I've been saying something about B12 a bit wrong -
 

Hi,

I just realized that I've been saying something about B12 replacement therapy a bit wrong.

I just realized that when someone uses Methylcobalamin lozenges for replacement, that it requires a whole month of taking them every day before it equals B12 shots.

While it is true that a 1,000 mcg Methylcobalamin lozenge a day (for a month) is about equal to one B12 shot a month, what I forget when I'm talking about how quickly you will see and feel results, is that at least a whole month of using the lozenges must go by.

When I tried to switch to lozenges from shots, I experienced my B12 symptoms radically increasing.

I had to go back to shots immediately.

I now begin to see that had I not had injectable cobalamin to go back to, and if I had continued using the sublinguals, I probably would have had an easing off of symptoms after a month or two.

The thing was, however, that I was having a shot a day at that time, and I was not using 6 of the 5mg sublinguals a day. So even after a month or two, I would not have been getting as much B12 replacement as I was having by using injections.

I'm writing this because I've often written about how effective B12 is, and that if someone has ridges on their fingernails and loss of moons, and also has other symptoms of low B12, and they begin using Methylcobalamin lozenges they will have noticeable changes for the better in a few weeks.

That's my mistake, it would be a few weeks if they were having injections, but with the lozenges it will take at least a month or two because of the gradual way that they work.

I hope this is clear.

I should add that one of the reasons it's good to keep an eye on your fingernails, is that the ridges reduce in size and begin to go away, but not overnight. In the last ten years of B12 replacement therapy, the huge thick ridges that I had are nearly entirely gone on many of my fingernails, but on some are reduced in size, not gone.

Actually, it is quite common for people low in B12 to have an obvious response to oral B12 within days to a couple of weeks. Several days is quite common. It is absolutely not the case that it takes at least a month or two.

As a matter of fact, even if one were using the far less efficient cyanocobalamin orally, the response would usually be in far less time than that.

It is more complicated than it sounds. The dose one gets with a shot of cyanocobalamin must be converted to usable B12, and then a portion of that smaller amount is stored or used, and the balance goes out with the urine.

One who malabsorbs severely does get a smaller amount with a day's oral dose of 1000 mcg, but it is taken every day and there is not the gap between doses (most generally a month when being treated by a physician). The person taking an oral dose is being exposed to B12 every day and has an opportunity every day to store some.

And, when methylcobalamin is taken there is no need for the body to convert, so more is delivered.

In addition to all of that, there are individual differences. A person who does better on shots over the long run would be rare.

rose

I think the operative element here is the amount of B12.

Clearly a shot a day for a month is a lot more B12 than one 1,000 mcg B12 lozenge a day for a month.

It is my feeling that people who have replenished their B12 supplies using lozenges, and who have had episodes when things stopped improving and instead got worse, were feeling the effects of some temporary additional drain on their B12, like a particular stress, and that had they realized the connection, they could have upped the amount they were taking with beneficial results.

New Here hello from Tassie in Ozzy Land
 

I have been reading all the posts about B12 deficiency....... and wondered if you could point me to a website/reference that shows moons and ridges are damaged/missing with B12 deficiency? I have pictures of my thumbs and fingers if anyone can 'read' them.

Also I am curious if anyone has had Hcy and MMA testing done? I truly believe that I may well be seriously B12 deficient even with a reading of 500+

I have given myself a B12 injection .... one every other day (3 in all) these last few days but seem to get worse symptoms after each injection. Symptoms like a sore tongue, extreme chilling coldness, headache, pounding in my chest........ this is most frightening. Anyone care to speculate?

Thanks for listening.

Clare in Tasmania

Karen,

Again, it appears that you are a very rare case, if that is what happened to you. And you should do what you feel is right for you.

Certainly some people store B12 very badly, and you may store so badly that you need a shot a day. I will not dispute that, as there is a rare exception to most rules.

However, the possibility of anyone here having that situation and benefitting more from a shot a day of cyanocobalamin than a daily methylcobalamin is about as likely than being hit by lightning today.

