I have another quick question:

I do not know if I have pernicious anemia. That is, I do not know if I lack Intrinsic Factor. Do you know how much of B12 gets absorbed if a person does NOT lack Intrinsic Factor? For example, if a person who does not lack Intrinsic Factor took a 1000mcg methylcobalamin sublingual pill (but swallowed the pill and didn't absorb it under the tongue), do you know if that person would absorb MORE than the 10mcg (or 1%)?

I hope my question makes sense.

I would guess, that intrinsic factor is tied to the RDA for B12.

Biologically systems don't make "extra"...and only what you need.

So with that basic trait, I'd assume that enough intrinsic factor is made to deal with daily B12 absorption from animal foods.

The only difference is that intrinsic factor when latched onto B12 can work in the presence of food (as it arrives naturally) whereas passive absorption requires an empty stomach for best results. If intrinsic factor is broken, than passive absorption is all we have. Doctors don't even use the Schilling's test anymore to see if it is working. The labs have discontinued it.
http://en.wikipedia.org/wiki/Schilling_test

There is a test for autoimmune damage to the parietal cells in the stomach-- it looks for antibodies to the parietal cells:
http://en.wikipedia.org/wiki/Parietal_cell

B12 cobalamin is a very large molecule, difficult to absorb, so nature evolved this system of intrinsic factor helping because so little B12 is available in each meal.

The MMA test and homocysteine test show if the B12 is actually working in the tissues. The MMA test is specific for B12.
http://labtestsonline.org/understand...s/mma/tab/test

I found a sublingual with NO sugar alcohols that I don't react to negatively.
Has anyone had good results with this? It's Superior Source 1000 mcg methylcobalamin and only contains the B12 (methylcobalamin), lactose (milk), and acacia gum.

Here is a link to the product:
http://www.iherb.com/Superior-Source...-Tablets/26977

If they work for you that is all that matters.

I'd still do them on an empty stomach, as sublingual
absorption is not all that great. That way you will get passive absorption from the intestine as well. (your swallowed saliva will contain much of the B12 dose).

Thank you.

I was even thinking taking two: one swallowed for the intestinal absorption and the other sublingually for the under-the-tongue absorption. This brand also makes the higher dose like other companies (Jarrow), in 5000 mcg. I would have to work up to a dose like that.

How come you say not much is absorbed under the tongue? I think it must be, as others see results with it and, despite the bad reactions I have had to others, I could feel some of the B12 effects (the upswinging) in others I have tried.

Here is a study comparing oral with injectable.

Because in the past it was believed that oral was not an effect route, injectable was the only treatment given for B12 deficiency. Now there are studies showing oral works as well.
Studies cost money to produce, and B12 is not a drug where lots of money or patents are at stake. So finding reliable data on sublingual is not common.
The size of the drug molecule and its lipid solubility, determine success with sublingual administration. Both of these traits are missing for B12, which is very water soluble, and a huge molecule.
Because of the lack of data that is reliable on sublingual forms, most comments on scientific sites are like this one:
from http://ods.od.nih.gov/factsheets/vit...hProfessional/

Certainly you can do whatever you like. I just suggest if you choose sublingual, keep it there for a LONG TIME and don't swallow. Most people find this difficult. Some complain of mucus membrane irritations, as well. To get the most potential from a sublingual given its lack of data ...do this on an empty stomach.

This brand that I'm using dissolves really fast - under a minute. I don't swallow and don't have a hard time holding it and letting it dissolve under my tongue. I think it dissolves so fast because it is only three ingredients - the B12 (methylcobalamin), lactose (milk) and acacia gum. It isn't like Jarrows and takes 45 minutes or whatever to dissolve, with all those extra ingredients.

I'm so confused. I read you say to always just swallow and get the couple micrograms from diffusion, but I read the complete opposite (never swallow and always use sublinguals) from others, like that Freddd person (whose protocol appears way too intense for me).

I just want to know that I'm getting B12 so that I can get better, and not have to keep doing shots.

I just want you to get the B12 into your blood stream as much as possible.

I used to chew up the Jarrow and swallow. I switched to Puritan's, which is very soft and soluble, and I swallow them too.
I even ground up Puritan's and gave to my cat who was very ill last fall (finally diagnosed with mast cell carcinoma). She really showed positive response, when the vet thought she had inflamed intestines. I put it in a little whipped cream.. 3 times a week!
She no longer seems to need it, she went into a remission with steroids and is still with us, months past her estimated life span!

