Oh no! Did you get them from a store? Have the receipt? Sometimes returns are a hassle, but with how expensive vitamins and supplements can be.... might be worth the trouble. :)

This is unusual for Puritan's... usually that sale, which is the best one for savings is only in the spring and early summer.

I get a few things from them, and might get more biotin since I gave my son some of my extras.

Thanks for the reminder.

Need help
 

I am new to this forum.My wife BlueHill already posted in this forum about our cases. I request your attention particulary mrsD's in my case.
I am 44 years male living in Singapore,regularly doing excersise and with active life style. It all started around 4 years back with some breathing issues.They are solved after using duonase nasal spray for some time. After that I started to feel tightness in neck, shoulder and chest and also numbness in hand on left side.After consulting cadiologist and neurologist all my tests were normal. Since then I have been consulting various doctors for proper diagnosis for these issue. Last December I was admitted into Emergency for chest tightness. My TMT, echo, ECG all are normal. I visited my home country India 3 times in these 3 years for better diagnosis. Finally doctors tagged it as Somatization and suggested to do meditation etc.They think that it is all in my head, can only send me to a psychiatrist. I spent several hours meditation but didn't help. Recently as my eye sight is diminishing particularly my right eye and my numbness spread to my left leg too, I went to India again for treatment. Finally a doctor diagnosed it as Vitamin B12 (< 150 pg/ml) and Vitamin D3 (14.3 ng/ml) deficiency.
Doctor prescribed the following
For B12 :
Vitcofol injection (folic acid 15 mg, vitamin B12 500 (cyanocobalamin) mcg, nicotinamide 200 mg)
2ml - once a week for 5 weeks after that 2ml - once a month for 5 months. I have completed 5 weekly shots.
For D3 :
Arachitol(Cholecalciferol) 600000 units - 1shot (taken)
Tayo(Cholecalciferol) - 60000 - chew - 1 tablet once week for 8 weeks (taken)

Other findings were
Thiroid Stimulating Harmone (TSH)- 2.6(.3 to 6.02) - doctor said no need to worry about this(really ?).

On my personal request doctor did MRI of Cervical Spine & CVJ and result is mild diffuse disc bulge noted at C3-C4 and C4-C5. But doctor said it is not an issue for now as my neck movement is fine and advised to do some neck excersises.I am a software engineer spending around 8 hours a day before computer.

After reading in this forum, I ordered methylcobalamin from puritan and I am taking them one in the morning empty stomach for the last one week.
How ever I don't feel much difference so far. I am taking Telsartan(Telmisartan) 20mg one tablet in the morning (Cardiologist prescribed this as precaution for chest tightness and my BP was some times 140/90 now it is normal). I have the following issues and need the forum members advise to further diagnose( particularly item 1 ).

1. Constant tightness on front side of chest, shoulder, neck on left side.What worries me more is slightest irritation or anger triggers more tightness and uneasiness in my head, chest and neck area. Sometimes I feel that I am about to get a stroke. I checked my BP while I felt irritated but it is normal (around 130~135/85~90)
2. Feel vibration (tremors) in the body (not visible outside) as if I am sitting in a truck with engine on but not moving. Mostly this happens in the evening times.
3. Feel some uneasiness in the abdomen just below left ribs.Sometimes feel drumming sounds. Consulted gastroenterologist but nothing found.
4. Mild Numbness in left hand and leg.
5. There is a dark patch on the skin above collar bone on left side and similar patches below the knees on both the legs.
6. For the last one year my eye sight is diminished. I have to wear glasses for the first time (for both long and short vision)
7. Swaying and confusion while walking.
8. I fell foggy
9. Mostly depressed, sometimes unknown fears.
Are all these symptoms belong to B12 deficiency?
I am really worried and not able to concentrate on my job at all. Always feel that I am waiting for major disaster. Appreciate any advise or if any one has the similar symptoms and any other info regarding the issues. Sorry for my long post.

With a B12 that low, it will take time to recover. Often there can be temporary shifts in potassium in the blood. This is because B12 stimulates the formation of new red blood cells, which gobble up potassium. So temporary lows, should be dealt with by eating foods high in potassium.

