There are differences between people, who can benefit from B12.

I think in your case, having a tentative diagnosis of autoimmune disease...3 months of very high dose steroids, the hyperbaric oxygen treatment, etc,
your needs are probably (no guarantee) for remyelination of damaged nerves.

You are very young to have failure of intrinsic factor. But it can happen.
If you were totally vegan before you became ill? Or if you used acid blocking drugs to protect your stomach during that long haul with Prednisone.

Here is an article that suggests Omega-3 for damage to the nervous system.
http://www.sciencedirect.com/science...bdd1ed86239c46

In order for the Omega-3s to work you do need the 3 Bs... B12, folic acid and
B6. So if you want to try and get that pain out of your legs...I'd give this a try. It takes months to repair, and you won't see sudden results.

There are going to be people here reading this forum, who have hereditary errors in B12/homocysteine chemistries. There are going to be people with malabsorption from disease (like Crohn's), or damage from chemotherapy, or chronic damage from lack of stomach acid, or destruction of the cells that make intrinsic factor.

You can also try to increase you food consumption of antioxidants, like that article suggests. Red, yellow, orange, purple fruits and veggies are high in these.
Broccoli is very good too.

You are young, and I think you can heal. But healing takes time, and some effort on your part.

Paul, not at all.

It is important even when we think we know what we are doing to be cautious and continue to investigate, research and learn.

I just learned a few momments ago that supplementing with B12 in mega doses can cause Potassium depletion. I do not have any more information than that at the momment, and found this from reading something the author of "Could it be B12" said. I am trying to find more information on this at the momment.

However, this is interesting as for the past few days, I had been experiencing constant excessive tightening in my calf muscles that prevented me from being able to pull my foot up all the way, and was quite painful when I would try. Attempting to stretch the calf did not work either.

I didn't take my methyl-B12 supplements for 24 hours, and during that time, the tightening/spams lessened. A few hours after the 24 hours were up, it was gone.

Interestingly, after almost 6 months of absolutely no arrrhythmia, I started having some isolated palpitations in the last couple of weeks. Potassium deficiency can result in both, the heart being much more sensitive to potassium levels.

Funny, I noticed I've been eyeing the bananas on the counter more than usual recently.

the potassium connection is much greater in people injecting B12.

When you take it orally, not much is absorbed in reality.

You might want to consider magnesium for those feelings and palpitations.

3oz of unsalted almonds have 270mg of magnesium.
Edamame beans have good levels of both potassium and magnesium.

well, as I looked into it further it appears that it is when treating severe b12 deficiency induced anemia intensively with b12 that huge draws on potassium can occur specifically related to the red blood cells, even leading to fatal hypokalemia. I am not dealing with hematological issues, so this doesn't appear to fit.

Since doctors tend to inject 1000mcg daily during "intensive" therapy.

Here is ONE case from 1987:
Typically oral therapy is not considered intensive...since only a few micrograms are absorbed from one dose. It is a slow process, taking weeks/months.

Hi, all.

Sorry I've been away for a while. Glad to see so much activity here.

A drop in potassium is generally brief, and I suspect that the people who are seriously affected are in very advanced stages of deficiency and very fragile.

The danger as far as I know is in masking a B12 deficiency with folic acid supplementation.

It is unfortunate, but one can go through many doctors (even holistic ones) before finding one who isn't dangerously ignorant regarding B12, it's diagnosis, treatment, etc. Ironically, the MD who plagiarized my writing and put it on his commercial site is "holistic."

In my opinion, the danger is in not getting the B12 one needs, not in taking it for life.

Wow, you guys have been busy.

rose

Hello mrsd, theresej and rose,

Part of the reason for my decision to use oral B12 rather than injections was the risk of fatal hypokalaemia. I have ventricular tachycardia, a potentially fatal cardiac arrhythmia. Using the oral dose did not completely protect me because I still suffered a very frightening episode of hypokalaemia after taking my first oral dose of 1000µg cyanocobalamin, when my serum B12 level was 100 pmol/l; I did not take Slow K until after this episode. This is how my then GP reacted to my hypokalaemia:

Here are quotes from reputable sources (I added the bold):

This is from Cyanocobalamin, Hazardous Substances Data Bank, TOXNET, NLM, reference J6 in the References page of my web site:
This is from Medsafe NEO-CYTAMEN Data Sheet, reference J6:
The second quote also is relevant to the potential problem of masking folate deficiency, by commencing B12 therapy without first ensuring that there is a not a folate deficiency.

