Pernicious Anaemia Society
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G.P. changed husbands B12 injection to tablets


My husband has all the symptoms of B12 deficiency and 7 weeks ago had it tested.

Level was 222 range 180 - 1100. G.P said he was depressed but we disagreed and eventually she said he could have the injections.

He had the first one and initially felt worse (which I believe can happen) but over the weeks there has been a slight gradual improvement.

One lingering symptom remains and that is that he feels breathless. He had had a chest X-Ray and blew into the metre and both results were good.

He went back yesterday for the results and saw a different G.P. she said there had been a recent survey which revealed that tablets work as good as injections and has now cancelled his next injection.

The tablets she has given him are Cyanocobalamin 50mcg one a day.

Does anyone know if these are as good as the injections as from my little knowledge the tablets will not work as well, I do not even think they are the lozengers that dissolve under the tongue just the one's to swollen with water.

Thank you browny

17 Replies

I am lucky enough to still be injecting at home but my father is in a similar situation to that described here. We were recommended to use the sublingual tablet Dibencozide (available from Amazon). It has had good effects so far.

Good luck!


Hi, Many thanks for your reply, we will look into this. I have heard of the Jarrow B12 but not Dibencozide, again thanks for letting me know.

Best Wishes browny


If he has auto immune , (do check back in his family) only injections will work because the recepters are being or have been destroyed , by auto- immune I mean -: Diabetes type1 , Thyroid Hypo , Pancreatic Insufficiency , Pernicious Aneamia , Adrenal Hypo , desroyed by your own immune system . If tablets dont work its a case then it is a case of believing the NHS or self medicating you find details on this website it isnt expensive , but B-12 levels need to be top of the range .


Hi Many thanks for your reply, my husband had the test for P.A. and it came back negative.

As far as he knows there are no family members with auto immune conditions so we don't really why his B12 is low. He does suffer with IBS and does like a drink so maybe this is contributing to it.

We are going to buy the high does B12 lozenge's as the tablets the G.P. has given him are only a small dose and I doubt they will raise it much if at all.

Best wishes browny


AAAgggghhhhh! A recent survey saying the 50 mcg B12 tablets are better??? I doubt that very much! What did she do, stop 10 random people on the street and ask them what they thought?

I would be inclined to return and very politely ask for a copy of said "survey". There is some movement (worryingly so) towards the idea that oral cyanocobalamin is as good as injections at treating PA, but that research was based on doses of 1000 or 2000 mcg per day, and these studies are always measured on the response of blood levels, rather than on how the patient actually feels. As with anything, oral supplementation might work for some people, but do nothing for many others.

Having said all that, there is no doubt that 50 mcg oral B12 is absolutely and completely useless for anyone with B12 deficiency which is not caused by dietary factors (i.e. veganism). From the NICE guidelines:

"Be aware that oral cyanocobalamin is suitable only for the small number of people with proven dietary deficiency of vitamin B12. It is available on an NHS prescription only for a person who is a vegan, or who has a proven vitamin B12 deficiency of dietary origin, and the prescription must be endorsed 'SLS' (Selected List Scheme)."

She has no business prescribing these tablets to your husband. Save the prescription charge and go and buy a large packet of smarties instead, they'll have much the same effect but taste nicer.


Also you can show this Pulse Article to your doctor, which does mention, and provide a link to, the oral B12 study:

I think you have to register to see the article, but it's free to do so.

Also, re. your hubbies IBS, you should ask your doc to test him for Coeliac, Crohns, H Pylori, Giardia (intestinal parasites), and tapeworm, which can all lead to nutrient deficiencies. The IBS label is often given based on symptoms alone, without proper investigation.


Hi Hampster, many thanks again, I could not believe it when he came back from G.P. with these tablets. I wish now I had gone with him . I have said lets make another appt. but he said no as he feels worse when he comes out of the surgery then when he went in. I have read the Pulse article and I am going to print and take it to G.P

I have just ordered him some Jarrow 5000mcg.

The only test he has had regarding his IBS is for coeliac (our daughter has it) but the blood test came back normal.

I will try and persuade him to make another appt. to ask for tests re his IBS and discuss the B12.

As I replied to johnbarriesmith we do think there are any auto immune conditions in his family but we have just realised he had Psoriosis (which I now understand is a auto condition) about 20 years ago which eventually cleared but still gets flare ups in his scalp.

Many thanks again for replies.


B12 50mcg tablets have the following note by them in British National Formulary:

The symbol Considered by the Paediatric Formulary Committee to be less suitable for prescribing is used to denote preparations that are considered by the Joint Formulary Committee to be less suitable for prescribing. Although such preparations may not be considered as drugs of first choice, their use may be justifiable in certain circumstances.

So the GP is actually choosing to be in a position in which she would have to positively justify their decision to prescribe them, if challenged.

The somewhat controversial Cochrane review of oral vs injected B12 used 1000 and 2000 mcg doses.




Thanks Rod for your reply.

When G.P. said to my husband he could take the B12 tablets instead of the injections, she did not tell him the strength of them. It wasn't until he came home and showed them to me, I said they are not going to do you any good and I insisted he went back to see her, but he will not.

He has up until now enjoyed good health and I am afraid he is the type of person who will only go to G.P. if I force him, I have kept on at him but he still refuses to go back.

I have ordered him some Jarrows 5000 lozenges so hopefully these will help him

Best wishes browny.


Blimey Rod, 4 months, is that it? This massive swell of change towards high dose cyano is based on response to tablets in less than 100 people over only 4 months? What about the long term effects? Disgusted.


True - but it makes even more of a damning case against the GP.

It is difficult to think of anyone who should take 50 mcg cyano, isn't it?



Quite. If you're interested I found this old study recently about the ineffectiveness of this dose, the poor woman in the study ended up with stomach cancer, and goodness knows how she actually felt over the 10 years on them:


How is it that we are still in the same place, in so many ways, all this time later?


We had been told by our doctor that the best is to have the injection as the tablets does not work as good .


Cyanocobalamin is not the form of B12 to choose. That is the inactive form of the vitamin and needs to be changed in the cells into the active form methylcobalamin before it is of any use to the body. Many people lack the cell enzyme to do the conversion so are advised to take the latter. Solgar do an effective sublingual one and it is available on Amazon UK. If you look up mthfr,net you will be amazed at the information on there about this situation. If you would like any more info about methylation please feel free to contact me. Barbaraj



Many thanks Barbara, I have sent for some sublinguals from Amazon.

I will take a look at mthfr,net this evening, and thank you for the invite to contact you for more info.

Best Wishes browny


Hi, on reading this article, i had to reply i had the b12 loading dose 2 months ago, after a reading of 155 i had my 2 month injection yesterday, also have pernacious anemia and also been changed to cynaocobalamin 50mcg tablets. All symptoms got better apart from completely fatigued legs. My reading from injections has dropped from 155 to 140, confused. Maybe its because tablets will boost daily.


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