[mrsD]

Magnesium, yes, is always helpful. It is involved in hundreds of other enzymes in your body as well, including the heart, and metabolism of essential fatty acids.

All you mention are fairly side effect free, and cost is only the factor that some use to decide upon. CoQ-10 with good absorption is costly, and so is acetyl carnitine. Puritan's tends to have Q-sorb CoQ-10 at reasonable prices. Puritan's sale of buy one and get 2 free ends tomorrow. They will then probably go back to buy 2 get 3 free. I just ordered more B12 and D for us today in fact.

R-lipoic has a long history of studies as Alpha lipoic for neuropathy, and so does the benfotiamine. So yes, all are quite good and worth the cost. Over time you may find some more effective than others, and make adjustments. Usually this is when improvements occur, and people tend to drop one thing here or there and see if the improvement holds.

[mrsD]

Today I am searching B12 and immunity (mostly for my cat), but I found these papers which are useful for us, here:

http://www.ncbi.nlm.nih.gov/pmc/arti...able/T1/#TF1-4

This one above is a chart of various oral doses and their absorption.

This one is a discussion on which oral doses helped elderly patients the most:
http://www.ncbi.nlm.nih.gov/pubmed/15911731

RESULTS:

Supplementation with cyanocobalamin in daily oral doses of 2.5, 100, 250, 500, and 1000 mug was associated with mean reductions in plasma methylmalonic acid concentrations of 16%, 16%, 23%, 33%, and 33%, respectively. Daily doses of 647 to 1032 mug of cyanocobalamin were associated with 80% to 90% of the estimated maximum reduction in the plasma methylmalonic acid concentration.
CONCLUSION:

The lowest dose of oral cyanocobalamin required to normalize mild vitamin B(12) deficiency is more than 200 times greater than the recommended dietary allowance, which is approximately 3 mug daily.

PMID:
15911731
[PubMed - indexed for MEDLINE]

And this review article from 2009:

Int J Lab Hematol. 2009 Feb;31(1):1-8. Epub 2008 Nov 19.
Oral cobalamin (vitamin B(12)) treatment. An update.
Andrès E, Dali-Youcef N, Vogel T, Serraj K, Zimmer J.
Source

Department of Internal Medicine, Diabetes and Metabolic Diseases, Hôpitaux Universitaires de Strasbourg, Strasbourg, France. andres@chru-strasbourg.fr
Abstract

The objective of this review was to evaluate oral cobalamin (vitamin B(12)) therapy in adult and elderly patients, from the perspective of a hematologist. PubMed was systematically searched for English and French articles published from January 1990 to January 2007. Data from our working group, the 'Groupe d'étude des carences en vitamine B(12)des Hôpitaux Universitaires de Strasbourg', have also been included. Several prospective studies in well-determined population (n = 4), prospective randomized studies (n = 3) and a systematic review by the Cochrane group (n = 1) provide evidence that oral cobalamin therapy may adequately treat cobalamin deficiency, particularly hematological abnormalities or manifestations. These studies suggest that at least 1000 microg/day of oral cyanocobalmin are needed for pernicious anemia and a mean daily dose of 250 microg for food-cobalamin malabsorption. This present review confirms the previously reported efficacy of oral cobalamin treatment in adult and elderly patients.

PMID:
19032377
[PubMed - indexed for MEDLINE]

You may copy these citations and give them to your doctor if he/she needs educating!

[ger715]

Originally Posted by mrsD

Magnesium, yes, is always helpful. It is involved in hundreds of other enzymes in your body as well, including the heart, and metabolism of essential fatty acids.

All you mention are fairly side effect free, and cost is only the factor that some use to decide upon. CoQ-10 with good absorption is costly, and so is acetyl carnitine. Puritan's tends to have Q-sorb CoQ-10 at reasonable prices. Puritan's sale of buy one and get 2 free ends tomorrow. They will then probably go back to buy 2 get 3 free. I just ordered more B12 and D for us today in fact.

R-lipoic has a long history of studies as Alpha lipoic for neuropathy, and so does the benfotiamine. So yes, all are quite good and worth the cost. Over time you may find some more effective than others, and make adjustments. Usually this is when improvements occur, and people tend to drop one thing here or there and see if the improvement holds.

Mrs. D, I just looked up Puritan's Pride and not sure what kind of Magnesium I should order, also the mg's as well. The same with the COQ10; not sure which to order. Thanks for all your input. I really do appreciate all you do for us PN'ers.

[mrsD]

This is my magnesium thread:
http://neurotalk.psychcentral.com/thread1138.html

While Puritan's is good for many things, they don't have much in the way of magnesium to choose from.

Using a chelate is best. Avoidance of Oxide type important. I do not like aspartate, because aspartate stimulates pain receptors (NMDA receptor).

Some people get laxative response from magnesium. So using a delayed release for them is helpful... SlowMag --generic called Mag64. Studies have shown this form is absorbed well.
http://www.google.com/products/catal...ed=0CE0Q8wIwAg
I get my Mag 64 at Costco for about 5.00 But not all Costcos will have it on their special OTC shelf. The Costcos where it has been requested typically have it. WalMart also carries it and the brand Slow Mag ($9.99)

Ionic Fizz is also good and I have used it too. It is very fast acting, and you control dose with the little scoop provided. But it costs a bit more money. Some people use Natural Calm which is a powder of the citrate. But too much=laxative action.

You can use the topical lotion which many of us now use with success:
http://www.cvs.com/CVSApp/catalog/sh...new_crumb=true

I find this at my local CVS stores. It may be in the first aid section with the epsom salts, or in the pain section, near the Thermacare patches and Tylenol etc products.

