NeuroTalk Support Groups - View Single Post - Looking for articles linking B12 deficiency and Nitrous Oxide

mrsD · 03-10-2009, 11:48 AM

Quote:

Originally Posted by Vern

MrsD-
I had a resection 20 years ago for Chroyns removing some large intestine and ileum. I have tried 5mg of methylcobalamin, but my PN seems stable versus improving. B12 level hovers between 250 and 400. Decades ago I also played with nitrous oxide recreationaly. I would appreciate any thoughts you might share.

If all the ileum is gone? Most of the textbooks say the ileum is where B12 is absorbed...but this is when it is hooked up to
intrinsic factor. I cannot find adequate information about passive absorption in other areas of the small intestine other than the ileum:

Quote:

Int J Vitam Nutr Res. 1999 May;69(3):228-33.Links
Studies on vitamin B12 status in the elderly--prophylactic and therapeutic consequences.
Loew D, Wanitschke R, Schroedter A.

Institute of Clinical Pharmacology, Johann Wolfgang Goethe University, Frankfurt, Germany.

Because of the large liver stores (about 5 mg), low turnover rate (0.143%) and small daily requirement (3 micrograms), vitamin B12 deficiency does not occur under normal circumstances. This is not the case in individuals with chronic inflammatory or trophic changes at vitamin B12 absorption sites. Without supplementation, vitamin B12 deficiency can be expected within 5 years of gastrectomy. Characteristic features of type A gastritis are hyposecretion and mucosal atrophy in the fundus and body of the stomach, with absent intrinsic factor.In the small intestine, active and/or passive absorption is impaired by extensive ileal resection, exocrine pancreatic insufficiency and chronic inflammatory disorders such as Crohn's disease.
Definitive plasma concentrations cannot be quoted for vitamin B12 deficiency. Dietary habits, subjective symptoms, hematological laboratory results, function tests and gastrointestinal endoscopic and histological findings must all be taken into account in the diagnosis. Modern diagnostic parameters, such as methylmalonic acid and homocysteine serum assays, are useful for achieving early diagnosis and hence optimal treatment. With their assured availability, parenteral vitamin B12 preparations remain the treatment of choice. Results from vitamin B12 bioavailability studies in healthy subjects suggest that > 300 micrograms probably suffices as an oral maintenance dose after parenteral loading. Further well-documented cases are needed in order to establish whether these doses are adequate in malabsorption syndromes and gastrointestinal diseases. Various case reports indicate the value of prophylactic and therapeutic oral vitamin B12 administration, especially in disorders of homocysteine metabolism, a substance postulated as a further important risk factor for atherosclerosis.

PMID: 10389032 [PubMed - indexed for MEDLINE]

from http://www.ncbi.nlm.nih.gov/pubmed/1...ubmed_RVDocSum

I don't agree about 300mcg daily..after loading. I don't understand why doctor's are so stingy with oral B12. There is no reason not to use higher doses and get better results!
No side effects not expensive...<shrugs>

This book link claims 1-2 % of B12 is passively absorbed throughout the small intestine:
http://books.google.com/books?id=HMF...ErSlsjIZ3LsbFk
The keyword here is PASSIVE.
1% of 5mg is alot of B12...so it should work for you.
I would make sure you use the methylcobalamin form, which is already activated.

But if it doesn't work for you then injection is what is left.
I'd go with hydroxycobalamin form in this case, since cyano is synthetic. I'd get that level up...near 1000 if possible. When serum levels are low, then the spinal fluid levels fall. You want to get those up too and a dose gradient helps with that issue.