It is not a big deal to take on an empty stomach. It is certainly easy, and not uncomfortable like trying to hold in the mouth for long long minutes! Rapid dissolving does not imply rapid or complete ABSORPTION. Lipophilic molecules, meaning FAT SOLUBLE are the best candidates for sublingual absorption. B12 needs intrinsic factor to get thru the membranes of the GI tract because it is present in food in 2-5mcg amounts. Not because it is quickly dissolved.

Do what you want, however. In this case it will show over time if it is working for you, when you get retested. Just keep in mind you are swallowing most of it anyway, therefore empty stomach at the time is best.

Thank you,

I think I am going to try my idea, then, of taking two - one by just swallowing and one by dissolving. That way I will be getting it in me no matter what (and help to stop my worries). I also may take IM injections once a week till I'm out of injections and keep using the oral on the days I don't take the injections.

I just hope this brand is good. I've read that some brands can be totally ineffective. I'm not sure how true that is. B12 is B12 is B12, right? How can the brand make that much of a difference?

Oh, and yes, of course, empty stomach at all times for this. How long do you wait till you eat after taking them?

I wait 1/2 hr to 1 hr depending on how hungry I am.

The only downside to a poor brand would be mislabeling. That is a company not putting it in the pill to begin with. One never knows what some of those companies are doing. Not putting it in there or less than the stated amount. I would also suspect poor absorption from TIMED RELEASE products.

That is why I tested out the new Puritan's one... and had testing 3 months later. I went from 800 to 1999 on 5mg daily orally.

This is true. I think this is a reputable brand, as there were good reviews people saying they could tell it works. that's what scares me - I don't want to be spending money on something and then let my body get sicker and sicker by not having a good product.

:eek:
Which brings us all to the ? of How do you know if your brand is a good brand?; OR is there a web site or a Consumer Report (reliable,and reputable, of course,) where we can go that evaluates and rates the reliabilty and quality of vitamins and supplements?:confused::confused:
Robin

There is a site called ConsumerLab... I used to belong. But I didn't like it that they automatically renewed me and charged my credit card without my permission.

It has also been charged that they favor "certain" manufacturers.

Some of their site is free however, so you can look there.
http://www.consumerlab.com/

Some companies have GMP membership (good manufacturers policy)... and others give USP on their labels.

But over time posters here have shared experiences.
Jarrow's, was always a favorite. NOW brand, LEF, NatureMade, CountryLife, Source Naturals, Doctor's Best. But not every one is best on every thing, I've found. For example I started with Doctor's Best Theanine, then tried Swanson's Ultra, and was very disappointed, and went back to Doctor's Best.
I use Doctor's Best for all my specific nutrients now because I think they are labeling nicely, affordable etc. (theanine, R-lipoic stablized, and Benfotiamine).

I use Puritan's for my methyl B12 now, since I tested it out and it worked so well. It is really inexpensive there, esp when the buy 1 get 2 free sale is on.
I use NatureMade for my SAMe, and Flaxseed oil.
I use some brand names, like EsterC with bioflavinoids, and Mega Red Krill oil.

I don't think there is any one company that can provide everything I need. So I shop around for quality and price.

My doctors look REALLY carefully into each supplement they want me to take. It is not always one brand, there are better brands for each supplement. As better formulations come up, they look into them. Lots of work goes into looking into them.

Hello MrsD,

Do you use Doctor's Best for a daily multivitamin?

I am concerned that I am getting the most from my multivitamin. I know I need to take one because I'm sure my diet, while I am trying very hard, isn't giving me everything I need. (I have lost so much appetite over the last 6 months or so due to an adverse reaction to an antidepressant and to the low vitamin B12 situation... eating is hard, but I am trying to get better!) I currently take Target's brand Up & Up Men's Daily multivitamin, but I've read that so many different multi's are just wastes of money. And now that I am going through the horrors of a severe and probably long-term vitamin deficiency, I don't want to suffer needlessly anymore.

I know you aren't a doctor. But you do seem to have a lot of knowledge when it comes to vitamins and supplements. Any advice you have would be greatly appreciated.

Thanks again,
Jason

I really can't say who makes Target's vitamin products.

But stay away from products that contain iron (for males and post menopausal women).

I like the Centrum Silver formula because it has added minerals.
I get the generic from Costco.