Potassium and magnesium work together in the muscles. You may need some additional magnesium too. Go for high mag containing foods like almonds, beans, oatmeal, yogurt. You can take a good chelated form as a supplement, NOT OXIDE however. Aim for about 1/2 the RDA which is 200mg elemental daily. Muscle issues, tightness, etc often respond to fixing magnesium.
Here is my magnesium thread:
http://neurotalk.psychcentral.com/thread1138.html

normalizing potassium and magnesium will help blood pressure, sleeping, and muscle tension.
This excellent food link will tell you what is in your food.
http://nutritiondata.self.com/
For example, a V8 juice 12oz will deliver just over 800mg of potassium, which is a goodly amount.
3oz of almonds = 270mg magnesium.
You can for the most part get both from food, if you're a mind to.

As far as B12 in monthly injections... many people post on the net that they don't feel right using this regimen. So consider taking the oral methyl form daily which is more natural and easier on the body. Doctor's manuals all give the monthly regimen, for everyone. They are basically old and outdated.
Times and understanding have changed, but the references have not. It is unrealistic to expect EVERYONE to need the same treatment with a nutrient like B12.

Some hypothetical questions
 

It has been a while since I've posted on this forum. Things for some time were getting better. I'm having some strange symptoms creep back up again, that I didn't have since around the time they found my B12 levels were low. So I have some hypothetical questions.

1) Would there ever be a situation in which a person couldn't live on B12 sublinguals alone? And they would NEED shots for life? From everything I read, the answer should be "no."

2) I haven't had my level check in a few months, but last time it was checked it was >2000. I wasn't taking shots, hadn't had one for months, and was on various sublinguals (Puritan's, Superior Source, Natural Factors, etc.). Could it be possible to have B12 deficiency symptoms with a level of >2000? (Again, haven't tested but I'm sure that's where my level is right now.)

The reason I ask these things is because a few months ago when I started to feel like I was getting B12 deficiency symptoms again (despite the reading of >2000... odd), I upped my B12 dosing from 5000 mcg/day sublingual to 2 X 5000 mcg/day sublingual (used Puritan's and Natural Factors). I also began giving myself weekly injections again, of methylcobalamin, 1mg/ week on Saturdays. Things started to improve by doing this. I stopped the injections about three weeks ago and have remained on 5000 mcg Puritan's everyday, sublingually. Within the last week I have noticed strange, vague back pains return that I didn't have until before both starting injections and the ramping up on B12 I did a few months ago.

Please don't tell me I need to restart shots! The only other thing I am thinking this is, is still my antidepressant withdrawal (yes, I am still going through that, it can last up to years I have read). It would make sense that this is just a resurgance of AD withdrawal symptoms and that B12 would help cool those down a bit, since it's a nervous system vitamin, and my nervous system needs a lot of repair.

Any advice is greatly appreciated, as always.

No I don't think you need shots. If you are taking methylcobalamin? That is the active form.

You may be out of balance however with folate, or other nutrients. If you decide to take a folate, please choose methylfolate which is active too. Metafolin by Solgar is one brand. 800mcg a day is plenty for most people.

I'd try to stay on a fixed plan...say just one form of B12 daily at a regular dose, so your body can settle down and use it properly.
Say 5mg daily. Then get tested in 3 months, and do not take any for a week before the test. Injections flood the system suddenly and within 72 hrs that dose is gone. You can develop a see/saw phenomenon, with highs and lows, which you may be feeling.

B12 is not only one thing that works in the nervous system. Magnesium, folate, bcomplex and omega-3 fatty acids also do lots of jobs there.

Thank you, MrsD. I always appreciate your knowledge and advice.

I did a bad thing this morning. I gave myself a shot of methylcobalamin, but then I looked at the vial and noticed it expired on 9/5/12! :( Ugh, can't believe I didn't see that. I should be OK, right? I'm thinking the worst that will "happen" is it's too inactive to still work, and will simply do nothing. I hope I don't get ill from an expired shot.

I hope I don't need shots. To be safe, I picked up another refill on that methylcobalamin at my compounding pharmacy this morning. It expires 11/25... I didn't know it didn't last very long at all.

I do take methylcobalamin in the sublingual form, too. I never use cyanocobalamin anymore. I also do still take dibencozide everyday, personal preference. I notice when I do not take it, my appetite is poor.

I notice you said B complex. I have never tried a B complex, but it has always piqued my curiosity. I take a multivitamin that has 100% RDA for all the other Bs. It's Target's Up & Up brand, and is actually pretty good and rated pretty fairly (I think I saw it in Consumer Reports or something of that nature). However, I have thought about maybe trying a B complex that has the active forms of the Bs in it, but at a very, very low dose (maybe only 100% RDA or so). I can't find one! Would you happen to know of any off the top of your head? Also, my B6 was kind of high when it was tested back in May. I don't want high B6. It was 47.9 (the range is 2.1 - 21.7).

