[ger715]

Mrs. D - When I joined in July, 2011 I had done a post to you; not realizing at the time, you were on vacation Had spine fusion/laminectomy L4-5, red angry nerve (doctor's words) and cysts going surrounding many of the vertebrae (cysts removed). Post surgery, still left with severe pain, as well as shin pain in both legs. Orginal and 2nd surgeon both felt there was nothing more that could be done and was referred to a Pain Specialist, which I currently am seeing.
Due to heavy pain meds (oxycotin, percocet) developed severe constipation eventually resulting in Cystocele surgery. Within a week or so, my legs,feet,ankles started swelling. (currently take Spironolactone and Furosemide daily)Also, developed statsis dermatatis in feet and ankles now up to knees.Shortly afterwards the burning feet, ankle and leg pain was awful and kept getting worse. I thought it was from the Statsis Dermatatis. My internist/endocrinolgist said the pain was from my Neuropathy. Started lookin info and now everything going on made sense, including balance problem as well.

Until a couple of months ago, when I started taking Methyl B12 took Miralax about 5 or 6 times a week. Although I have a lot of cramping and stomach issues since taking the Methyl B12, I only need Miralax once a week.

I recently had lab work done prior to doctor's appointment. Appointment cancelled and do not see doctor until the end of September. Since I had started taking the Methyl B12 and a B Complex asked doctors' office to check B12 & B6 (had purchased B6; but only took a few days) levels as well as other tests (hypothroid) Also, am taking 2,000 Vit D's daily since originally had been low at 18.
After six weeks of taking the Methyl B12 my count was 922. My D had gone up to 32. I had the B6 lab test done last week. The doctor's office called today to tell me my B6 was 54.1 and the normal is 2.0 - 32.8. Since I had only taken the BComplex for about a week and only a couple of days of B6 (about 8 weeks ago) and now take only the B12, I don't believe the high B6 number is due to the BComplex or B6 vitamin. I will be seeing the doctor in a few weeks; but am concerned about the B6 number. I would appreciate any imput you can give me.
Gerry

[mrsD]

Different labs have different B6 ranges. I've seen some in US go up to 90 or so. Others lower.

This remains a gray area in vitamin testing. Serum testing is always less accurate than cellular testing, because cells can rupture and spill contents into the serum causes false highs.
Potassium also can be affected this way.

If you eat any enriched foods, then you can be getting B6 that way as well.

None of the studies I've looked at which reported very high B6 side effects ever noted the actual number on the abstracts. So we don't really know if your level is worrisome or not.

[ger715]

Originally Posted by mrsD

Different labs have different B6 ranges. I've seen some in US go up to 90 or so. Others lower.

This remains a gray area in vitamin testing. Serum testing is always less accurate than cellular testing, because cells can rupture and spill contents into the serum causes false highs.
Potassium also can be affected this way.

If you eat any enriched foods, then you can be getting B6 that way as well.

None of the studies I've looked at which reported very high B6 side effects ever noted the actual number on the abstracts. So we don't really know if your level is worrisome or not.

I had started the Methyl B12, and a few times a week took R-Lipoic Acid. Also, for a brief period, Benfotiamine (B1) because of having read some articles about the possibility of regenerating damaged nerves using these vitamins/ supplements. Do you think taking these may help the process or regenerating the damaged nerves?
Gerry

[mrsD]

Originally Posted by ger715

I had started the Methyl B12, and a few times a week took R-Lipoic Acid. Also, for a brief period, Benfotiamine (B1) because of having read some articles about the possibility of regenerating damaged nerves using these vitamins/ supplements. Do you think taking these may help the process or regenerating the damaged nerves?
Gerry

Yes, I think all 3 are helpful for some people. R-lipoic helps with mitochondrial functions, and Benfotiamine is a cofactor in
metabolism carbohydrates and of certain dehydrogenase enzymes ...one of which metabolizes alcohols and aldehydes.

[zeeclass6]

Well this is interesting. I came across an old lab test from 7 years ago, in 2004. It's the only time (as far as I know) that my B-12 level was ever previously tested.

My B-12 level in 2004 was 1627.

And my B-12 level from last month was 398.

I have taken a B-complex vitamin daily for many years, so it's not like I wasn't trying to get extra B vitamins. And I have always eaten a sensible well-balanced diet.

What would cause a woman's B-12 level to drop so dramatically in 7 years?

I've had Hashimoto's Thyroiditis for the past 15 years. Would that be the sole reason, or might there be something else?

I need to know what else to ask my endocrincologist to test me for when I see her next month.

[pabb]

Originally Posted by zeeclass6

Well this is interesting. I came across an old lab test from 7 years ago, in 2004. It's the only time (as far as I know) that my B-12 level was ever previously tested.

My B-12 level in 2004 was 1627.

And my B-12 level from last month was 398.

I have taken a B-complex vitamin daily for many years, so it's not like I wasn't trying to get extra B vitamins. And I have always eaten a sensible well-balanced diet.

What would cause a woman's B-12 level to drop so dramatically in 7 years?

I've had Hashimoto's Thyroiditis for the past 15 years. Would that be the sole reason, or might there be something else?

I need to know what else to ask my endocrincologist to test me for when I see her next month.

not enough in most B complex tabs/caps to matter...you are apparently not absorbing as well as you were....consider celiac disease...good luck

[zeeclass6]

Originally Posted by pabb

not enough in most B complex tabs/caps to matter...you are apparently not absorbing as well as you were....consider celiac disease...good luck

Thanks. I got tested for celiac about 12 years ago (full blood test for all markers, or whatever you call them) and it was all negative/normal. But who knows...I've been having a more difficult time with my lactose intolerance lately, so I suppose it would not be out of the question to get another celiac test to see whether something has changed in my gut. I do eat a lot of wheat and other whole grains, but have never noticed any overt symptoms of trouble with gluten. Only dairy gives me a direct problem....thank God for Lactaid pills and Lactaid milk!

I will ask my endocrinologist to add the celiac test to my next lab slip. Specifically what should be tested (what should I ask for)? I want to make sure that the test is complete.

[ger715]

Originally Posted by mrsD

Yes, I think all 3 are helpful for some people. R-lipoic helps with mitochondrial functions, and Benfotiamine is a cofactor in
metabolism carbohydrates and of certain dehydrogenase enzymes ...one of which metabolizes alcohols and aldehydes.

Mrs. D. Do you think adding Magnesium lactate and COQ10 acetyl L carnitine with the Methyl B12 lmg, R-Lipoic Acid 100mg and Benfotiamine 150 mg that I am already taking would round out a regimen of vitamins/supplements for aiding the possible regenerating of the nerves?

[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!