[mrsD]

I take both my B12 and thyroid together. Never had a problem with this as tests show both are doing well.

FOOD, esp the fiber in food complexes the B12 and reduces its passive absorption in the intestine (this is not including intrinsic factor).

Complexes usually have small amounts of B12 and this will not make it to the intestine if food is present and/or you have little or no intrinsic factor activity. If you have good intrinsic factor status, you may absorb the B12 in them. But people who are testing low and/or have neuro symptoms typically have low serum levels, and hence that implies that intrinsic factor is not working. Hence you need to assure passive absorption instead, meaning taking a high dose orally on a empty stomach.

Intrinsic factor needs acidic stomach and can be destroyed by autoimmune disease or be not present genetically .

[Dr. Smith]

Originally Posted by zeeclass6

sometimes some Ester C,

Sometimes? I can't take ascorbic acid due to IBS, so I take 1000-4000 mg. of Ester C daily. Since it's a water-soluble like B-12, and there's no upper limit, it's probably not a bad idea to take it daily (amount up to what works best for you; I take more undr stress, when I'm exposed to viruses, etc.). The extra calcium in Ester C isn't bad either.

I recently had the same question about B-12 & Synthroid for my aunt (and got the same reply from mrsD). No problems that I've heard of.

Any idea why the CPAP isn't working well? There's a separate forum for that, if you'd like to go into it.

Most of the other symptoms you describe may be the Hashimoto's (from what little I've read about it - all kinds of thyroid issues in the family) but could be other things coincidental. Off the top of my head, magnesium and pantothenic acid come to mind, but that's something to investigate, decide for yourself, and talk with your doctor about. Sounds like your new PCP may have more on the ball.

Best wishes,

Doc

[zeeclass6]

How can I be checked for intrinsic factor? Is it a blood test or something more complicated than that? Do regular laboratories do the test or will I need to do something with a special lab? I'm seeing my Endocrinologist in early October and usually get various blood tests before the appt.

Should I also get my other B vitamins tested? My folate levels are good, as are my Magnesium and other blood work I've done.

The more I think about the, the more I'm angry that none of my doctors thought to add this simple blood test to my panel until now. I started seeing a new GP and she added B-12 as an afterthought! I may have been deficient in B-12 for the past 15 years (I have had Hashimoto's since the birth of my second child 15 years ago).

Thanks for letting me know that I can take the B-12 and Synthoid together. That really helps.

This morning I took my Synthroid early (half awake in bed) and later after I got up, I took 1,000 mcg of B-12 sublingual, as well as my regular B-complex (which I now see has 400 mcg of B-12). Within a half hour I began to feel rather shaky. I suppose it will take some trial and error to find the right dosage, at least for first thing in the morning. Perhaps taking 1400 mcg all at once is too much for me at the moment. Should I divide it up and take it a couple of times per day? I know that I shouldn't take it too late in the day, as it is "activating."

The sublingual B-12 I got at Walgreens is Cyanocobalamin (sp?) and is made by Nature's Bounty. My B-Complex has 400 mcg Methylcobalamin and is made by Pure Encapsulations. It also has 20mg of B-6 (10 mg of Activated B-6 and 10 mg of non-Activated). I could list all the ingredients if you want. It's supposed to be a very good brand, but I would appreciate advice from you guys on a good brand of each of these (B-12 and a B-complex). I know that being on the birth control pill can additionally sap me of B vitamins, so that might be an additional factor in this.

I noticed that someone had said they were taking Jarrow. I know that is a good brand. I have an excellent health food store in town that I could get that from (or just go online).

Thank you all so much for your advice and help!

[zeeclass6]

Another question about B-12 or what auto-immune disease can do to your gut....

After my second child was born 15 years ago, I got depressed, was found to have Hashimoto's....and began to get lactose intolerant, "out of the blue."

Until recently, I just took a Lactaid pill with dairy and I was fine.

But in the past few months, the lactose intolerance is beginning to become a huge problem. Even if I take 1 or 2 Lactaid Ultra pills, some dairy foods still give me a problem with gas, bloating, and very embarrassing very foul smelling wind, like an awful sewer! It is disgusting. It's as if I didn't even take the Lactaid pills. I have had to totally avoid dairy for several days to calm it down when it gets bad.

I drink Lactaid milk and that's OK for me (a little in my decaf or cereal....I don't guzzle it). I know that soft cheeses are worse, and that dairy foods low in fat are worse, so I try to avoid those.

Can B-12 deficiency and/or auto-immune disease be causing this sudden increase in lactose intolerance?

I'm sure you guys might tell me to give up dairy, but I don't want to!

I wasn't this way when I was younger....never used to have any sort of problem with dairy before my daughter was born in 1996 and all hell broke loose in my body.

Oh, BTW, I had a colonoscopy last year (welcome to age 50) and was found to be squeaky clean, no problems whatsoever.

[mrsD]

Very little B12 is absorbed orally. That is why you take a huge dose so a few micrograms will get thru. Not likely to cause anything noticeable at all. Doctors typically don't test intrinsic factor anymore (Schilling's test--most labs stopped offering it)
There is a test for antibodies to stomach parietal cells to look for autoimmune issues.
http://www.nlm.nih.gov/medlineplus/e...cle/003351.htm

You could be shakey due to low blood sugar, in the morning.

You can try something for foul smelling GI issues. Get some Psyllium seed (either powder or the capsules) Take one or 2 capsules daily to start with alot of water at mealtimes, and see if they work. Say one for breakfast and one dinner.
They will absorb any toxins in your bowel, that are causing you grief (smells and IBS type symptoms). This works very well for minor bowel disruptions. You may find you can eat better after a couple of weeks of this. Also look at your sugar consumption. Fructose can cause lots of gas, as well as sucrose, because it feeds Candida. Stop all sugar and fructose for 2 weeks and see if the gas is better. These are two common causes. If this does not work, you'll have to think of something else to try.

You may need some good probiotics ultimately, but try this simple inexpensive thing first.

[zeeclass6]

Any advice on brands of B vitamins which are better than average?


Also, is the sublingual Cyanocobalamin OK, or should I be looking for sublingual Methylcobalamin instead?

[mrsD]

Oral works the same. I don't believe much is absorbed sublingually. The tablet dissolves and you swallow that saliva and it then becomes ORAL.

[karsten]

Originally Posted by mrsD

Oral works the same. I don't believe much is absorbed sublingually. The tablet dissolves and you swallow that saliva and it then becomes ORAL.

I take mine as a sublingual. There are a few differences between oral and sublingual.

The tablet is placed under the tongue and kept there as long as possible letting it slowly dissolve. I can make a single 5000 mcg Jarrow Mb12 last about 30 minutes this way before it's completely dissolved. After it is dissolved, I wait another 30 minutes or so before drinking anything to allow for some additional absorbtion of the B12 into the tissue lining of my mouth and throat.

Avoid chewing or slurping down the tablet which is the same as taking it orally. Placing it under the tongue lets the B12 be directly absorbed by the blood stream. In theory, it is then easily absorbed by the body for immediate use.

Naturally, a sizeable portion of the tablet does get consumed orally anyway as it runs down into the throat to the stomach.

I believe one can achieve a faster rate of absorption for this method of administration than by purely oral use.

Tablets taken orally undergo the process of normal digestion. I'm almost paranoid regarding the ability of my digestive system to properly absorb B12 so I go the sublingual route knowing that part of the dosage passes through the blood stream to the brain.

[glenntaj]

--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:

http://sites.google.com/site/jccglutenfree/

[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).