I may not worry about other Bs since I can't find one that isn't super mega dosed and has inactive forms in it.

B-Right by Jarrow has a nice formula.

http://www.iherb.com/Jarrow-Formulas...eggie-Caps/110

It has a modest formula with not too high levels of B6, and has activated folate, B6 and B12 in it. Of course the B12 is not really high enough for intense treatment.
You don't have to take this every day...you can do every other day or twice a week, to start, if the B6 worries you.

Many people over the years who have posted here have used it, with success. I believe it is available online at other places too, and perhaps Amazon now.

Those compounded injections, may not have a preservative in them, and in that case injecting them may be problematic. I'd call the compounding pharmacy up and ask. I hope you are keeping them in the refrigerator? Most of the time that storage is recommended.

What can happen with very high dose vitamin supplementation that lasts a long time, many months or years, there can be a vitamin dependency syndrome that occurs. This is one reason I don't recommend really high doses of anything.

Vit C was the first to be recognized as causing this. And I think it is possible with other vitamins. It involves the body "getting used" to very high doses, of some thing, and then over time the chemistry and enzymes, then "expect" this flood all the time. Withdrawing the vitamin then can cause deficiency symptoms. In the case of mega C dosing, trying to reduce may produce scurvy in some people.

http://orthomolecularvitamincentre.c.../dependencies/

Some dependencies may be inherited like B6 dependency in infants who have neonatal seizures, that respond to high dose B6. But cases of induced dependency also occur, for whatever reason.
http://emedicine.medscape.com/article/985667-overview

http://books.google.com/books?id=QBJ...ndency&f=false

So I think it is important for you to find a dose, that works for you and keep it steady. Flooding systems here and there may not work over the long haul. Stopping and starting high dose apparently is not working well for you.

Thank you for replying, MrsD.

Well it appears I have a bad cold again. I had a severe sore throat last night. I'm taking some EmergenC today and trying to rest. Later I will try to get a bit of sun for natural vitamin D (it will be in the upper 80s here today, in Phoenix, AZ).

I appreciate your advice. I do keep the injection solution methylcobalamin refrigerated, yes. I don't think the injection did anything to me yesterday, aside from make my thigh muscle a little sore. I'm not going to continue to use it, but I do like to have it on hand as an "emergency."

Thanks for the info on vitamin dependencies. I knew about B6 dependency (I have read your B6 thread some time ago), but didn't know it can happen with virtually any nutrient. I'm wondering if this is what will happen to me with B12. This link (http://www.doctoryourself.com/dependency.html) also talks about vitamin dependency, and discusses well-known B3 enthusiast Dr. Abram Hoffer, who found that after treating POW victims who became severely nutrient deficient over a long term period of time, the victims needed unusually high amounts of vitamins on a long-term basis. Since I may have been B12 deficient for many years now, I'm wondering if my body is simply going to require high dose of this vitamin for the rest of my life. Although, I have read that, after a period where some people take 10mg a day, that it may not be for life one would need that much all the time. It takes time to replenish the liver, and I'm sure within the first six months to a year, that part of the megadose goes to both nerve repairs and liver replenishment.

I will try sticking to doses of 1-to-2 X 5000 mcg per day and see how I feel. I can't imagine needing any more than that. Besides, that gets expensive. Shots are very expensive, too, which is why I don't want to continue them for life, if the high-dose sublinguals will work just as well if not better.

I met a man I was possibly going to rent a room from, who after I told him I was B12 deficient, told me that a long time ago was diagnosed with pernicious anemia. He takes only 1,000 mcg/day of sublingual B12, each and every morning but this is after doing this for quite some time I imagine. He does fine on it. No shots. (I don't believe.)

Again, a lot of this is likely antidepressant withdrawal issues. I can't believe I spent all those years putting all those toxins into my nervous system, all the while depriving it (of course not by my own fault or means ... I suspect this all came about for me from using proton pump inhibitors for years, not knowing the potential damage that could cause down the road) of a nerve vitamin.

