How do you figure out how much to take? I don't have my PCM's support on this at all. At least I don't have the support of the person filling in for him. (He's doing a fellowship at a civilian hospital at the moment.) My number is at 548 but I have PAINFUL numbness in my hands and feet along with shaky balance. I'm thinking I'm going to need to buy the shots myself and go for it and I know that one kind is easier for the body to absorb than the other but....how much? My hand was numb for three days (my non dominant one) and she insisted it was carpal tunnel.

Welcome to NeuroTalk.

You don't need shots to supplement B12. Here is a long thread with alot of medical links including to Dr. Snow, who is an expert on the subject:

http://neurotalk.psychcentral.com/thread85103.html

Near the end of that thread is an article from Dr. Snow that states he found a small number of people who seemed normal with B12 levels from testing, who still benefited from supplementation.

Oral forms do work, if taken on an empty stomach. Use the methylB12 form which is active in the body, not like cyanocobalamin which is synthetic and requires methylation.
Some people lack the enzymes that methylate folate and B12 so using the active forms works better for them. (it is called the MTHFR mutation).

Since there is no upper limit dose placed on B12 you can take it yourself. There have been no studies ever showing toxicity to it.

Since you are fairly normal you can start at 1mg (1000mcg) oral daily, on an empty stomach. Only about 10% or less of this is absorbed in people with no active intrinsic factor.

There are other nutrients that help with PN symptoms. B12 is not the only player.

http://neurotalk.psychcentral.com/thread121683.html

Locally it was hard for me to find just plain B-12. I found a complex, but B-12 was the last ingredient. I feel positive effects with the B-12 shot when I was hospitalized last year but I didn't realize how much until I lost that in my system. I went back to my pychiatrist (I'd stopped seeing her because of a bad experience in her office but my dr's replacement refuses to handle my meds so back I went) and she prscribed me the shots. I just have to hunt down needles now.

Hi WickedRose,

If you're really into needles, fine. I can't stand 'em, so I've been going with the methylcobalamin mrsD recommends. It can be found online in 1000 & 5000 mcg doses, which are equivalent to the injectable dosages:
http://www.articleclick.com/Article/...jection/930880
I believe the nuggests will be much cheaper than injectable+needles anyway, depending on your insurance.

On occasion, I drop a 5000 mcg nugget into a bottle of 5 HR. ENERGY. I DO NOT recommend this on a regular/daily basis, as the 5 HR. ENERGY product contains other ingredients (like B-6) which could be problematic if taken too much/often.

Doc