[karsten]

[QUOTE=glenntaj;801966]--given some of the symptoms you've described, and the strong possibility of malabsorption and autoimmune issues, some testing for celiac and gluten sensitivity would seem to be in order:


Thanks Glenn. I'm looking for a new neuro willing to actually listen and perform more than just the most simple tests. This possibility will be on my list.

[pabb]

anyone..with..Hashies...should..be..checked..for.. celiac,..gluten..issues

[karsten]

Originally Posted by mrsD

I have never found any papers in 10 yrs showing sublingual is a good way to provide B12 in supplement form. The oral mucosa is a very small surface area and the molecule needing absorption is very large.

If people insist on doing this, the only harm is causing some inflammation or reaction of the mouth membranes to the tablet and its other contents. If the pH of the tablet is acidic, then erosion of dental enamel may occur as well.

There ARE however many papers evaluating ORAL vs injectable forms and the oral has shown repeated success and value.

more here:
http://en.wikipedia.org/wiki/Vitamin_B12

B12 remains a sublingual because historically that is how it began orally. Now we know orally works (especially if used on an empty stomach). This is common in medicine...historical use. Magnesium oxide now known to not be absorbed at all orally is still prescribed by doctors for low magnesium levels, because historically it was the only magnesium supplement for a long time. Another remaining historical use is D2 on RX...which has been found about 80% less effective than OTC D3 in correcting D deficiency. But doctors continue to prescribe it anyway.

If anyone can find a good study showing sublingual B12 is better than oral, I'd like to see it.
There are many papers on PubMed now concerning ORAL administration, and its usefulness.

I chew up my tablets (which are cherry flavored) and swallow on an empty stomach. My tests showed a very robust response to my trial of the new Puritan's methylcobalamin. (level 1999 after 3 months of treatment--this is the top of the testing range and US labs typically cannot read higher).

I can't find any "real" studies suggesting sublingual is better than oral. Everything I have found through research indicates that oral and sublingual B12 abosrption rates are equal. The one difference is that sublinguals might be better with those that have intestinal aborption issues. There are potential disadvantges as well if inflamation occurs inside the mouth with use of sublinguals.

Here are some links of interest:

http://sublingualb12report.com/

http://en.wikipedia.org/wiki/Sublingual_administration

http://www.livestrong.com/article/51...orbed-quickly/

http://www.livestrong.com/article/22...mins-absorbed/

I don't have any inflamation issues in my mouth associated with sublinguals, but I know they can occur in some people. My first experience with sublingual B12 was a strong reaction (feeling anxiety combined with a jittery caffiene type feeling) about 2-3 minutes after putting it under my tongue so I know it abosrbs quickly into the blood stream. How much actually is abosrbed through the tissue lining into the blood stream vs. orally as it passes into the stomach is debatable. I do know that the longer you keep the pill under your mouth or between the cheek and gums, the better the absorption rate through the blood stream. Some days I can make the tablet last a long time and other days not so much.


Sublinguals are not for everyone and the effective use of B12 administered orally is well documented.

[zeeclass6]

Originally Posted by pabb

anyone..with..Hashies...should..be..checked..for.. celiac,..gluten..issues

I was tested for gluten intolerance about 8 years ago and was found to be fine with that. We did the full blood panel for it, whatever that was.

Should I be tested for that again? Can you just "develop" it if you've tested negative for it in the past?

[mrsD]

Yes, some studies imply that heavy use of NSAIDs (like Aleve and Ibuprofen and others) suppress Cox-2 enzyme in the GI tract that is useful there in preventing unwanted substances like the gluten peptide from entering.

So it is possible but not proven 100% that gluten intolerance may be acquired. This is different from genetic Celiac which has gene markers present. It is not known at this time if other drugs also cause this. But so far with the abundance of tablets consumed by the American Public RX and OTC daily, significant GI impact may occur and contribute. Even little kids, are taking Motrin liquid commonly.

Other inflammations of the GI tract may also be an issue.

[zeeclass6]

Interesting. I do take more Ibuprofen than a lot of people because of my back pain. I "try" not to take it, but some days I just can't function without it and will take 2 or 3 Advil a couple of times per day. Or more if I'm really suffering (which thankfully isn't too often).

I will have to pay close attention to see if my GI issues get worse when I've been taking Ibuprofen. I never correlated that before, so thank you!

