondary to hypokalaemia during initial therapy have been reported. Plasma potassium should therefore be monitored during this period.
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The second quote also is relevant to the potential problem of masking folate deficiency, by commencing B12 therapy without first ensuring that there is a not a folate deficiency.
Another problem is that Slow K interferes with absorption of B12. I only used it in the first two weeks in 2005.
There are some more details of my hypokalaemia episode on the
My Story and
Vitamin B12 Deficiency - Doctors pages of my web site.
Please post any comments or questions to this thread. If you wish to contact me for a private discussion, please Email me from Paul in the
Contact page of my web site at
http://www.paulgolding.id.au/.
Paul