B12-need advice

My b12 in May was 238 it has now dropped to 150, can anyone explain why such a quick drop?

My gp wants me to have b12 injections but I break out in hives that last ages, so I'll pass on the injections. Is there only one type of injection? Or best b12 tablet?

Thanks in advance for any advice

[Hidden]

I can not say it dropped so much because this or that, I do not know, But you should get treatment, you can try perscribed high doses B12 tablets and see if that helps raise your serum B12. Also different makes of B12 can be tried injections wise. Best bet is to try, ask GP and see what happens. Marre.

[Hidden in reply to Hidden]

Thank you

[Gambit62 Administrator]

Please do take this condition seriously - sounds like you are but just saying that in case. The consequences of not treating it will make the hives look like a walk in the park. Whatever you do, do it as an informed decision - which means talking to your GP, trying to get referred to a specialist ... and probably quite a lot of frustration with people not listening to you and not explaining things very well and a lot of us have been through that so you won't be short of sympathy if you need a rant here.

I'm sorry to hear that you are having hives as a result of the injections. One theory is that this is actually your immune system kicking back in and it will go away if you can bear to persevere though it sounds at the moment as if for you this is a bit of the cure that is worse than the illness.

It may be that you are having a response to something other than the B12 in the injection. In the UK the form of B12 used is hydroxocobalamin, in US it is cyanocobalamin. Methylcobalamin is another option but this is less stable which is why it isn't the form of choice.

Injections are used because a problem has occurred and the normal way of absorbing B12 - in the small intestine - is no longer working properly, though you may still be able to absorb B12 by this route but you will need to take much higher amounts than RDA etc to make sure that enough gets through. Reasons for malabsorption include changes in acid levels, the effects of aging, autoimmune responses that are either absorbing the binding agent that allows B12 to be absorbed (intrinsic factor) or the actual cells (parietal cells) that absorb the B12, and gastric surgery that has removed the relevant part of the small intestine. Options available are:

- injections

- supplementing orally at very high doses in the hope that enough can be absorbed (not going to work in the case of surgery),

- use of sublingual supplements (idea being that B12 is absorbed through saliva in the mouth rather than in the gut)

- patches (absorbing B12 through the skin

- nasal sprays (though can be a bit hit and miss) - most seem to be cyanocobalamin, though it is possible to get hydroxocobalamin as a spray and I personally have found that this works quite well for me (though I use it at doses about 3 x the norm).

Although this is actually US you may find sharing this with your GP useful

cdc.gov/ncbddd/b12/patients...

as it discusses the fact that there are different ways of supplementing.

Unfortunately in the UK the regime really boils down to injections of hydroxocobalamin at prescribed intervals (which seem to be much too long for many sufferers). This means that the other options are only really available in the UK if you can afford to pay for them yourself and they can work out quite expensive. A nasal spray tends to last about 3 weeks for me which means it is costing me about £1 per day ... but as the alternative is being a zombie - struggling to move, stay awake etc for weeks on end between injections and not really being able to work or support myself it's probably a small price to pay.

You can be B12D for some time before symptoms actually show because lots of B12 is stored in the liver - once this is depleted - which can take years - then things can go downhill at different rates for different people. The levels you are reporting are low.

[Hidden in reply to Gambit62]

Thank you for such great info and for pushing home the importance of treatment.