5 - 10 mg of B12 should be OK, I am thinking and hoping. About the other Bs, I am not sure... I have check out Jarrow's B Right but read mixed reviews. I do like the methylated and co-enzymated forms of the Bs, but I don't like some of the negative reviews I read such as the packaging (the plastic bottling) contains a plastic that is carcinogenic? And that also one of the fillers in the pill is carcinogenic? I don't know how true this is or to what degree it is a potential problem. Also, it contains straight niacin, which can cause a flush sensation. I have never experienced one of these, but have read about them, and, knowing my super-sensitive self, could imagine myself freaking out and having a full-blown panic attack from such an instance. If it only contained niacinamide (which, ironically, is spposedly good at quelling panic and anxiety, in fact valium is said to be modeled after the chemical structure of niacinamide), then I may consider it.

Thanks again for the info.

Jason

There is a pretty good oral GABA now. I used it last May, and continue with it now at 1/2 dose. It is called PharmaGaba.
We lost our young cat last May, and I was a wreck for weeks looking for her (to no avail).

Natural factors used to make it, but Amazon stopped carrying it in the capsule while I was on vacation. I just ordered the newer company called PharmaGaba Gold.
http://www.amazon.com/GABA-Supplemen...ds=pharma+gaba

GABA is antianxiety and not supposed to work orally, but this one seems to....made a different way using a natural source.
I tend to be anxious at night, and sometimes upNorth in the spooky dark woods on vacation too. ;)

I find it very calming without hangover or side effects. When I was a wreck I used it twice a day, but now only one at bedtime.
The new brand is slightly less expensive than the old Natural Factors was.

Houdini? Is that the name of the cat that went missing? I remember you being worried about this, yes, back in May. I'm so sorry he/she never turned up. :(

I'm originally from Wisconsin, and have spent some short periods of time in northern Wisconsin and the UP of Michigan. Really beautiful places, they are. :)

Wow, well I can really feel the vitamin C kick in. I will be sure to be careful on megadosing anything now, given what I've learned today. I am always worried about my B12 deficiency issue (never in a million years thought a simple vitamin could wreak so much havoc on the system, but, if we think about it, these are the types of things people used to DIE from - scurvy, pellagra, etc...), and my nervous system after years of antidepressant poisoning. Wondering how this will all heal, but, time... time... time is probably the best medicine with regards to all of this. :)

MrsD, thank you for everything!

Jason :hug:

Yes, it was Houdini... We adopted a new kitty upNorth. A barn cat and she has taken most of the pain away.
Tough to tame her though, but now she is delightful. Wednesday is her spay. I guess I'll be taking two PharmaGaba caps on Wednesday. I have her photos in my album here.
We had to put Oreo to sleep 3 days before our vacation as her cancer came out of remission with a bang, and we couldn't take her up there the way she was. sigh. It was so sad. She was 14.
She had a rare cancer with a rapid course, but our new Vet kept her active and enjoying life for year. (prognosis was 2mos).
A friend of ours runs a rescue/spay non profit up there, so I contacted her and she picked the best kitten for us and saved her until we could pick her up. I told her a black was okay as long as shorthair with intelligence and nice personality. Weezie here has become Maya's surrogate mother and friend, and you should see them together...Maya adores her. Weezie was kind of lost without Oreo too, so having Maya was good for her as well. It was tricky being up there with a kitten, but since Maya hid most of the time she never tried to escape and all went well. The trip home was unpleasant tho, but they have to learn sometime! Lots of carrying on and crying. HOURS of it.

I really think that the effervescent and soluble liquid forms orally work very fast. AlkaSeltzer works in minutes too.

Emergen C has a loyal following of customers too!

MrsD
I saw a foot Doctor last week. He gave me Metanx sampes for my SFN and said to take two a day to start. The label says one pill has 3000mg of folic acid, L-methylfolate. That translates to 6000 a day. Im reading that high doses of folate may not be safe, should I stop taking the metanx and buy the supplements P5P and B12 and take them seperate? Im really concerned now, last thing I want is for these pills to make my neuropathy worse.Thank you for all your help!

Small Nerve Neuropathy-Is The folate in Metanx to high?
 

Hi My Doctor gave me samples of Metanx last week. He said to start with taking two a day. The Folic acid converted to Methylfolate is 3mg in one pill. I read on another post that it may not be safe to take folate in high levels. I have SF neuropathy in my legs , arms hands and feet with alot of tingling and pins and needles. I wondern if they are safe to take? I dont think I want to ask my doctor because I dont think he would even know. Any thoughts on this would be appreciated. scared and worried now...Thank you

Yes, you can take them separately.

I bet the Metanx does not say empty stomach either?
Unless that has changed recently.