The lotion is the easiest to tolerate by far, is unscented and penetrates quickly into the skin. My husband uses it too for muscle strains and stiffness.

[mrsD]

This paper is getting alot of attention in the press. There are many links to the media on the net now. However, those media links do not last long...so I found the original abstract:

Neurology. 2011 Sep 27;77(13):1276-82.
Vitamin B12, cognition, and brain MRI measures: A cross-sectional examination.
Tangney CC, Aggarwal NT, Li H, Wilson RS, Decarli C, Evans DA, Morris MC.
Source

Department of Clinical Nutrition 425 TOB, Rush University Medical Center, 1700 West Van Buren St., Chicago, IL 60612 ctangney@rush.edu.
Abstract
OBJECTIVE:

To investigate the interrelations of serum vitamin B12 markers with brain volumes, cerebral infarcts, and performance in different cognitive domains in a biracial population sample cross-sectionally.
METHODS:

In 121 community-dwelling participants of the Chicago Health and Aging Project, serum markers of vitamin B12 status were related to summary measures of neuropsychological tests of 5 cognitive domains and brain MRI measures obtained on average 4.6 years later among 121 older adults.
RESULTS:

Concentrations of all vitamin B12-related markers, but not serum vitamin B12 itself, were associated with global cognitive function and with total brain volume. Methylmalonate levels were associated with poorer episodic memory and perceptual speed, and cystathionine and 2-methylcitrate with poorer episodic and semantic memory. Homocysteine concentrations were associated with decreased total brain volume. The homocysteine-global cognition effect was modified and no longer statistically significant with adjustment for white matter volume or cerebral infarcts. The methylmalonate-global cognition effect was modified and no longer significant with adjustment for total brain volume.
CONCLUSIONS:

Methylmalonate, a specific marker of B12 deficiency, may affect cognition by reducing total brain volume whereas the effect of homocysteine (nonspecific to vitamin B12 deficiency) on cognitive performance may be mediated through increased white matter hyperintensity and cerebral infarcts. Vitamin B12 status may affect the brain through multiple mechanisms.

PMID:
21947532
[PubMed - in process]

What this paper discusses is the MMA test which is specific to show if B12 is being utilized. In general it pertains to the levels of B12 also but only indirectly. A low B12 reading will raise MMA levels. MMA test is slowly being accepted for elderly screening for low B12 activity today.

This is one media link: I don't expect it to be active forever, but I'll post it because it is in the news today:
http://www.wbaltv.com/r/29307110/detail.html

[MelodyL]

Originally Posted by mrsD

This paper is getting alot of attention in the press. There are many links to the media on the net now. However, those media links do not last long...so I found the original abstract:



What this paper discusses is the MMA test which is specific to show if B12 is being utilized. In general it pertains to the levels of B12 also but only indirectly. A low B12 reading will raise MMA levels. MMA test is slowly being accepted for elderly screening for low B12 activity today.

This is one media link: I don't expect it to be active forever, but I'll post it because it is in the news today:
http://www.wbaltv.com/r/29307110/detail.html

Hi.

I've been taking the Malic Acid from Puritan's pride.

For years now.

The bottle says 825 mg 180 coated tablets
and this consists of Magnesium (from Magnesium Malage) 50 mg
and Malic Acid (from Magnesium Malate 825 mg


I hope this is good because I just got my blood work done, and had an exam and Dr. Fred says I'm EXCELLENT!!!

So....so far so good.

I wonder if it's all the green stuff I eat every day.

I'm probably filled with clorophyll.

lol

Melody

[ger715]

Thanks Mrs. D for the info on the Magnesium. This will be very helpful. I am also at a loss on choosing the COQ10. Do you have any suggestions?

Not sure I can use the Epsom Salt Lotion. My feet,ankles and legs are the bigggest problem with burning and pain. I have Statsis Dermatatis in those areas; primarily the Feet and ankles, starting to go to the knees. I use a petroleum jelly because the skin is so thin and discolored with brown, red and purple under the skin and some on top. This is prone to ulceration and the jelly will help the skin from drying and cracking. Unfortunately this adds to the PN pain.

[mrsD]

You don't have to apply it to your targets....some people do when they can.

If you apply to intact skin the magnesium will get into you anyway and travel around your body. This is an alternative to taking oral if you are prone to being loose.

I discovered it will sting, if there is any skin irritation, because it does have a "salt" in it...a magnesium salt.
The lotion itself is moisturizing I have found as well.

Puritan's CoQ-10 contains Q-sorb to help improve absorption.
That is one place.
Another is a more fixey type to be found here: Q-gel.
http://www.epic4health.com/
These tend to cost much more, but reading the pages on them might be useful. They also have Ubinquinol which is a concentrated form that allows for a lower dose.
There are some on iherb.com by Doctor's Best...that have Bioperine in them, but if you are taking RX drugs I don't think Bioperine has been cleared as safe with RX drug absorption (may increase it).

@Melody--- the magnesium malate is fine...it is just such a huge pill, many people may not like it.

[ger715]

Mrs. D, Was recommending the methyl B12 to a friend yesterday. I told her it was best to take on empty stomach; at least 2 hrs. before and 1 hr. afterwards. She asked if it was okay to use water or liquid during this time. I do take a drink of water at times. I, myself am clear on this either. Is taking water in between those time make a difference? Thanks

[mrsD]

Yes, I do tea with mine sometimes.

I put the 5mg methyl B12 for my cat in a bit of whipped cream, which she will take easily. It is working for her that way, but she is only 8 lbs compared to humans. She is really perking up since I started this, and the vet said to continue. Saves me much $$ from the shots they were going to sell me.

It is the FIBER and volume of the food, that acts like a sponge to block passive absorption of the B12. Some liquid, seems to be okay.