I know it has to be on empty stomach, but how long after you take the b12 orally can you have a cup of coffee ( with sugar and creamer ) ?
I take my probiotic in the morning on empty stomach, could I take them together ?

I'm a newly diagnosed with b12 deficiency, will start taking 1000mcg methyl type tomorrow.
I'm newly diagnosed, because my dr. 2 and 1/2 years ago didn't tell me that a level of 259 is low. Is it a "good" thing though that my level staid almost the same in these 2 and a half years ( now is 244 ) ?

Thank you !

I'd take 5mg daily on an empty stomach for at least 3 months.

The new low (which labs do not still use) is 400pg/ml.

It is fiber and volume of food in the stomach that absorbs the micrograms of B12...and hinders passive absorption in the small intestine.

If you get up in the night to use the bathroom, you could take it then too. (don't eat with it though)

So does that mean don't drink a coffee at least for 1/2 hour ? and don't take it with probiotics ?

If the milk/cream curdles in the stomach, it could absorb the B12.

The probiotics would have a binder in it...a flow enhancer to make the product, and it could bind the B12 too. Complex it chemically so that the B12 would not get to the transcobalamin in the intestinal wall.

We have to assume you don't have good intrinsic factor in the stomach for some reason, so we assume the B12 has to be passively absorbed which is tricky. Out of 1000mcg only about 13 make it thru...the rest is lost.

It is only very recently that we have learned that this passive absorption is possible... still many doctors don't know it yet. And they don't know the new low of 400pg/ml either.

Thank you for your quick answers !
I will have to take my probiotic some other time during the day ( even though first thing in the morning was the best ) and the coffee will have to wait an hour after the vitb12. I will try to take the vitb12 when I wake up in the morning but before I get up ( I usually do wake up a couple of times anyway ).
I will start with 1000mcg, I'm afraid of a reaction to start with 5000mcg, but I'll work up to 5000mcg in a few weeks. This is so new to me so I'll try to take it slowly.