I know lots of PN'ers take B12 supplements, I take no supplements as my only "food" is Ensure supplement and the docs dont want me taking anything else (right now only one or two cans a day) and bullion broth (no nutritional value, just for salt (due to autonomic neruopathy I cant eat regular food at all).... I have been recently in the hospital a couple of times, and also am facing major back surgery that they say will lay me up at least six weeks.... I'm very worried about nutrition going in to surgery since I already cant eat, but maybe they can temporarily put in a tube....

But, they did my vitamin levels in the hospital and my B12 is 1,500.... how is that possible if I'm taking no supplements at all? Anyone have an idea how it could get so high (used to be about 750 - 800)? and if there are any ill affects? I had mal-nutrition most of the spring again due to autonomic problems, but no supplements at any time....

?????

Each can of Ensure has 25% of your B12 so that would equal 50% of your daily B12. When I looked up bullion one site said it is high in B12 as well as some others. And, of course, it's high in sodium.

Have no idea why you test what you do for B12. I'm sure someone will give you an answer.

Elevated B12 in the absence of supplements can be due to some
serious illnesses.

This article discusses some:
http://www.ncbi.nlm.nih.gov/pmc/arti...480434/?page=1
This link explains how bacterial overgrowth in the bowel may cause elevated B12 levels:
http://www.yourhealthbase.com/vitamin_B12.html#overload

Ensure Plus has 1.5 mcg of cyanocobalamin (supplements have much higher doses than this amount).
http://www.nutritiondata.com/facts/d...roducts/7708/2

At Nutritiondata.com here are some examples of broth:
http://www.nutritiondata.com/facts/s...gravies/1230/2
http://www.nutritiondata.com/facts/s...gravies/1030/2
both show no B12 content.
I'd have to have the ingredients from your particular broth source...it may be medically fortified, and if so I would suspect it similar to Ensure.

I don't see getting high serum readings from this intake.
Your reading is not that "high" compared to studies, which typically go over 2000-3000.

In fact, if you have intact intrinisic factor still, you are absorbing the small amounts of cyanocobalamin from your Ensure drink efficiently.
This suggests you don't have pernicious anemia or autoimmune dysfunctions at the parietal cell level.

If you are having a spinal fusion? Zinc and protein are the most critical nutrients for that. Calcium, Vit D, magnesium, B12 (which you already have), and trace elements like boron, manganese are typically recommended --the same as for osteoporosis treatments.
Avoidance of smoking, NSAIDs, steroids will help with fusion of bone.

Thanks guys.... I'm not sure whats going on - I'm only gettting down like 2 ensures a day, and the broth is just plain boullion - no nutritional value other then salt and liquid.... levels have almost doubled though in last few months.

Mrs. D, thanks for advice on taking supplements for surgery.... they are doing a decomopression interbody fusion at L4-L5, and to go thru all I will have to - it better work. I dont drink or smoke or take nsaids, so that sholdnt be an issue at least. Got to be prepared......

As my docs are discussing my back surgery (again, I have severe PN but its not caused by the disk problem, which is so painful I cant sit up literally for more then an hour or so) - they cant even agree..... the docs who have known known me the longest are advising against it because of the PN - they know how much longer it takes me to heal and tell me I'm too "frail" to survive anything like this not being able to eat and move around (rehab facility for about 8 weeks, just get weaker overall).... also pain control, cant take opiates... people keep telling me to try tramadol but I looked it up and it says its an opiate - I dont get it. I just know the PN is keeping me from healing anytime I get anything, takes eons longer then a normal person...

Any ideas? I've always heard surgeons usually opt for surgery... Other options any one knows of? Weight gain looks like a lost cause.

I am so sorry you are in this difficult "place"... at this point with your health.

Have you had a bone density scan run? If you are osteopenic already it would not bode well for a surgery requiring fusion.

I was osteopnic couple years ago, have a scan in a couple of weeks.... (dont know why - I am young to have this but seems to run in fam) - I'll be sure to ask surgeon about effect of this too (I asked him if it caused the damage, he said no). We'll also have to see what this scan says.

PN in general has really affected my ability to bounce back from surgery and any illness though - what used to take a week now takes months.....

I would get a Vit D level run. You can't fuse in that surgery if you are not modeling your bones in the first place. If you can't fuse, the surgery will fail, and only expose you to risks.

AbSoLuTeLY!

Thanks guys, saw GP today and she ordered Vit D, etc..... anything that may affect my ability to heal from the surgery - thanks for suggestion. Is also doing some more testing for autonomic PN swallowing etc., and the bone density is next week.... its so great to finally have an awesome group of docs!