How long is the ideal space between Vit B12 and Nexium?

Thanks.

I don't think it really matters. Once you are on Nexium, you have blood levels stable already. Also Nexium is enteric coated, and does not break down until out of the stomach. If your acid is really low it may start to absorb there but not likely.

So if you are an hour late for the Nexium you will not miss much.
Once you get on a schedule that new time will become your dose time.

You might think about whether you really NEED Nexium so much.
It also impairs protein digestion and when your protein goes down, your blood carrier proteins become impaired. Many hormones are carried by these proteins, including your levothyroxine.

I dont take Nexium on a regular basis. Although, the doctor says it has to be taken daily. I normally take it in the morning after Vit.B12 and R-Lipoic.

I really want to limit myself from taking drugs. But, sometimes even if I dont eat anything that I think it aggravates the acid, the reflux just happens.

Mrs. D, I am not taking anything for my osteoarthritis. My pinky has been swelling and all my fingers are really stiff in the morning and painful the whole day. I think my knees are also starting to hurt. Is there a supplement (other than Glucosamine) that I can take that would not interact with my other supplements?

Thank you Mrs. D.

Yes, I have been thinking about you, and that arthritis.

You know I have great success for my arthritis from using SAMe for the past 10+ yrs. It in fact fixed my knee 90% (I still get twinges but no swelling) and so I avoided a knee replacement.
At that time 10 yrs ago, the MRI and xrays indicated my left would "go" in 5 yrs and it never happened as yet! I had a steroid shot in the knee after the MRI was mostly normal, and that was it. I started the SAMe then as insurance. Back then it cost $1.50 a 200mg pill and now is down to about 30 cents. A huge reduction.

I use NatureMade, and started at 200mg a day on an empty stomach in the early morning, and raised it by 200mg every other month or so until I was at 600mg daily. I used it that way for years. I stopped it 2 yrs ago, when I started some expensive things and I guess I shouldn't have. So now I am back on the SAMe at 200mg a day so far as I feel like I am relapsing some. NatureMade has buy one get one free at all 3 big pharmacies, CVS, Walgreen's and RiteAid...they rotate the sales. It is easy to save big bucks this way. Also NatureMade has a rebate point program of $7.00 refund with 500pts. The SAMe typically gives 500pts for 3 boxes or so. So you can apply that to the next purchase, etc. Costco now has SAMe at very low prices too. SAMe is moisture sensitive and should be blister packed if you choose another brand. It must be packaged this way for best shelf life. I stick with NatureMade because they created the oral dosage form from the injectable that was used in Europe. In Italy and other countries SAMe was given typically by doctors to patients in injectable form. It is not stable orally, but NatureMade figured out how to do it...so I stick with them.

Studies have shown SAMe as effective as NSAIDs after 6weeks in patients. It is a slow but steady acting anti-inflammatory and the only side effects typically are insomnia, or hyper feelings in the beginning. SAMe also protects the liver, and enables neurotransmitter synthesis. So you can really feel better in several ways. But go slowly, as in the beginning it can be quite a blast. Younger people get that effect more than older people I have seen, as well. You can take it every other day, if needed, if you get that hypomanic effect in the beginning.

It is something to consider...and now that it is so much more affordable it is doable too. Many people avoided it because of the cost, etc back when.

Dear Mrs D,
Just have some clarifications:

1. Can I take Same along with vitb12, r-lipoic?
2. Can I take synthroid along with these 3 vitamins (since they should be taken all on an empty stomach)?
3. The co-factors of SAMe are vitb6, folate and vitb12 - I am taking vit12 separately, would vitb6 and folate in multivitamin be sufficient?
4. Is there an aspirin or ibuprofen in SAMe - i dont see these in any of the sites i read, just want to confirm with you. I have strong allergic reactions to asppirin and ibuprofen.

Thank you so much.

SAMe does not have aspirin or NSAIDs in it.

Take the thyroid, wait 1/2 hour and then take the lipoic and SAMe. Since you are fluctuating with the levothyroxine, take it alone, for insurance. With a full glass of water it should leave the stomach in about 1/2 hour and move along.

The SAMe does not dissolve until the intestines. It has a special coating. That takes time, so the thyroid should have moved along by then. You can take the lipoic, B12 and SAMe together.

Wait another 1/2 hr or so before eating.

SAMe is made in the body from homocysteine, using the 3 vitamin cofactors and glycine (which supplies the methyl group).
Once it gives up the methyl group, it is regenerated using the 3 B vitamins over and over. Some people fail in this step with age, so taking it as a supplement repairs that.

I'd start with a small package of 200mg... a 30 pack. Take one a day for a month. See how you feel. You should notice mood effects within the first week. But the effects on joints may take a month or two and then are slowly progressive in a positive way.

This link explains the chemistry:
http://einstein-syndrome.com/biochem...#MTHFRMutation

It gets complicated. But... if you do respond well to SAMe, it might point to a DNA test for the MTHFR problem for you.
This link also shows the interlinking of the methylation chemistry to each other.

Dear Mrs. D,
Thank you so much for your reply and information.

But, I am sorry I forgot to ask you last night - as you may know, I am taking Gabapentin, is there any "sedatives" component of Gabapentin that may have interaction with SAMe?

Thank you very much.

I have been re-reading the link above, it is complicated but the author wrote it so that layman people, like me, could understand it.

I am wondering, what is the DNA test for the MTHFR called, in case I need to mention it to my doctor?

Mrs.D, my folate serum before my PN symptoms was normal. But, you said that I should know the number between the folate and folic and there was no differentiation in my test, it was just called : "folate (folic ) serum". I want to mention this also to my doctor ... I have consumed now 8 tabs of SAM-e and it seems my arthritis pain is reduced. It could be that I may be resonponding well. That is why I am considering the test you mention above.

Thank you very much.