You can get the methylcobalamin and take 5mg daily for 3 months on an empty stomach. It is very inexpensive. Swanson's, Puritan's Pride, Vitacost etc.

The methylfolate is OTC too, and Solgar makes one at 800mcg.
One of these a day is enough. Folate is not typically a player for PNers, unless they have that genetic mutation...MTHFR polymorphism. I agree with you that massive doses of this are not needed. You might want to watch your foods, and try to keep folic acid levels down, since some papers now suggest that folic acid in fortified foods may compete for methylfolate at the blood brain barrier. This will probably cost the most for you...iherb.com may help with that. There may be other brands now out there less expensive, but Solgar brought it out first OTC on the second round of availability after Merck company refused to sell it OTC! That was a huge scandal, but is now over.

P5P by NOW is a good brand, and is enteric coated as well. It is not expensive. There is a movement now by a drug company to take THIS off OTC status so it won't compete with a new P5P being developed RX...I hope this is till available therefore.

One of each of these a day should help you in a way similar to Metanx.

MrsD Thank you for your quick response,
Are you saying you agree I should stop the Metanx because of the high level of folate. You mention massive dosages are "not needed", if I keep taking the Metanx at this high dose could it be harmful or is it just being wasted?..Metanx goes on about how the high levels , Methylfolate being the highest dose 3mg per pill are what makes this medical food different and works best. You are correct no mention on how to take it, with or with out food.
I will shop for L-methylfolate 800mg as you suggested. (right now I have about 2 weeks samples of Metanx from Dr)
How much P5P is effective and safe? Should the bottle read only P5P (for the B6) or can it read P5P B6. Which is the better or correct way to buy B6 and at what dosage per day? Im a bit confused being I never bought them converted before. (Some companies have both B6 P5P and just P5P.)
massive doses of this are not needed. You might want to watch your foods, and try to keep folic acid levels down, since some papers now suggest that folic acid in fortified foods may compete for methylfolate at the blood brain barrier. This will probably cost the most for you... MrsD Im a bit confused with the above statement where you wrote about "cost", what will cost the most for me? Did you mean "cost" by it could affect my health, or more costly (expensive). sorry for my confusion and all my questions.:confused: Thank you again as always for your help!!!!

Massive doses of methylfolate are used to try and treat some depressions. It is not working out as they planned however.
Some people get agitated on high dose folate.

Also there is a situation of very high dose folic acid in young women increasing the rate of colon cancer. This is thought to be due to pre-cancerous lesions gobbling up the folate and that is stimulating growth. But no one knows for sure yet. Some young women take 5mg or more of folic acid before and during pregnancy, especially if they have had a child with neural tube defects already. Because colon cancer is not common in this age group it is a concern, but not proven yet.

Metanx (just because is RX) is not really approved for efficacy by the FDA. It is under an umbrella called "Medical Food". It is only RX because it contains more than 1mg of folic acid and there is a rule that anything over 1mg requires RX in US. But studies were not needed for its status for releasing to the American Public.

I don't think the short course of samples is a concern, but if you get agitated with that high folate, you could just take one instead of two a day.
I prefer this product because it is enteric coated. P5P is not stable in stomach acid:
http://www.iherb.com/Now-Foods-P-5-P...60-Tablets/740
One of these a day, is plenty.
B2 is included because it is the cofactor for pyridoxal kinase to convert B6 to P5P... that is why it is in there. The enzyme works on other B6 present in your foods.

Thank you MrsD!
So far I do not feel any agitation from the folate so I will continue (if its just about the agitation and is relatively safe to take at this high dose) with what I have. Just alittle jitter but i think its from either the Rlipoic acid (100mgs), Im having a hard time with the AL-Carnitine even at 250mg, guess my system is very sensitive to stimulating type meds.
I went searching for the B12 -methylcobalamin. I can only fnd it in either 1,000 or 5,000. I was thinking I would go with the 1000 because my B12 level is already at 1280. (Im nervous bout taking higher doses because Im already at 1280, dont want to make things worse) but I wanted the "benefits" of the 5,000 as so many people have reported they are using the higher dose and feel better with no side effects. Oh what to do :confused: Thank you!!

I find the lipoic acid to be quite stimulating. I take it early in the day therefore. ;)

Each person is different. You may not need the carnitine if you suspect it of jittering you.

This is why I suggest people start up one thing at a time,
to see what works and what is not necessary.