BTW, I hurt my foot recently and my podiatrist told me to take Aleve twice a day for a week. It made me incredibly depressed and I had to switch to Ibuprofen instead. When I stopped taking the Aleve, my mood felt better within a day. I'm staying away from that stuff! As far as I can tell, Ibuprofen doesn't give me any mood problems. (Either does Tylenol).

I also want to add....I've been taking 1,000 mcg of B-12 for the past few days and my energy level and concentration are so much better already! Not sure why I felt so hyper after taking it the first time (the Cyano variety), but the Methyl variety seems to be fine. Not sure if the fact that the first one was Cyano has anything to do with it. But anyway, I'm thinking about increasing to 2,000 mcg for a while if I tolerate it. I understand that a person should usually start off at a higher dose for the first few weeks, then level off a bit.
Does that sound like a good plan, or should I stay on 1,000 steadily? I'm getting my blood tested again in mid-October, which will be enough time to see whether the B-12 supplementation is helping raise my levels.

[mrsD]

You can go up if you feel like it for the B12. I'd stop it about a week before testing, just to eliminate the contribution of the supplement to your test results.

I would expect a good response to be 1000 or more. If it is less than 1000, then I'd go higher on the B12 until it serum levels go up.

If you have good intrinsic factor status, you should see a robust response to the B12. This would be because you are absorbing more than a person with damaged intrinsic factor. This is important to know, for future supplement needs and use.

NSAIDs vary in how lipophilic they are. (soluble in fat). The high lipophilic ones pass into the blood brain barrier more easily.
Ketoprofen is typically the one chosen for topical use for this reason.(many compounded creams use it) The more lipophilic ones will cause blurred vision and drowsiness in some people. Indomethacin, which is highly lipophilic, is often used for headache treatments in fact.

I tried to find a list of NSAIDs according to lipophilicity, but was not successful.

I personally find Aleve tablets useless for my purposes. But the liquigel? I find it excellent. Hubby does not like it however. So there are personal reactions to the various dosage forms.

[pabb]

Originally Posted by zeeclass6

I was tested for gluten intolerance about 8 years ago and was found to be fine with that. We did the full blood panel for it, whatever that was.

Should I be tested for that again? Can you just "develop" it if you've tested negative for it in the past?

YES!!!..you..can..develope..celiac...at..any..time ...you..inherit..the..predisposition...need..a..tr iggering..event......ie,...stressful...event...... physical-or-psych.

[zeeclass6]

I need a little more advice. I've been searching the web and can't seem to get a straight answer on this....

At first the B-12 was making me feel good and energetic. In fact, these days I feel pretty good in the morning and early afternoon. I've been taking the B-12 for about a week, and I have been noticing that I have begun to feel extremely tired by around 3 p.m. I mean, REALLY dragged out like I need to take a nap. This is not usual for me. I am beginning to suspect that the B-12 has something to do with it, because this late afternoon tiredness began a few days after starting the B-12.

I read something about the connection between B-12 and potassium...that if you start on B-12 supplements you might get low in potassium. There is no way for me to know my potassium levels without a blood test, and I won't have one for another month.

In the morning, I take the 1,000 mcg B-12 along with my Synthroid about 45 minutes before I eat, and my B-complex with breakfast.

In the afternoon I usually take my multi-vitamin (which has 80 mg potassium), along with 2,000 IU vitamin D, and fish oil capsules.

Sometimes I'm out for lunch and don't have my vitamins with me, so I don't take the lunchtime vitamins until dinner. Either way, I seem to be getting really tired by 3 p.m. and I remain tired for many hours.

I don't drink caffeine (can't tolerate it -- just wanted you to know that caffeine has nothing to do with this).

Any ideas why I'm getting so tired? Could it be potassium? Should I be taking a potassium supplement as well? If so, when should I take it, and how much? (Or I could try adding more potassium-rich foods to my diet, like maybe one can of prune juice (I love prunes!)

If it's not potassium, then what could be causing it?

Thank you!

[glenntaj]

--that have nothing to do with your supplementation, including a low blood sugar state post lunch (relative hypoglycemia), which is not all that uncommon . . .

Also, people's circadian rhythms differ, and a number of people report a natural down period in the middle of the afternoon, especially if they are prone to post-meal hypoglycemic states . . .

Has this only been happening since you've been supplementing, or has it been present before and been exacerbated by it, or is it more noticeable in comparison with the relatively higher morning energy state?