Every once in a while Consumer Reports rates things, and they did multivitamins last year.
http://www.consumerreports.org/healt...view/index.htm
You might be able to find back issues at your library. Consumer Reports website requires a magazine membership.
http://www.youtube.com/watch?v=KHwq-XvcJb4

The magazine rated the Costco Senior (comparable to Centrum Silver) #1 in value and quality.
The YouTube above, shows the two common brands that failed.

Mrs. D, just a little segue from the main topic, is it safe to increase my dosage of SAM-e from 200mg to 400mg and then later back to 200mg? I know SAM-e 200mg is working for my arthritis but my fingers are stiff in the morning and always painful. My right pinky is still swollen but not as swollen as it used to before taking the SAM-e. I am wondering if it is better/safe to just take it slow with the 200mg, or increase the dosage to 400mg then back to 200mg when my pain has subsides. I have finished 28 tablets now.

Thank you.

If you don't have troubling side effects from the SAMe ...then you can raise it to 400mg a day... take it all at once in the morning on an empty stomach.

If it is not agitating you or giving insomnia, then you can increase.

I didn't get the joint effects until I was taking 600mg a day
for a while. I think the mood effects come first, and the repair of damage takes a while.

question for Mrs D or any one with similar issues
 

Hello,
I'm trying to get help for my husband of 25 years who came home from work on April 22,2012 and was complaining of not being able to remember/forgetting things. When I questioned him he could not remember what we had just bought our son for his birthday the week before and other obvious questions. We went to urgent care he was given a cat scan, mri, labs, urine tests. First ever consult with Neurologist on April 26th. All tests were negative and diagnosis was vitamin b12 def with a level of 195, or a-typical global amnesia. The Neurologist said that he would be fine. (The next day 04-27-12 his internist agreed and told both him and myself that he would be fine as well) He was given a b12 shot in the office of 1000mcg, and started on sublingual 2500mcg tab of b12 daily. He was given another shot of b12 1000mcg on 05-01-12. He takes other bp meds for the past 7 years as well. His memory at this point is very poor in my opinion. He does not remember what we did yesterday, or even things in the last few months. He asks me the same questions at times over and over again. At time with hints from me he will remember some things. This was an immediate onset with no other symptoms known to me other than leg cramps leading up to the event on 04-22-12. Its almost been two weeks and I'm not seeing any real permanent improvements. In my delirium of last week, I failed to ask the Neurologist or his Internist how long it would take for him to improve. Just looking to see if there is anyone else out there experiencing this and for some friends and support. Sorry if I have left out any info that you may need to assist.
Sincerely, Julia

Julia, I had extreme memory loss due to b12 deficiency as well as not being able to read or perform my normal daily activities. I couldn't operate my sewing machines, couldn't spell. After starting on liquid sublingual methylcobalamin, most of my memory returned, as well as reading. I noticed a difference in energy immediately but the memory slowly improved, maybe within a few weeks. Due to some adverse reactions, I had to stop treatment for several weeks and my memory deteriorated. I restarted and felt a big change again. It's been 8 months and I still need daily b12 to maintain my ability to function well. I think it's different for each person and depends on how long b12 levels were low. I responded well to the Methyl. I hope, given a little time, your husband will see real improvement also.

...deb

I would also suggest that if your husband takes a statin drug for cholesterol, that he stop it after discussing this with his doctor.
Here is a review of the years of statin reports:
http://people.csail.mit.edu/seneff/w...ally_work.html

Dr. Graveline MD, a former US astronaut lost his memory on statins. He wrote a book on it called Lipitor, Thief of Memory. You can Google him for tons of information.

Our FDA in US has just released a warning about statins and memory, too. Many years too late IMO for many people.

So it may be MORE than B12 in your husband's case if he uses any drug in the statin family.
I'd get him on 5mg of methylcobalamin daily, on an empty stomach. This is inexpensive and pretty fast in correcting. Much better than injections in fact.
There are many drugs that deplete B12 today. Some very common ones, including OTC.

Good Morning and thank you for your quick responses.

Thank you Deb, you have no idea how much encouragement you have just given to me.

Thank you MrsD. My husband does not take a statin drug. He has only taken plendil, benicar, atenolol and a baby aspirin for several years. I started giving him the Jarrow Methyl B-12 5000 mcg one tablet daily on Tuesday 05-01-12 after it came by mail. I went to the Puritan website and ordered their formula Methyl B-12 5000mcg after reading that it had worked so well for you. By the way the buy one get two free sale is on now.

Any further advice is much appreciated.

You all are in my prayers.

