By the time anemia shows up, a person can have significant neurological damage, and some or all of that can be permanent!

Here is a very good video on this subject:
http://www.youtube.com/watch?v=BvEiz...ature=youtu.be

You can also have the genetic MTHFR polymorphism and be unable to activate cobalamin to methylcobalamin. 10-30% of people have this problem or a variant.

Any level lower than 400pg/ml is considered problematic.
Today it costs pennies a day for oral methylcobalamin. No excuse for being low. While this was mostly only available online, today some major stores like WalGreen's and Costco have it on the shelves. We pay 6 CENTS a day for ours! (Costco).

"Use cautiously in patients with subnormal serum levels of potassium, as the correction of megaloblastic anemia with vitamin B12 may result in fatal hypokalemia in susceptible individuals. "
From https://www.mayoclinic.com/health/vi...SECTION=safety

Totally unsourced as best I can tell but reprinted w/o comment here and there a few places on web

Seems very rare but should be taken into account.

From
PERNICIOUS ANEMIA AND OTHER MEGALOBLASTIC ANEMIAS.

Method of
Victor Herbert, M.D., J.D., M.A.C.P., F.R.S.M. (London)
Mount Sinai & Bronx V.A. Medical Centers
New York, NY.

"Megaloblastic (Greek: megalo=giant; blast=germ cell) anemias are those anemias resulting from pathologic slowing, by any cause, of the doubling of the nuclear DNA necessary for bone marrow nucleated cells to divide, with only minor slowing of the synthesis of cytoplasmic RNA. This nuclear-cytoplasmic dissociation becomes greater with each daughter germ cell division, until either the cells die or omit terminal division, surviving in the marrow as end stage giant red cells, white cells, and platelets. These are extruded into the peripheral blood as macroovalocytes, hypersegmented neutrophils, and giant platelets, all with a shortened life span, hence the pancytopenia (anemia, leucopenia, and thrombopenia), characteristic of full-blown megaloblastic anemia.
The most common causes of megaloblastic anemia are deficiencies of vitamin B12 (cobalamin) and/or folate (folic acid). As with any nutrient deficiency, these two B-vitamin deficiencies may arise from any of 3 inadequacies (inadequate ingestion, absorption, or utilization), or any of 3 excesses (excessive requirement, destruction, or excretion).
Pernicious anemia is the descriptor for that insidiously progressive B12 deficiency resulting from genetically predisposed and age-expressed gastric atrophy, which first produces inability to free B12 from food peptide bonds due to loss of gastric cells secreting acid and digestive enzymes, and eventually results in inability to absorb free crystalline B12 by the physiologic intrinsic factor-dependent mechanism due to loss of gastric cells secreting intrinsic factor. By age 65, approximately 50% of the U.S. population has low serum holotranscobalamin (holo TC; B12 TC) due to inadequate B12 absorption, and approximately 60% of that 50% has vasculotoxically (and neurotoxically) high serum homocysteine due to B12 deficiency (with low serum holo TC but total serum B12 still >400 pg/ml). (See Table 1). Because of the above, I recommend that, starting at age 50, everyone should take a daily 100 μg pill of vitamin B12 on arising each morning, a half hour before breakfast, so it does not bind to the breakfast protein and thereby become unabsorbable. Starting at age 50, everyone should also take a daily pill of 400μg of folic acid (For further details on both these recommendations, see www.victorherbert.com). "

<Note-This looks like a very interesting paper!!


This appears to be very old news but I didn't get the memo!

"
1. Minerva Med. 1987 Aug 31;78(16):1255-7.

[Hypopotassemia and megaloblastic anemia. Presentation of a case].

[Article in Italian]

Omboni E, Checchini M, Longoni F.

A case of megaloblastic anaemia probably caused by malabsorption is analysed.
Blood potassium levels were monitored before and during treatment with vitamin
B12. It is concluded that low potassium levels in chronically hypoxic patients
may be dangerous and that blood potassium should be monitored constantly during
the treatment of this type of anaemia.

PMID: 3627537 [PubMed - indexed for MEDLINE]

"

Some of the warnings on the Mayo site are for very rare circumstances. Yeah, if the doctors wait until you are so far gone that you have ANEMIA, then treatment for ANEMIA will spur the
bone marrow FAST and use potassium quickly since red cells have lots of potassium in them. Some very ANEMIC people can get temporary, signs of low potassium. But the general person does not have this problem. And never with ORAL...since so little is absorbed each dose. It is the massive INJECTION by DOCTORS which may be a problem. Some doctors give INJECTED cyano daily for a week or 10 days....and that is ALOT 1000mcg per dose.

The IV mention for hydroxcobalamin is for cyanide treatment, from smoke inhalation, or cyanide poisoning. B12 is typically not used IV except in some dramatic situations.

Polycythemia Vera is a very rare disease and will show up in regular screening blood work, and would be tagged hopefully by doctors before B12 injections.

The acne mentioned is also rare, few reports in the literature.
It is most likely from high INJECTED doses.

Studies of oral, show that about 13mcg only get absorbed from 1000mcg oral dose. At that intake, any symptoms of anything, are unlikely.

CYANOcobalamin is contraindicated in patients with the rare genetic disease called Leiber's optic neuritis, because these people cannot metabolize cyanide in any form.

B12 remains with no upper limit of toxicity for the vast majority of the population. The FDA has no upper limit posted for it.

