A question about vitamins and PCS recovery. Would it be overkill to take a B-50 supplement in addition to the following vitamins and minerals (which are already contained in my daily multivitamin)? Any comments or suggestions would be much appreciated.

Vitamins

Vitamin A 7500 IU
Beta Carotene 2500 IU
Vitamin C 150 mg
Vitamin B1 25 mg
Vitamin B2 50 mg
Vitamin B3 25 mg
Vitamin D 800 IU
Vitamin E 100 IU
Vitamin B5 25 mg
Vitamin B6 25 mg
Vitamin B12 1000 mcg
Folic acid 800 mcg
Biotin 25 mcg

Minerals

Calcium 100 mg
Magnesium 100 mg
Zinc 25 mg
Chromium 500 mcg
Selenium 400 mcg
Manganese 2 mg
Iodine 0.1 mg
Vanadium 25 mcg
Molybdenum 25 mcg
Copper 1 mg

I personally don't think you need a B-50. You might investigate P5P (pyridoxal 5 phosphate) only instead of B6, just in case you are not converting...but that would be optional.

I would not count on the magnesium as mixtures are usually oxide form for economy and new studies show it is mostly not absorbed, and remains in the GI tract.

Take that vitamin on an empty stomach or the B12 will not necessarily be absorbed.

That is all I see for now.

Your multi is high on B12, but you still may not absorb the B12. Only a blood test can tell if you are absorbing your B12 and what your folate level is. The B6 is very low. I have never used the P5P MrsD mentioned. I do take a B-50, actually I take 2. I do not get my B's from a multi. I don't take multis. Instead I take a prepackaged assortment from Costco that includes a B-50 and the other good stuff. To that, I add 100mgs B6, 250mcg B12, a second B50, 400 mgs niacin, 1000 mgs of C, 1400 IUs of D3, 300 IUs of E and a long list of micro-nutrients and minerals/metals

By taking about 400 mcgs of B12, my blood B12 is just right. With 1300mcgs of folic acid, my folate is just right.

If you are not absorbing the B12, you can try taking it by sub-lingual drops.

The concept is there is an extra needs for the B's to help the brain detoxify from the injury. My regimen was prescribed by an MD almost 30 years ago to help me recover from a severe depression. Within 8 weeks, I was back to great shape. When I stop the regimen, my moods get messed up and a whole bunch of less than desirable behaviors. My wife can tell when I have missed a few days.

This needs to become a lifestyle. The injured brain needs to stay properly fed.

As I mentioned in other posts, this approach takes a few months to see the real benefits. A side benefit is a much improved immune system. My allergies are almost non-existent when I an on my regimen. I also rarely get sick.

There are some (me included) who believe that vaccines, especially those derived from dead cell viruses, are not good for a sensitive brain. When the immune system goes looking for the invading virus and only finds dead cells, it tries to find something similar to attack. Nerve cells (brain cells)can get caught in the cross-fire. Plus, the antagonist (a substance that antagonizes the immune system into a response) in the vaccine can be rough on brain cells.

Live cell vaccines do not cause the same kind of immune reaction and do not usually have the antagonist in them since the immune system can find, and identify the weakened live cells and develop antibodies properly targeted against it.

P5P is the activated form for pyridoxine (B6). B6 has to be converted to P5P in the body using pyridoxal kinase enzyme.

Some people fail genetically at this step and B6 will build up in the blood from not being utilized and may cause neuro symptoms.
NOW company makes an affordable P5P product...which should be enteric coated to bypass the stomach acid, for best results.

People with conversion problems may show high homocysteine levels as a test result... because pyridoxal, folate and B12 are necessary to convert homocysteine to SAM. Having a homocysteine level run is a good indicator to show if methylation problems exist. About 10% of the population cannot metabolically handle this process and need special forms of the vitamins. The special folate is called methylfolate.
This DNA mutation affects folic acid which has to be methylated to methylfolate in the body to work. The special B12 is called methylcobalamin.

Thanks for the responses - so, what sort of blood work test should I be requesting (is a "complete" blood works test sufficient)? Can my family doctor's lab do this, or do I need to go to a specialized lab?

Also, could you please summarize what variables I should be looking for in the test results? (Eg, B12 and folate levels...anything else?)

You will want a test result of 400 or higher on serum B12.
Or you can have an MMA test, which should be normal or low to indicate active B12 utilization.

Or you can have a homocysteine test which should be 8 or lower.
(some ranges go higher for normal, and that is controversial.)

It is not common to be low in B6. But the test does not distinguish P5P levels. Some people at PN board here do have reactions at 100mg a day of B6. So we tend to stay more conservative about it, for that reason.

Your vitamin seemed adequate to me. But don't rely on the magnesium being useful. See if the label distinguishes the type.
If it says Oxide alone or Oxide and chelate, assume none is really bioavailable to you. Most mixtures use oxide form.

Thanks, MrsD.

Is there some way to measure magnesium levels to determine if it's being absorbed? You also mentioned accumulation of unabsorbed magnesium in the GI tract - is this something to be concerned about, or does the body simply flush it out over time?

Magnesium in the GI tract that is not absorbed acts as a laxative.
Phillips tablets are magnesium oxide.

You can also apply magnesium as a lotion. CVS makes one called
Epsom lotion. There is another online available from some suppliers called Epsom-It...but it tends to be more expensive.

Oral forms should be a chelate, like gluconate, citrate, carbonate, lactate, etc. The gluconate one is called Magonate.
SlowMag is a chloride in delayed release, which allows for lower dosing twice a day. They have this at most WalMarts.
3oz of unsalted almonds have 270mg and getting magnesium from foods is an option.

Interesting - I actually eat almonds quite a bit (usually with my cereal in the morning), so it sounds as though I may be getting enough from my diet.

Thanks for your help.

Mag citrate is very affordable and easy to find.

My doc suggests target B12 levels of 800 to 1000 pg/mL and folate of about 20 ng/mL.

The B12 is just above the high end of the common suggested range of 200 to 840. The folate is at the top of the suggested range.

Healthy brains may do fine at the lower ranges but healing and stress are a big consumers of B12 and B6.