Sincerely Julia

Oh, good. Statins are so common and so toxic to so many!

I will say this however, the atenolol, can affect the brain and memory. It is less specific in this action than other beta blockers, but older patients can still have depression and memory effects from it:

https://docs.google.com/viewer?a=v&q...YT5DQYUM8yk3HA

So do consider this and discuss with the doctor. Sudden cessation of beta blockers is not recommended and a short taper is best. (this prevents rebound cardiac negative effects).
So if he decides to stop it, please do a taper, for safety. It doesn't have to be a long taper, just slowly for a few days reduce the dose. 50mg to 25mg to 12.5mg and off.

Thanks for the reminder on the Puritan sale. They do this every May and only once a year. That is when I lay in my B12 and some other things like l-lysine, etc. I just received my new catalog in fact! ;)

Thank you Mrs D.:hug:
On our way to the doctors this morning.
Julia

Question for MrsD
 

Do you take a B complex supplement in addition to the Puritan's Pride B12? I have asked doctors to test me to see if other B vitamins are low (can they do this?) and none have done it! :( I see my multivitamin covers the B vitamins. Is it even safe to take a B complex in addition to a multivitamin that contains B vitamins? I know that B vitamins are water-soluble, but I do know that a couple of them should not be taken in excess (niacin and b6 I believe are the two that can build up if taken too much over time).

I don't know if my sublingual B12 is working. I've increased it to 3000 mcg sublingually a day. I ordered the Puritan's Pride since they're having that sale you mentioned. I guess I could get my B12 level checked in a month or two and just stay on this brand and take it sublingually to see if it is working (like how you tested with Puritan's) and then if it's not working I could try your method of 5mg/day NOT sublingually with Puritan's and just swallow them to see if the level increases. I'm done with shots I hate the up and down feeling, plus I hate giving them to myself I don't feel too comfortable doing that - plus I've read the studies that shows oral over time is better anyway.

Thanks,
Jason

Most people do well on RDA multivits for the other Bs.

An exception for this, is B1, if you have a genetic error in its use, and need higher B1 (may be a cause of neuropathy).

Folic acid is added to many foods now, so high dose folate is not really needed in US today.

The high dose B-complexes, have high B6, and some people do come here complaining about B6 causing neuropathic symptoms.
They are also hard on the stomach for some, causing reflux or nausea.

See how you do on the high dose methylB12 ... you can always add in others later.

Eligen B12
 

I was reading earlier posts in this thread that brought up the patented B12 product, Eligen B12. Has anyone tried this form of B12? It's supposedly supposed to be better absorbed (through patented technology) and enter your bloodstream with peak at about 30 minutes versus peak of 6 hours for OTC oral B12 supplements. I think it's only available as cyanocobalamin, though, so what's the point?

I have not seen it yet.

But searching now I see Life Extension has it.

http://www.myhealth-store.com/elb12100mg30.html

Very pricey too for 30. Some people may not try it because of the expense.

For those without the MTHFR mutation, it is an option.
The carrier developed for it, I believe may be used for other drugs in the future.

Studies show oral B12 does work even without this carrier that this product has. So it is the buyer's choice in the end.

It would have been nice to see it as methylB12.

Thanks for all your quick replies to my questions, MrsD! :) I'm really grateful:hug:

I have another question about some of my symptoms. I have been having a lot of mental confusion and some scary memory issues (can't remember details of things I did earlier in the day, for example). I also sometimes get these jamais vu feelings (being somewhere I know I've been feels "new" to me). Could this be related to low B12? I honestly don't know how long I have been low but I suspect it has been over the last few years, as that's where some other symptoms have come up (depression episodes, feelings of apathy, and then in the last year hunger loss and more confusion). I know you're not doctors so you can't say for sure. I see a neurologist tomorrow and I want to express these concerns. I'm just afraid I have subacute degeneration of the spinal cord or something, and that any damage from low b12 can't be undone. Can it?

I've also stopped nearly 10 years use of antidepressants a little over 2 months ago (I'm on a support forum for antidepressant withdrawal). They said the cognitive loss can be from that as well. It's sad, but over the last few years I've attributed everything going on with me symptom wise to those damn antidepressants and their withdrawal, but it could have been from this vitamin and I never knew it! I'm also low in D which I'm working on repleting as well. All these problems...

It is difficult to say with the antidepressants in the mix.

These drugs were put on the market without long term studies.
And millions and millions of people took them.