One has to keep the clinical list from that Mayo site in perspective, therefore.

They are sending copies of the lab work but got the verbals awhile ago. I seem to remain disgustingly healthy. They say that the B-12 was "good" although there was a little confusion at their end. The only thing out of the "Norm" was the Vit D and, of course, the prostate.

I intend to move slowly and see what I find. Among the interesting bits thus far is that with a B-12 deficiency, a wide range of neurological problems show up early in the process in a band of dosing much lower than formerly believed. And if you ignore a serious deficiency much more than six months the damage can become permanent. Onward men!

Rick...get the actual numbers for your B12 test. The lab ranges
in US have never been changed to reflect the new low normal of 400pg/ml (which is a decade old now).

So if you had 250pg/ml it would not be red flagged on your report and your doctor most likely will say normal. It is up to you to
verify this result so you know where you stand.

Our PNers here try to keep their B12 at 1000 because Dr. Snow found a subset of "normals" who improved with extra B12. He suggests treating anyway. His paper is linked in the B12 sticky on PN.

A very weird day! And even now a I prepare to hed for the cave my vsion is screwed hp the wy it sometimes dets . I amnot going to worry about typos tonight so get used toit until morning.

Awoke at 6:00 AM and began the day by taking first sinamet while still in bed. Then followed that with Jarrow methylcyanobobulyn-5000. I had chosen a single 5000 tab last night and crushed it, mixed it with water to produce 500 drops of solution. That should be 50 droppers full at one ml. each if someone will check my math. Had a little stomache distress. Felt knotted up but only a minor amount. Was gone most of day but has returned bt no worse.

After about a half-hour from taking the drops I felt a "profound weakness" washing over me rather quickly and so retreated to the safety of my bed. I was oon weak as a kitten and stayed that wat until 3:00 PM at which time I revived over about a 30 min period. Have felt good ever since!

More detail tomorrow but for now g'nite.
-Rick

Rick, you still have not mentioned your test results. When they come if they are in the lower part of the reference range then you also need an additional test to see if you actually have pernicious anemia. Doctors are notoriously lax about these figures, and often do not really consider them, as they have not been educated about them. This is even the best doctors. So please take it seriously.

IF, and I am not saying this will be the case, if you have B12 deficiency it needs treating aggressively to limit damage. I was unbelievably unwell with this, and the PN stuff was the worst pain I ever had, enough to make me cry. I got this way because I was not being treated for the symptoms I was experiencing but in a formula way. If I had experimented with it I would have been no better either, as it took quite a lot for me to start seeing real results - initially I felt worse.

Basically I am saying if your results are low you need treating by a B12 savvy doctor, or one who uses a protocol drawn up by somebody who is.

Not at all what I expected but look it over and give me some feedback. And some discussion of my lingering questions at the end would be greatly appreciated.

B-12: Result >1500 pg/ml ; Range 180 - 914

Glucose: Result 83 ; Range 70 - 105

Bun: Result 21 ; Range 7 - 18

Creatinine (Serum): Result 0.92 Range 0.6 - 1.30

AST: Result 23 ; Range 10 - 42

ALT: Result 8 ; Range 10 - 40

ALP: Result 62 ; Range 32 - 92

Total Bilirubin: Result 1.1 ; Range 0.2 - 1.0

I am going to leave out the ones that fall well within the norm unless someone asks about a particular one of importance-

Calcium: Result 9.3 ; Range 8.4 - 10.2
Sodium: Result 139 ; Range 135.0 - 145.0
Potassium: Result 4.3 ; Range 3.60 - 5.00
Chloride: Result 102 ; Range 98.0 - 111.0
CO2: Result 29 ; Range 21.0 - 31.0
Magnesium: Result 2.4 ; Range 1.8 - 2.5

TSH: Result 0.530 ; Range 0.340 - 5.600 <????>

PSA: Result 10.14 (I know. I know.)

Vitamin D: Result 25.5 ; Range 30 - 100

Lym%: Result 17.1 ; Range 20.5 - 51.1


That does not look like the lab work of a sick man to me. With the possible exception of the borderline low of TSH. And why would the consumption of extra B-12 lay me low? A similar effect occurs when I take magnesium and maybe when insulin gets stimulated by a big old honeybun....

A low TSH like that if you are not taking thyroid hormone already, indicates potential hyperthyroid conditions like Graves.

Your BUN may be a bit high if you were a little dehydrated. Most people giving blood do it on a fast, and may be a bit dehydrated.

If you were taking your B12 daily at the time of the testing and did not stop it, it would register a false high.
If you were NOT taking B12 and you registered that high here are possibilities:
1) you have the MTHFR mutation and are not methylating cobalamin and it is building up in the serum as the inactive form.
2) you have some form of kidney disease. Some people with kidney problems conserve B12, but not all. If you were not dehydrated when this test was done, the elevated BUN should be rerun soon.
3) you have a smoldering cancer of the liver or blood (leukemia etc).
4) some severe GI dysbiosis (too many colon bacteria), may lead to high B12 levels.

If you were taking a B12 supplement, then it would show in the blood and your test is not very useful, therefore.

I certainly don't understand your diluting the B12 in water that way. That is not necessary, because oral is not majorly absorbed.

If you have that high B12 level and you were NOT taking B12 at the time, then you probably don't need to supplement it all unless you have the MTHFR mutation.