Another problem is that Slow K interferes with absorption of B12. I only used it in the first two weeks in 2005.

There are some more details of my hypokalaemia episode on the My Story and Vitamin B12 Deficiency - Doctors pages of my web site.

Please post any comments or questions to this thread. If you wish to contact me for a private discussion, please Email me from Paul in the Contact page of my web site at http://www.paulgolding.id.au/.

Paul

Have you been evaluated for renal tubular acidosis? This is a kidney disorder
that wastes potassium. Paul, did you go to the ER and did you get a serum reading showing you were low in potassium during that
event? Did you have megaloblastic anemia?
Since you already had that ventricular issue for years, you could have been hypokalemic for a long time already. I suspect you have other issues, besides the low B12. You already state a DHA (fatty acid ) deficiency and EFAs help regulate heart rhythm. Also magnesium. If you are not converting to long chain EFAs like DHA that could mean you are low in magnesium and B6.

Often when people get into a severe state like you describe, there are many variables at work.

One dose is not enough time wise to increase production of red blood cells. This takes place in the bone marrow and
is a time dependent situation. I only found one page on PubMed with one case on hypokalemia.

The quotations remind me of many references that have not been updated for many years. Of course, the context may tell a different story, but I believe they are operating on the assumption that everyone who is B12 deficient has anemia (megaloblastic or macrocytic anemia wrongly referred to as pernicious anemia). That would mean that some of the people they are referring to have become extremely fragile, and depending on how they have tested the subjects, some may be B12 deficient even though the docs think it has been ruled out.

Regardless, since folic acid is added to many foods, and since malabsorption of B12 from foods becomes quite common as people approach and pass middle age, B12 deficiency is more likely and extremely damaging. Also, because B12 deficiency is very likely to go undiagnosed by ignorant physicians (most on this issue), a person would be statistically far safer to take their 1000 mcg B12 and separate B complex at another time of day than wait to be diagnosed.

Unless a person has some other problem, the likelihood of serious consequences of brief low potassium due to B12 treatment is almost surely because B12 deficiency has been untreated far too long. And I have yet to see anything that convinces me a person would experience a potassium dip if they didn't need the B12. I'm open to any credible information to the contrary.

As suggested here often, when people have serious symptoms and begin B12 treatment, it is a very good idea to make sure potassium-rich (brief dip in potassium when beginning to get the needed B12) and iron-rich (longer heavy draw on iron stores when the body works on repairs) foods are eaten and a B complex taken.

It is also a very good idea to insist on a ferritin test. If iron stores are high, of course a person would not want to eat a lot of iron-rich foods and would certainly want to avoid anything fortified with iron, Most docs will not order the ferritin test unless the patient asks, and high or low iron often goes undetected because the more common and less sensitive tests are relied upon. Those common test results can be smack down the middle of the "normal" ranges while a patient is low or high in iron and/or B12.

rose

Red blood cells contain alot of potassium. In fact if a blood sample is improperly taken, too tight a tourniquet or improperly stored so that the cells burst,
the potassium reading is factitiously elevated for that test (falsely high).
The red cells dump the potassium into the serum where it reads inaccurately.

So the reverse also occurs during rapid cell formation. As the cells are stimulated to grow faster, they consume the potassium. If they are not doing that (no megaloblastic anemia is present), then the B12 goes elsewhere, and hence no fall in potassium occurs. We need to consume quite a bit from diet daily--- the new suggestions are 4.7 grams a day.

People can lose potassium thru the kidneys if they have renal tubular acidosis, take steroids, or have chronic diarrhea/vomiting. Diuretics given for blood pressure also deplete potassium (except for Dyrenium and Spironolactone).

I think that is why the literature has so few reported cases. The patient has to be in a medical crisis of sorts already, to react to B12 with hypokalemia. And I would expect injected doses to be more problematic with it.