What you refer to as getting worse has been explain repeatedly here as the healing process, whether with cyanocobalamin, hydroxocobalamin or methylcobalasmin. When one has been damaged badly, there is no guarantee that improvement will happen at all. For most people, the regular dose of usable B12 (methylcobalamin), as opposed to cyanocobalamin that must be converted to methylcobalamin, optimizes the possibility of improvement.

rose

Hi Clare,

Yes, some people have been shown to be deficient with B12 levels higher than that. It is not common, unless one has begun getting some B12 and that is being measured in the blood, but it does happen. Usual people who are elderly, but I know one who was shown deficient (with MMA) while well over 500, and she was in her 40s.

I will speculate that either you are benefitting from the B12 injections and experiencing temporary worsening of symptoms or you are sensitive to some other substance in the injected product.

Your fingernails may or may not benefit from more B12, but they do not diagnose or rule out B12 deficiency.

rose

Mcharris

I can't see the pictures very well on my computer screen. They are very little.

Did you go to my site? I have some large images of my fingernailss over a period of time, and some show how they look when the infection I have in my jaw flares.

Your tongue may be sore because you are short of other B vitamins in addition to B12. It's good to take a Mega B of some sort while you are having B12 replacement.

I don't know about that chest thing. I had it badly this spring and again this summer after some intense stress. I stayed in bed, and I found that B12 shots helped, but it was weeks before it resolved, and yes, it was very scary.

Are you taking a mullti with all the Bs in it along with your B12 shots? A swollen or very red tongue can be a sign of low B vitamins.

Stick with it. Remember, when you are very low on B12 it isn't something that one shot or even three in three days can repair..

A 500 level for a blood B12 test is still lower than the low normal in Japan and some other countries. I have a great article on my site about how the low in Japan is 550 because that's the level at which changes for the worse in cognition can be seen.

I still haven't found the great article I have someplace on how if a spinal tap is done to test, then the level for Methylmalonic can be 600 times lower than the other tests for it... I think that's it.

What that basically says is that the blood can rapidly change to look way more healthy than we actually are, deeper inside out bodies.

I hope you get a mega B if you aren't taking one already, and I hope you stick with the shots... no pun intended. :)

Rose,
Isn't this site for people who do have unusual health circumstances?
If it is, as I believe it is, then my experience may not be rare in this community.

I understand that you think it is a normal part of the healing process to get worse, I disagree with you.

In my experience I always improved except when there were additional stresses and then I got worse until after I increased the amount of B12 replacement I was having to handle the drains from the additional stress.

In terms of your "lightning" analogy, you are wrong. You have no data to indicate that is even remotely true.

You have been writing to people in the peripheral neuropathy forum for years, and many of them still have the same pain levels I had but which went away after I had a shot a day for several months while I had tetanus.

It does a disservice to people to encourage them to take less B12. What people need to do is find the right amount for themselves by recording their symptoms, their shots, and the changes in their symptoms.

Please show me some medical, scientific research that explains how people who are taking B12 get worse as a part of the healing process.

It's important to remember that one doesn't take B12 to improve one's fingernails, one takes B12 (Methylcobalamin or shots or Hydroxycobalamin) to improve the health of one's body, to include parts of it that we cannot see but which are reflected in the health and appearance of our fingernails.

Hi again, Clare,
I've looked as hard as I can at your images, and I think that it's possible they show that you don't have ridges on your nails... is that true? And they show that you only have moons on your thumbs? is that right?

I don't quite understand the difference between what the two things show... but I do know that my ridges reduces in size and went nearly away before my moons began to reappear, and I also know some people with exceptionally bad ridges who function great in their jobs... I had a hard time functioning because of my memory problems and problems related to the peripheral neuropathy that I had.

Do look at the photos on my site. They are pretty clear. Quite a few people with sites have asked me if they can use them, so you may well see them on other sites, as well. But of course I think my site has the best explanations. :)