Vitamin B12 Shots and Frequency
 

I was hoping someone could help me with the frequency of my vitamin b12 shots. My levels were very low in October of last year 223. After a lot of convincing my neurologist finally put me on shots in December. I took the shots in December and January. Prior, I took oral supplements. I skipped February because my numbers were way up. My b12 went way up to 1309 by January 15th. I just had it tested on Friday and my level is 935. I am a vegan.

My question is how quickly does your body deplete the vitamin? Should I take the next shot in the middle of March or beginning of April? My doctor recommended every other month. Is that often enough?

There is no upper limit set by our government on B12.

I would not stop your supplements at the levels you state. Most of us here at PN keep our B12 at 1000 and above from blood serum.

You really need to discontinue supplements several days before any testing to get accurate results. Otherwise, there may be false elevations. Injections should be 7 days old or so. Oral at least 3 to 5 days.

If you have not been tested for MTHFR DNA mutations, you will not know if injectable cyanocobalamin will work for you. B12 is easiest, most effectively, and affordable to take orally in the form of methylcobalamin. Taken daily ON AN EMPTY STOMACH can give good results and is easier on the body. A large bolus of injection is cleared in 72 hrs, and the rest of the month or longer there is none being provided. Oral use provides daily amounts for the body to send to the needy areas that use it. The liver, bone marrow, muscles, and brain are huge consumers of B12.... but really all tissues need it on a regular basis.

Cyanocobalamin is synthetic and requires activation in the body to its active forms. Methylcobalamin is the main active form that the tissues use. If a person has the MTHFR mutation, this cannot occur so cyano form is useless. Up to 40% of people are thought today to have one or more mutations in this system.

More info here:
MTHFR Mutation | MTHFR Gene Mutation | What is MTHFR? - MTHFR.net

This is my B12 thread. On it are links to studies and medical sites explaining further:
https://www.neurotalk.org/peripheral...12-thread.html

More Questions
 

What dosage of the Methylcobalamin should I be taking daily? I currently have neurological issues (burning pain /slight numbness in feet).

Start with 5mg (5000mcg) daily on an empty stomach. Food reduces absorption, and oral needs high doses to get even a small amount of B12 into the bloodstream.

After 3 months, you should get retested, and see where you are.
You may see progress during that time or not, depending on how long you have been very low. After reaching 1000 or more blood levels, you can reduce to 1000mcg a day, or use your 5000 tablets up 2 or 3 times a week.

It took a long time to get where you are now. It will take time to improve because of that. You probably will need the B12 forever.
If your diet caused this, you will need to supplement daily. If you have the MTHFR mutation you will need methylfolate as well since it is part of the methylation chemistry your body uses to activate B12 and folic acid, so they can work in your tissues properly. The mutation is a lifetime genetic thing.

If you use acid blocking drugs for GERD and heartburn, these drugs interfere with getting B12 from food.

Some people have a fast response to B12 supplementation, so you may see improvements before the 3 months are up.

Methylcobalamin is becoming more common in stores in the US. Walgreen's, Costco, Sam's club sell it now. But you may have to find it online depending on where you live. Amazon, iHerb, vitacost, Puritan's, Swanson's, all have it now. It remains inexpensive, and easy to fix.

Forget about the shots... use your doctor for testing only. Most doctors are not up to date at all on B12 issues.
Here is an example of a medical website for doctors that is easy to read and understand.

Vitamin B12 Deficiency - American Family Physician

This is a very good video. The woman who made it has a book out about it too. She does not go into the methylcobalamin information, on it though, but it is in her book. She is a nurse.
Diagnosing and Treating Vitamin B12 Deficiency - YouTube

This is from a long paper on PubMed, and has a table about the measurement in volunteers who took oral B12 and also had injections.
PubMed Central, Table 1: Blood. 28 Sep 15; 112(6): 2214–2221. Prepublished online 28 Jul 7. doi: 1.1182/blood-28-3-4253

How I Treat: How I treat cobalamin (vitamin B12) deficiency

The only major interaction I have found is that people who have the rare blood condition, called polycythema vera, should not supplement B12 unless supervised by a doctor. This blood condition is where too many red blood cells are made (a genetic error), and since B12 is involved in red blood cell manufacture by the bone marrow, these patients may see a rise in red blood cell counts.

Otherwise, B12 remains OTC (over the counter) for people to buy for themselves. Deficiency is very common today, and when it is severe then shots are used daily for a week or so until the patient rallies. I have seen this being done in nursing homes, where there is staff available to monitor and give the shots in the beginning.
But really, shots are not necessary for the most part, and remain an historical habit. New studies show oral works well, if done correctly.

Thank you.
 

Thank you for the information. I supplemented with Methylcobalamin up through the middle of January. I just started back and have skipped the shot per your advice. So from what you are saying is I shouldn't worry too much about going too high with my level and continue with the methylcobalamin orally between somewhere between 1000 to 5000mcg per day moving forward. The good news is my levels did bump nicely from 223 in Oct to 1309 in January and stayed relatively high at 935 last week. Hopefully, the burning/pain in my feet will go away eventually.

I just started on this liquid product. Take 4-5 half dropperfuls first thing in the morning on empty stomach. This is about 5000mcg per dose. Very pleasant tasting.

Now Foods, Ultra B-12, 5,��� mcg, 4 fl oz (118 ml) - iHerb.com

I also have Methyl B-12 in lozenge form of 1000mcg also by now foods.

I'm sure I became very low when I was in recent hospital/rehabs for knee issue.

I think that it is best to stick with the methylated form of Vitamin B12 (also known as methylcobalamin).

This is because many people have mutations in a gene called MTHFR which means that its encoded protein is not very active.

The full name of that protein is methylenetetrahydrofolate reductase. It is an enzyme which, among other things, converts Vitamin B12 into its active (methylated) form.

People with these common mutations are not able to convert Vitamin B12 into its active form very well.