Hi Rachel,
Until Rose gets here.... here are some references I have in regard to B12 treatment. Most of the information I have has come through Rose
.
You might want to talk to your doctor about trying oral supplementation (1000-2000mcg DAILY). Some people have reported that they have symptoms or slumps between the shots whereas the daily oral supplementation actually worked better for them...a more steady supply of B12. I would worry about whether you are getting
enough B12. I would not worry about too much. Rose may have more to add when she sees this.
On dosage, from:
Vitamin B12 Deficiency
ROBERT C. OH, CPT, MC, USA, U.S. Army Health Clinic, Darmstadt, Germany
DAVID L. BROWN, MAJ, MC, USA,Madigan Army Medical Center, Fort Lewis,Washington
"Contrary to prevailing medical practice, studies show that supplementation with oral vitamin B12 is a safe and effective treatment for the B12 deficiency state. Even when intrinsic factor is not present to aid in the absorption of vitamin B12 (pernicious anemia) or in other diseases that affect the usual absorption sites in the terminal ileum, oral therapy remains effective.
"Although the daily requirement of vitamin B12 is approximately 2 mcg, the initial oral replacement dosage consists of a single daily dose of 1,000 to 2,000 mcg (Table 4). This high dose is required because of the variable absorption of oral vitamin B12 in doses of 500 mcg or less.19 This regimen has been shown to be safe, cost effective, and well tolerated by patients."
Regarding oral B12:
Goldman: Cecil medical textbook --- Saunders 2000
COBALAMIN DEFICIENCY.
"One option is intramuscular or subcutaneous administration of cyanocobalamin. . . . Oral cobalamin therapy in a dose of 1000 to 2000 mug/day has recently been shown to be as effective and possibly superior to the standard parenteral regimen. Both regimens give prompt and equivalent hematologic and neurologic responses, but post-treatment serum cobalamin levels are significantly higher and post-treatment methylmalonic acid levels are significantly lower with the oral regimen. Oral cobalamin, 1000 to 2000 mug [mcg]/day, is the treatment of choice for most patients."
Is Oral Vitamin B12 as Effective as Intramuscular Injection?
http://www.aafp.org/afp/20060101/cochrane.html#c2
On Oral Dosing
Comparing costs of intramuscular and oral vitamin B12 administration in primary care: A cost-minimization analysis. 2006
Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency: a systematic review of randomized controlled trials. PMID: 16585128 June 2006
Oral cyanocobalamin supplementation in older people with vitamin B12 deficiency: a dose-finding trial. PMID: 15911731 May 2005
Hope this helps!
Cara