Each person reacts differently depending on their brain make up.

Subacute degeneration also has motor issues. Vision loss etc.

There is a point where damage is permanent.
http://en.wikipedia.org/wiki/Subacut...of_spinal_cord

See what your neurologist says.

To Deb64 and anyone else who can help
 

Hi again,
I guess I'm wondering what the treatment was that you used. On Monday May 7th, I started my husband on 1000mcg of vitamin B12 intramuscular every day. I am also still giving him Jarrows Methyl B-12 5000mcg sublingual tablets every morning on an empty stomach. He is still very upset daily and constantly asks me what is wrong with him and tells me that he is scared. He wants to know if he is going to make a full recovery. On April 23, 2012 his vitamin B-12 was 195. It seems like his long term memory has improved as well as his short term some. Every night his leg cramps are so bad he cannot sleep in bed and he has sores in his mouth. Any help is greatly appreciated.
Sincerely Julia

If you are having him hold that B12 in his mouth? Sores can result. The oral can be swallowed, instead. Some people get very poor gum and mouth health, from long term illness and nutrient deficiencies.
Vit C, zinc and Co-Q10 are often used to improve oral mucosa.

The injections...are they cyanocobalamin? Daily use would expose the patient over time to cyanide, as it is cleaved off to activate the cyanocobalamin. Some people cannot handle this much cyanide (which is a poison) metabolically.

I don't think daily shots are needed past 7 days, as long as the oral is being done, and correctly on an empty stomach.

Also rapid treatment with B12 may lower potassium levels, temporarily, as the B12 stimulates the bone marrow to make more red blood cells.
Low potassium can lead to leg cramps and generalized weakness. So eating a diet rich in potassium is important.

What other drugs is he taking? That could factor into response and side effects too.

Julia, I had leg cramps as well as burning feet and legs for the first month after starting methyl-b12 sublingual. I saw 3 of my docs for this, all of which said the cause was my feeling nerves regenerating. They also said to increase my potassium because this process requires more potassium than I normally needed.

Without much b12 coursing around, doing it's thing, building, repairing, allowing simple body functions possible, things most take for granted, our body just don't use much of the good nutrition we eat. B12 is a key that allows everything else to work properly. Put in that key and wham, things we've long forgotten, start happening again. In my case, a life altering surgery left me with little b12. Many of the changes I experienced during recovery were not just due to healing, but due to a b12 deficiency. I was grateful to be alive, the changes were assumed to be caused by the surgery.
Until that first dose of methylcobalamin I hadn't yawned, coughed, or been able to stretch my muscles. I "miraculously" was relieved of all allergies. (no b12=no immune system. Allergies are due to an over-active immune response.) Fibroids and psoriasis was gone
.
Many of my psoriasis friends are on biologic injections to supress their immune sytem. In essence, this is what my b12 deficiency did to/for me. With that first dose, everything changed, some not so good, but certainly wouldn't give up my memory and pain relief I've experienced.

Within a month of treatment, burning pain was gone, leg cramps still occur on a day when I take more b12 than usual. I eat a banana or a sweet potato and all is well. I've found rebuilding b12 to be very uncomfortable. The leg cramps are the worse pain I've ever expeienced.

I've had to stop using b12 several times in 8 months. Each time I stop, numbness and pain returns, as well as digestive problems, but allergies subside, no coughing, sinus, etc...As soon as I restart, leg cramps restart, though not as bad, I increase my potassium and all goes back to my somewhat normal function.

I use Pure Encapsulations liquid Methylcobalamin 5000mcg. I only use a small dose of this each day. I have never experienced mouth sores from it. This can be found online as well as some pharmacies. This is the brand recommended by all of my doctors. Perhaps a switch in brands would be helpful. I would also check with his doc to get their take on the mouth sores.

Hope some of this helps you all and best luck.

deb...

This link will help you select high potassium foods:

http://nutritiondata.self.com/

example:
8 oz of V8 juice:
http://nutritiondata.self.com/facts/...oducts/10449/2
469mg potassium
The 12oz can has close to 800mg

The low sodium version of V8 has more potassium in it:
http://nutritiondata.self.com/facts/...oducts/10452/2
819 mg of potassium!
I use V8 after a work out for this reason.

The daily intake suggested today for potassium from the diet is
4.5 grams
So take a look at what your hubby eats, and figure out if he is low in potassium intake.
Each category on nutritiondata.self.com has a serving size listed, so please pay attention to that so you get accurate data.