The folate thing didn't hit me until later...it was not a fast
response. I've tried several times to take the methyl form and each time I get anxious! go figure!

MrsD Thank you for your response,
I think the R lipoic Acid at 100mg is too much , I thought it caused me to have an anxiety attack ysterday, becuase it came on about 1 hour after taking it. (I had been taking it everyday for a week so far with no major problems, but now im thinking of breaking it in half.) But now after reading how the folate affected you Im wondern if the anxiety was triggered by high doses of the folic acid (6000mg in Metanx ,3000 2xday, doctors orders) . Are you still taking the folate at 800mcg? hows that working for you?
So you think 800mcg is all I need. That means I am taking 5999.2 mg too much. By taking one 800mcg that would mean my dosage would be reduced to .8mgs per day. Does this sound correct to you? Do you think such a small dose compared to Metanx would be enough or be helpful?
Also, on the P5P should I get one that has the B2 cofactor, the P5P dont all list the B2 as in ingredient. Thanks much!!!!

You can take the lipoic acid every other day for a while.
I started at 50mg (before we learned about the stabilized form) and then went to 100mg.

But unlike some other members here I couldn't increase to 200mg a day on the lipoic.

No, I gave up on the methylfolate...obviously it wasn't for me.
I think I methylate okay, since I was never low in B12 to start with. (849 to start). Now we have the gene tests, to clarify for those who wish to spend that $$ and learn more.
23andMe.

I think 800mcg of methylfolate is enough for most people.

The enteric coated product is what you need to look for in P5P.
The presence of the B2 is optional. Not all P5Ps are enteric coated, and hence protected from stomach acids.

Hi MrsD, Thanks.
I think I will cut back to half on the R lipoic Acid and see how that works for me. I will also cut back on the Methylfolate to one pill a day meanwhile I will order the 800mcg.
Do you mean your not taking B12 beacause you were never low, or are you saying your taking it anyway and if so how much do you take? My B12 level was 1280, and Im getting 4mg of the Methylcobalamin in the metanx . Im wondern if 4mg per day is too much since I dont really need it according to my blood lab level. Im hoping by taking high doses of B12 along with the other B's and pills will help with the neuropathy.
What does 23andme mean? Thanks as usual!!

23andMe is a DNA testing lab:

http://neurotalk.psychcentral.com/thread179732.html
this is a recent post about one poster's experience with the methylation testing.

Most of us keep our B12 over 1000. But 4mg a day is not "too much". You might read higher in testing...but really very little is absorbed from that dose. It is the methylfolate that concerns me about that product.

I take 2 tablets of 5mg methylB12 a week now. Just as insurance.

i am taking 1000mcg of methycobalimin daily and then 2000mcg on work out days, but i get a really drowsy and tired feeling from taking them, and i feel quite foggy headed with poor concentration.
Could this mean that my b12 levels are low?
i got blood tests for my vit d, iron and floic, b12 all came back normal, but reading posts on this forum and doctors normal is way too low.

I answered you on your other post. ;)

You really should get the numbers for your tests.

Diet has a lot to do with sleepiness...too many carbs and sugar stimulate sleep. (due to the action on serotonin).

Hi. What is your number for the B-12 on your blood tests

Melody

A very interesting resource, which gave me quite a few ideas to try. Thanks for that.

I will introduce myself elsewhere, but I think I can add one tidbit of information here that I *think* has not been mentioned. (I have read the whole thread)

People often ask about B12 upper limits: therefor it is interesting to know that a common treatment against cyanide poisoning (think people who have been in a fire) is ... B12. I learned about this reading a Dutch forum dedicated to B12. No links, but the treatment is "commercially" available to first response teams and hospitals as the cyaono-kit. It is basically a 5 gram (no typo) IV of hydroxocobalamine. In severe cases the treatment is repeated up to 3 times, which means 15 grams of B12 is forced into the blood stream, binding with the cyanide - B12 has excellent binding to it, ho hum... - and secreting it via the kidneys/urine. Although some possible side effects are mentioned, it is generally considered safe, and if I'm not mistaken the kit is mandatory in ambulances where I live.

Of course, this is an emergency producedure (don't try this at home!), but 15 grams is many thousand times the dose you get with an injection, let alone the 10% or so you ingest when using the oral doses of 1000 or 5000 mcg.

In short: no need to worry about upper limits for most people indeed.

