Pernicious Anaemia Society

Additional B12 supplements

Hi, I am a 50 year old woman and have been diagnosed with pernicious anaemia with a B12 level of 91. I have had 4 loading doses of cyanocobalamin and due my next in about 2 months. I actually am feeling better apart from an outbreak of acne! But.... now terrified this feeling of well-being won't last. If I self medicate with over the counter B12 supplements will my body absorb them? I don't have the healthiest diet and a very stressful full time job. It had gotten so bad that I used to have to go and sleep in the car over lunch as I couldn't keep awake.

9 Replies

People vary very much in how long they retain B12 .... and it also varies with the different forms.

Good that you are feeling much better after the loading doses.

Treatment regimes vary from country to country but generally I think maintenance doses for cyano should be monthly so a bit surprised to see that your next shot is in two months time ... but that isn't necessarily a problem.

You can't overdose on B12 - though the acne you mention is quite a common occurrence during the early treatment of B12 - it usually goes away as the immune system sorts itself out again.

In theory you may be able to supplement by mouth as 1% of B12 is absorbed passively - ie outside the ileum. That means you would need to be taking at least 100% of RDA to be getting RDA amount - though generally people would go for somewhere between 1-5mg = 1000-5000mcg. Generally vitamin supplements contain a lot less than this.

Availability of different types and forms of B12 depends on what country you are - particularly in relation to injectible forms - though other formats - eg sublingual tablets, nasal sprays, skin patches - are vitamin supplements so tend not to have any restrictions on them. The idea behind sublinguals, nasal sprays and skin patches is that another membrane is being used to absorb the B12 so the problem in the gut should be by-passed. They work for some people and not for others so it's a question of try it and see I'm afraid.

make sure your folate levels stay high as these can dip as the body uses up folate to process the B12 it now has - best form is food but you can also supplement though there are some risks - upper limit for folate/folic acid tends to be around 800mcg a day.

May be time though to look at your lifestyle and think a bit more about your diet and eating habits though :)

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Thanks. I live in Scotland and that's the standard schedule 4 in the first month then 1 injection every 3 months. I'll give the vitamin supplements a try. Over the past year I have just managed to function. I now feel like looking after myself.

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I know exactly what you mean!

Just to give you an idea, I have found B12 Boost spray and Jarrows Formulas Methyl B12 5000, suggested here, that I have bought from Amazon have helped me but there are lots of other products from other sources available.

The most effective source for me is hydroxocobalamin from my Dr (England) which I currently need daily until my symptoms clear, so don't give up on the idea of more frequent dosing from your GP if you need it.

Good luck!

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check that you are receiving cyanocobalamin and not hydroxocobalamin. the format of choice in the UK is hydroxo and yes that is once every 3 months but if you are being treated with cyanocobalamin - even in scotland - it should be monthly.


Ooops just checked and it is the Hydroxo.

Ive also ordered :

Solgar - Folate (Metafolin)800 Mcg, 100 tablets

Jarrow Methylcobalamin B12, 5000mcg, 60 Vegetarian Lozenges (5000mcg, 60 Vegetarian Lozenges) (120)

I'll give them a go!

Thanks for all your replies



Makes more sense now - easy mistake to make ... and as nobody really seems to be able to come up with any scientific evidence to support 3 months it is more than possible that you will run out of b12 before the next shot is due.

Hope the supplements work


I have bought exactly the same supplements; Solgar Folate, Jarrows Sublingual B12, I've also bought some Magnesium supplement , vitamin D3, supplement and K2 - MK7 supplement, also some Iron sulphate.

Recovery progress is a slow painful process.


I'm sorry you've had a difficult time. If you are feeling better that's hopeful, isn't it? I see no reason why you cant find a type of supplement that works for you, should you need extra.

I'm sorry about the side effect of acne. It seems to occur when B12 builds up in the skin and triggers bacteria to be more inflammatory, that's true thought now.

I have struggled with acne from b12. Everyone is different, and for some it evens out quickly, but mine was very bad. It lasts for a long time for me and left many scars. If there is anyone interested in advice, mine would be:

Don't pick. B12 acne hurts, but picking makes it more inflamed and causes deep damage.

Acne facials with an expert esthetician who does GOOD extractions (hair thin needle, gloved hands, gentle downward pressure, NOT twisting or with orange sticks) sometimes these estheticians are affliated with a dermatologist's office.

Facial treatments like high frequency or Isolaz or red light/blue light. These are safe in the right hands and can reduce infection. Gentle peels are ok too. I don't at all trust lasers.

Topical creams for skin turnover and to reduce inflammation. Best gotten from a dermatologist. My sister had good success with tazorac. Id really recommend trying a topical to keep things in check.

Perhaps an antibiotic. This may conflict with other medical concerns but honestly, I wish I taken this route right away.

Being low in iron, zinc, magnesium, C, healthy fats, sex hormones, etc all weaken skin and worsen scarring. High blood sugar slows wound healing.

My diet was initially part gluten, high carbohydrate, highish amounts of sugar. Now it's gf/df, no sugar, carb controlled, very few processed foods.I am not sure if it's helped my skin, but it has helped me better respond to the b12 and heal better.

I just wanted to put this here on the off chance it might help. Hopefully it goes easily for you!

I am in the US and know of good derm practitioners in Pennsylvania and New Jersey if anyone wants to PM.

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Thank you so much for your kind words and advice.


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