This is a really good resource to also detail your magnesium intake, and that site also gives an inflammatory index which is helpful to lower inflammation in the body.

Glutathione and methylB12 deficiency?
 

Does anyone know if glutathione exacerbates methylB12 deficiency?

I ask because, since learning of my B12 deficiency, I have done some research online about it. I have found some aggressive B12 protocols around, one specifically that, due to my antidepressant withdrawal, I do not think I could handle (it's way too intense).

The thing that does concern me, though, is that the protocol mentions to avoid glutathione and glutathione precursors, as for some, taking these things (undenatured whey, NAC, etc) exacerbated symptoms. Does anyone here have any opinions or experiences with this?

The reason I am concerned is because I have been eating twice a day some protein bars that do contain whey protein in them. I am eating them at the request of my therapist, as I need to gain weight (I've lost so much weight from both the B12 deficiency and antidepressant issues). I do not mind the bars and actually do like them for the extra protein and range of vitamins that they provide. However, I do not want to jeopardize my B12 recovery if by taking these whey protein bars, they are creating more abundant glutathione in my system, which could be in turn clearing out any unbound, free active methylb12 in my system, which I need for repair and healing on my nerves and brain (I have been having an exacerbation of b12 symptoms lately, mainly memory/brain fog/confusion and some more nerve pains and loss of sensation feelings in some parts of my arms/legs). And, since I am only taking 5000mcg of Puritan Pride as an oral swallowed pill (the sublingual) on an empty stomach, I feel I cannot afford too much glutathione to inactivate the small amount of b12 I may be getting from the Puritan Pride sublingual.

I'm sorry if this question is a little too technical or if anyone even knows if this is the case. I should be OK with eating a couple of whey protein bars a day, and not have to worry about interfering with my B12 recovery?

I have been a member on Phoenix Rising for years. Fredd is a special case. Another member that does not have CFS has explained this to me. I take NAC, Liposomal Glutathione etc. I check my B12 levels twice a year. Most people get enormous help from these supplements.

Most people do well on Rich's protocol for CFS. Fredd scared me too! ha

Just get your level tested and take your supplement for B12. My level is good, but I do take the sublingual every few days.

Thank you, Sally! :)

I tried NAC in the past, but I didn't really like how I felt on it. I don't know if it was from the NAC or from other things I was going through at the time. I don't really think I need it.

Sally, when you say you take the sublingual B12 every few days, how do you take it? Do you swallow the pill on an empty stomach, as MrsD here advises, or do you let it dissolve sublingually a little bit beforehand? Do you use Puritan's Pride, Jarrow, or any other brand?

Thanks again! :D

Subligual is under the tongue. I let it dissolve slowly. I had such a low level of B12 15 or more years ago that it was barely on the scale. I had shots and sublingual for years, now sublingual works great. Source Naturals is good. Methyl B12.

I had severe vertigo and problems from that low level. Reg. docs had no idea why. :( Makes me so sad I went through that, then CFS, then POTS. Finding integrative doctors are the key for me at least. He tested a LOT of things.

Things are better now. Docs seem to know more about B12, Vit D and others. So easy to prevent illness by checking the blood.

Thank you, Sally.

This experience with this has been pure hell on earth for me, that and having had an adverse reaction to antidepressants and now withdrawal from them. My vitamin D is low, too. I'm supplementing that as well. I'm only 30 years old, too. I feel like a worn-out 75 year old man.

I really hope my conditions improve over the next year or so. I just worry I'm not getting enough B12 or that I'm not doing it right, etc. Everyone seems to do or say something different about how to get it. One doc said once-a-month shots were good enough, another says once a week then once a month. The method of taking oral (oral vs. sublingual) seems debatable, too. With all this debate, it just heightens my anxiety (which is already high from the antidepressant issues) as to whether I'm getting enough or am doing it right.

This might be a good question for MrsD - I have actually found a couple studies online that were done with the question of sublingual versus oral, and it seems that sublingual didn't make a difference in serum cobalamin levels versus high-dose oral just swallowed. I can't think of the studies off the top of my head, though. Maybe I can find them to share.

I am also giving myself a shot of methylb12, 1 mg, once a week for the next 9 weeks just to complete the shot series. It makes me feel better to just finish them off. That way I will have had 20 shots (or thereabouts) total, which should be more than enough to replete the liver. And on days I don't take the shots I will take the oral 5000 mcg.

Thanks again, Sally, for your advice!

Jason