As for me: I didn't know methylcobalamine was available OTC until this week. It makes sense for me to try this and see if this can replace the injections regimen I have followed previously. I have stopped all medication for 6 months to get a baseline reading (B12 now hovering around 400, which is still too low), and the injections are a real hassle. It would be nice if I can back to >1000 readings (like with the injections) just taking the pills. :)

Hello all. I have been reading up on b-12 and came across this forum. The advice and information in this thread is very helpful.

I have been feeling unusually weak of late- not tired or sleepy, but like I have no energy reserves to muster. Suspecting it may be b-12, I had a blood test and my b12 was reported as "normal" - 270.
Many years ago, I had issues with much lower b-12 (40) and had the usual treatment of injections. This was very unpleasant and hard on my body, and I would like to avoid it this time. I cannot remember exactly what it got up to after the injections, but I'd guess somewhere around 600-800.
I am optimistic that it took this long (7 years) after the injections for my b12 to become low again. I am hoping this means when I get it up where it should be with treatment, I can maintain it at a healthy level.

Although my level is reported as normal, I have read here and elsewhere that just because a doctor says it's in the normal level, does not mean it's enough for an individual.

As I do not want to have injections again in the future, I plan to take methylcobalamin drops daily. I do not want to overpower my body by taking a high dose, but would prefer to build up if necessary. Would taking 50-100mcg drops per day be enough, or is that more of a maintenance dose once my levels are higher?
My hesitancy is due to the high dosage injections I had causing bad skin reactions, which I have also experienced when taking high dose vitamins orally.

I'm not taking any prescription medication, and as far as I know, I have low levels as I do not get b12 from my diet.

I'd be grateful for any advice on the matter.

Welcome to NeuroTalk:

The liver will store B12 during available times and when you
don't have a source this may last up to 5 yrs or so.
We evolved this because we as hunter/gatherers had periods of famine where food was scant.

You should be at 400 US units (the number will be different in some other countries.)

Studies show that sublingual and oral give the same results.
Studies also show that from 1000mcg of B12, about 13mcg are absorbed by the body. So only 1% gets in. But since 2-5mcg are the RDA, it is still enough.

People who are very low, really should take 5000mcg daily for 3 months, and then get retested. This is because the liver will scoop up much of the dose to replenish its levels, and also the CNS fluid will soak up B12 for the brain and spinal cord. Once you are at a good level, and we here keep ours at about 1000 US units, you can reduce to 1000mcg a day to maintain.

It is best to take methylcobalamin orally, on an empty stomach.
Sublingual is swallowed with the saliva, and ends up in the GI tract for the most part. If food is present, absorption will be poor or nil.

The conversion math for other countries B12 tests is on this thread somewhere. If you read this thread carefully you will find all the information you need to understand your B12 problems.

thanks for your reply mrs D.

I have started taking 1000mcg sublingual tablets to check I don't have any reactions. If all is well after a few weeks, I will up my dose as you suggested.

It's hard to wait 30 mins to an hour to eat though! By that time I am starving.

Am I able to take my morning probiotics at the same time as the b12 or will this cause a negative effect?

Not sure.. For the most part, B12 is hampered by fiber that is with the food, and the volume of liquid that comes with eating.
The studies on drugs that are given in microgram doses show food keeps the drug like a sponge away from the lining of the intestine. But probiotics, are alive, and one would wonder if they would consume some of the B12. B12 is excreted, you know in the bile, and may then provide itself to organisms living there. I do know for a fact that parasites (tape worms in particular will cause low B12 in humans, as they soak up the small amounts we eat from animal food sources.) and that is not a pretty picture to imagine! Other organisms may also like to have it I'd assume. The cycle of life is quite complex.

As far as probiotics go, you might investigate Kefir. US Kefir has 12 different strains in it, and is far more helpful than yogurt in fact as a natural food source.

Just wondering if coffee, juice and water interfere with B12 absorption.

I don't think so unless huge amounts are taken with it.

I took my B12 with my thyroid first thing in the morning and had a cup of tea with it. I got a test reading of 1999 after about 3 months on 5mg a day, that way. It is fiber...food...that seems to affect it. Think of a big full stomach... how are micrograms going to be dispersed in all that?

As it is, most supplement makers and doctors haven't made this connection at all. The study on this thread however does state the absorption of B12 orally during empty stomach situations.
No one is calling that from the rooftops or commonly on the net!
It is only because of my training and experience that I know about it.

B12 and folic absorption
 

My serum levels af B12 and Folic are always very high....VERY high. 10X the upper limit.

