what strength?

[handy]

Hi all i have just gone past the 5 years post op and fatigue and tiredness has taken over.

i was thinking of trying some b12 tablets can anyone advise what strength to take.

[Hidden]

It may be that your body is not absorbing B12 and iron, so supplements are a good idea. Sometimes letting them absorb into your body from under your tongue is a good idea. It all depends on how low your levels are; some people have real trouble in raising their levels at all and have to have an intravenous injection, but others manage with proprietary brands over the counter. I think I would consider having a proper vitamin / mineral level check. I have just found the details of an old posting from the now-defunct Food Tube Forum, so I am copying and pasting that below:

Iron is a mineral found in every body cell. It is needed to make haemoglobin, which takes oxygen in the blood to all parts of the body. Iron also plays a vital role in many metabolic reactions. Low iron levels can cause anaemia (low levels of haemoglobin in the blood). the most common symptoms of anaemia are lack of energy, shortness of breath, headache and dizziness.

Some people suffer particularly from low iron levels if all or part of their stomach has been removed. It often depends on how much of the stomach has been removed as to how much Vitamin B12 can be absorbed into the body and this in turn affects the risk of developing anaemia. Some patients report that they are told that their stomach can no longer absorb Vitamin B12 regardless of how much iron-enriched food they eat as it slips through so quickly. Iron, folic acid and B12 are all necessary for the production of red blood cells. Vitamin C in the diet helps to absorb the iron from food, especially if the iron is of a non-haemotological source. Patients who have had their stomachs totally removed will often be put on to Vitamin B 12 injections from their GP; in oesophagectomy cases or where only part of the stomach is removed, this may not be necessary. Some patients have regular blood tests to check their ferritin levels. Some take 200mg ferrous sulphate tablets, some a Vitamin B complex with iron, some take Spatone (an iron supplement) with orange juice daily, whilst some suffer from mild anaemia, shortness of breath or tiredness because of iron deficiency. When patients cannot tolerate the normal iron supplements, an iron infusion or blood transfusion may ultimately become appropriate. So it is definitely worth checking with your doctor.

Increasing iron in your diet (reproduced by permission from the Department of Nutrition & Dietetics, St Mary's hospital, Paddington):

Haem iron, found in animal sources, is more easily absorbed than non haem ( from vegetables)

Animal Sources (haem iron) Clams, oysters, mussels*, liver* (lamb, chicken, pork or beef) - all excellent

Red Meat (beef, lamb, corned beef, beef burgers, pork, venison, veal), liver pate*, liver sausage, kidneys, black pudding, salmon, sardines, pilchards, mackerel, kippers, turkey, chicken, prawns, crab, shrimp, lobster - all good.

* but not if you are pregnant because of very high vitamin A content. Also pregnant and immuno-compromised people should avoid eating undercooked shellfish.

Vegetable Sources (non haem) Enriched breakfast cereals like Weetabix, bran flakes, cornflakes. Pulses, beans and lentils like baked beans, kidney beans, mung beans, lentils, split peas, chickpeas. -all excellent

Dried fruits (apricots, raisins, dates, figs, prunes, sultanas. Nuts and seeds (pumpkin, sunflower, sesame, almonds, brazils, cashew). All good.

Other Sources Blackstrap molasses, plain chocolate, treacle, tahini. Baked potato with skin, enriched pasta, canned asparagus, green beans, broccoli, cabbage, spring greens, leeks, kale, okra, fenugreek, karela, watercress. Breads, chapattis, pitta breads.

You can improve the absorption of non-haem iron by consuming heam iron in the same meal. Vitamin C helps iron absorption so taking food high in vitamin C will help an iron supplement to be absorbed.

Rich Sources of vitamin C Fresh fruit, fruit and vegetable juices (eg ranges, grapefruits, strawberries, mango, guava, papaya, blackcurrants, kiwi, tomato) Vitamin C enriched squash, or diluted fruit juice. Fresh or frozen vegetables like broccoli, brussel sprouts, tomatoes, potatoes, green & red peppers.

Avoid eating things that can inhibit or interfere with iron-rich foods you are trying to absorb: Tannins in tea (including green tea). Drink tea an hour after you have finished eating.

Phytates found in bran (eg bran cereals).

Red wine, coffee, vegetables like spinach, chard, beet greens, rhubarb, sweet potato, bran, soya products, calcium and zinc supplements taken at the same time as a meal or iron supplement.

Eggs inhibit vegetarian sources of iron.

[zookeeper]

Hi

I would suggest you go see your doctor who will give you shots in the arm every so often according to how bad it is.

[lilia]

I am 7 years post op and about 6 weeks ago I decides to limit my intake of tea and coffee. I have a cup of tea first thing in the morning and the odd cup of coffee if we go out otherwise I just drink water. I have much more energy don't fall asleep after lunch am sleeping better and have not had an acid attack. Worth a try!!

[janiehun]

My husband felt the same and although his doc didn't think he needed the b12 jabs he said the tablets won't do any harm and might make a difference. He has just started taking them so fingers crossed they will help. Good luck x

[handy in reply to janiehun]

Thanks I am waiting for blood tests results to see if I need b12 jabs if not will start taking the tablets what strength did you get?.

[janiehun]

Clive is on 500mg once a day. Going to see how he gets on with that and then review later on.

[listen]

Congratulations on 5 years post op! I have to ask for B Vitamin shots from my doctor and I would not have known to ask for them if I would not have been connected to this website because my doctors nor surgeon never told me that I could not absorb the vitamins since my surgery. So the website has been a god sent! I also take magnesium tablets and in between me requesting my B12 shots I do a sublingual B. When I stay on top of the vitamins and my insistence to have the shots at the infusion center I go to I have so much energy. In the UK it sounds like it is almost a given to have these shots given? Here in California you have to insist. The last time I went to the oncologist to have a Herceptin infusion I had to ask the nurse told me she would have to ask the head nurse to ask the doctor which he stated that it was o.k. for me to have the shot. The head nurse stated to my nurse that my levels looked good and I told my nurse Janie to let the head nurse know that I went to a doctor here in my home town of Morro Bay and paid $50.00 for a B cocktail shot and thus would be why my levels were o.k. Hope this helps and have learned from this website that the B vitamins are essential to our energy level as well as magnesium.

[handy in reply to listen]

Thanks for your reply I am waiting on blood results to see if they are going to give me the shots.