Hey mrs D –

just finding the time again to respond . . . as I jinxed myself the last time I replied . . . no sooner did I find the time to reply and then my family member took another turn for the worse that evening (but she’s back at a rehab center now, doing better) . . but I don’t think this time was as much of delay responding on my part . . . and I have fewer questions

thanks for the formatted red reply the last time – it really helped me (and hopefully others too) . . . OK, I still need a little clarification on few of your replies to my questions, so, I’ll copy/paste and format our ‘mini questions threads’ below and note my last reply/question in blue:

1) You originally wrote: “The main ingredient in Metanx is the methylcobalamin which should be taken on an empty stomach for best absorption. Does your pharmacy bottle have an empty stomach sticker?’ Well, I never did actually get a bottle of Metanx or Folax from my pharmacy (once I was told the price difference for the Metanx, I canceled my prescription) . . . and what do you mean "on an empty stomach": i.e., first thing in the morning, before I eat any breakfast, with all my other diabetes pills? . . . and then I usually don’t have something for breakfast 30 minutes later . . . is that OK/what you mean on a empty stomach? (or do you mean before lunch or dinner?)
on an empty stomach means first thing in the morning with no food. Fiber and food will absorb the microgram amounts of methyB12 and keep it from being absorbed. Normally in our bodies, intrinsic factor binds the B12 in food and carries it thru for us. When you take separate B12 orally you rely on passive absorption in the intestine. Some people may have some intrinsic factor but since many have signs of low B12 you cannot rely on yours to do that for you. It might be gone.
OK, I get it, first thing in the morning on an empty stomach, no probs . . . but, how long do I wait until I can have something to eat . . . and can I drink coffee soon after, or should I wait on this too?

2) I want to make sure I get your ‘prescription’ correct:
one Methyl B-12, 5000 mcg, per day on empty stomach (as per your link)
yes
no question, got it (clear enough)

one P-5-P (Coenzyme B6), 50 mg, per day (with the above? and again, as per your link)
you can take this every other day or daily based on what your other vitamin B6 intake already is. We have some posters on PN here who claim to have side effects at 50mg a day or lower. Not common but they do show up here. Taking this separately gives you freedom to control you doses better than a fixed mix like Metanx.
ok, so maybe I should start out taking it everyday . . . however, if I do get “side effects”, what will they be/what am I looking for? . . . or are you saying that maybe I don’t even need this vitamin due to my B-6 dosage now with my Puritan Pride One tablets (@ 50 mgs per pill daily) ? Please clarify for me (thanks) – net net, I’m not trying to be cheap here, however, the fewer pills/vitamins I need to take daily, the better off I’ll be, no?

one Folate Metafolin Folic Acid, 800 mcg, per day (with the above? and again, as per your link)
and taking this above, once a day, will equal 2 Mentax daily that was originally prescribed to me, correct?
Metanx is very high in the methylfolate. If you take 2 of them a day it puts you over 5mg a day! I posted on that thread the new reports of high folate dosing connected to colon cancer...please go back and read that. I believe that the OTC dose of 800mcg a day from Solgar is adequate for most people. It is the B12 that is the major player anyway. We consume folate now in foods that are fortified.
no question, got it, one a day is enough

3) assuming I take the above in the morning on an empty stomach with my other daily pills, do I need to be concerned that any in the above vitamins will react negatively with what I am already taking . .. specifically below:

for my diabetes type-2:
Metforman 1000 mg (and again before I go to bed)
Januvia 100mg
Glimepride 4 mg
should be no problems...I'd take the methyl B12 alone though, just to be sure. The other two don't matter.I assume your reply to my question above about how long to wait for the b12 to be absorbed into my body on empty stomach before AM eating/drinking coffee will also indicate how long to wait before I take the glimepride too

For my cholesterol
Simvastatin 80mg
This is a HUGE problem.... this drug causes NEUROPATHY...and loads of other neuro problems. You need to come to the PN board for further details. They are too numerous to list here. We even have some members damaged by this statin and other statins!
well, I certainly am happy that I asked this question . . . and I didn’t see this on the PN board the last time I looked via the link you provided … but, I have assince stopped taking this med, will search/read the forum and once I am more educated, I plan on contacting my diabetes doctor and podiatrist . . . do you know of any other generic cholesterol on the market that people are taking instead of simvastatin?

And I have one new question . . . how will I know if this is working (beside getting another density nerve fiber density test in 6 months and hopefully seeing my numbers go up) . . . only recently have my feet/toes started to tingle a tad a various random (?) times during the day . . . which I assume is the onset of PN . . . if the above vitamins work, will this tingling decrease/stop over time (in weeks/months)? – I understand that results my not be consistent for everybody/me, but I’m just looking for something I can watch for so I know this is working before another nerve fiber test

Thanks again so much for your time . . . I look forward to placing my vitamin order later this week and start on road to recovery