I do take a multi-vitamin. Could it be that I am not absorbing it?

I don't understand your question, I'm sorry.

If you don't absorb your vitamins how can you be high?

The actual upper limit of the old outdated B12 levels is 850- to 900 pg/ml (US units).

If you are 10 times that you would be at 9000? The machines used in US only are calibrated to 2000 maximum. We've had posters here in the past who work in the labs explain that.

People CAN have elevated B12, with no exposure to any vitamin. That usually reflects some serious medical issue:
kidney malfunctions, liver disease, and various blood disorders and cancers.

Folate tests can be high because foods in US are fortified with it. But not 10x normal, from food alone.

Can you post your lab results here? You can get them from your doctor?

I just posted in the other thread about glutathione, but said i was using this new liposomal B12 from MaxHealth Labs... 5000mcg and it is'nt destroyed in the digestive system. its liposomal encapsulated. it works so well i couldnt even believe it. i order new supplies way before im done because i dont want to miss a day. it is that good. try it... you really wont believe it.

B12 is not destroyed in the gastrointestinal system.

If you are happy with the product which BTW costs $40 for 30 days supply, then that is great.

If this system is for real, there has NEVER been an ultra highly absorbable B12 orally before on the market. Therefore I don't see why such a high dose is in this product. Even a 1000mcg size is huge. Why would we need 5000mcg when RDA is 2-4mcg a day on a regular basis?

I'd also like to see blood levels published for this product.

going to revisit my neuro ... thinking of asking about B12
 

Hi MrsD and all others who read the vitamin B12 thread! :)

I have been having some strange, very painful burning sensations on the tops of my lower legs, where they connect to the feet. I've also been having other strange, hard-to-explain sensations there, too. I've lost a lot of padding on the top of my feet, so the bones and veins stick out. I have not lost weight, either! Sometimes there are very vague, achy pains in the feet, muscle, and bone, too. Kind of like a malaise... almost like a belly ache sensation in my lower legs and feet. There is also a lot of joint cracking in the joints of the feet. So, off to the neuro again I go! See what he says or suggests. I get concerned because sometimes it feels like my feet and legs are heavy and the muscles don't obey... like they don't want to work. I haven't had foot drop (I know what this feels like as I had this when I was first diagnosed with B12 deficiency last year). It's just... like a neurochemical misfiring or something. But I can't help but think this is somehow related to this vitamin.

I am thinking of having the neuro pull my serum B12 level. I still supplement daily with sublinguals, @ 5,000 mcg daily (I use different brands: Puritan's Pride sometimes - a bottle is there for me at work if I forget to take some at home; Natural Factors - this I use at home when I remember before going to work!; and sometimes Jarrow's, but Jarrow's really irritates my tongue and teeth so bad that I can't use it often, if at all).

I was wondering if I should get shots each month? I don't do this currently but, maybe I need them? And I was thinking about hydroxocobalamin. Does anyone know much about this form? Does it have to be converted in the body, or is it similar to methylcobalamin and is ready to be used by the body?

Thanks all! I will let you know what I find out. I am hoping this is nothing serious and, actually... I am thinking this is related to the adverse reaction I had to Prozac over a year ago, and all this SSRI withdrawal nonsense, that, after one year, I am still going through believe it or not.

Jason :)

You can get injections of methylcobalamin--they have to be
compounded from a special compounding pharmacy.

You don't have to dissolve the Jarrows in the mouth. You can
swallow it with some water on an empty stomach.

There is no advantage to injections. They are typically cyano form, but doctors can special order hydroxcobalamin and it
is a bit easier to convert, and will cost more.

You might have CMT (Charcot Marie Tooth-hereditary) which causes wasting of muscles in the feet (and eventually hands, etc).
Genetic testing is from Athena labs, and quite expensive.

I had weekly injections for over a year. These were hydroxocobalamin 1000mcg injections. They did what they had to do, in that they kept the serum level > 1000.

I then stopped them to get a complete baseline reading, and it had dropped to 375 ng/L. Given the hassle of the injections, I now switched to the methyl 5000mcg B12/empty stomach routine. I will get a reading in a couple of weeks, but I have a hunch it works as well as - if not better than - the injections.

Best way to know for you personally is to have the B12 serum levels checked (and get a copy of the results). If the result is > 1000 after a longer period of taking the oral version, I see no benefit to switching to the injections. (especially not the cyano ones)