Self injecting methylcobalamin - Pernicious Anaemi...

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Self injecting methylcobalamin


Hi, I am just looking for some advice with regards to self injecting. I have low B12 and fed up with arguing with doctors.

Anyway I have some insulin injections with 29G 1/2 inch needle and also the longer 23G 1.25 needles if necessary. Some people seem to say the insulin injections work just as well as the intramuscular? Just wondering which is best?

Also I believe I will also need to start taking folic acid, should I start this with the injections?

Any advice would be much appreciated, thanks :-)

17 Replies

Others here will come along to help with self injecting Kelly.

Re. folic acid - it should never be taken while B12 is very low as it gets 'trapped', cannot be used, and could make neurological symptoms worse.

"Folate is required for the synthesis of red blood cells, those tiny disc shaped cells that carry oxygen in your blood to deliver it to each and every corner of your body. However, B12 is required in a reaction that converts folate into a form usable by the body to make red blood cells. Without that, folate cannot participate in the synthesis of red blood cells. So without B12, folate is literally of no use! ". - 'The B12 Deficiency Survival Handbook', by Dr Aqsa Ghazanfar.


"If there is concomitant B12 and folic acid deficiency, then B12 must be started first to avoid precipitating sub acute degeneration of the spinal cord.

In patients with isolated vitamin B12 deficiency and anaemia, additional folic acid is recommended until vitamin B12 is replete to prevent subsequent folate deficiency after replenishment of B12 stores.

Iron deficiency can be treated with oral ferrous sulphate (or suitable alternative) 200mg three times daily with vitamin C supplementation"

I hope things will start to improve for you.

Kellyjam1 in reply to Polaris

Thank you so much :-)

Hi Polaris,

I am wondering what exactly 'isolated VitaminB12 deficiency and anaemia' refers to. I have a clear diagnosis of PA with chronic gastric atrophy. Does this mean I should be supplementing with Folic acid? Thanks, Beth

I agree it's confusing Beth!

As I read it, it means B12 deficiency with anaemia and no neurological symptoms.

As you know, PA and gastric atrophy would mean you' re not absorbing adequate B12 and possibly other nutrients too, so your doctor would probably be the one to assess whether you are also folate deficient because of this.

If not, folate from leafy greens, etc. is the best source assuming you are able to absorb it.

I don't know if this helps but avoiding gluten and taking spoonfuls of sauerkraut daily has hugely relieved my stomach problems (years of gastritis, h/pylor, IBS etc.) and is, hopefully, healing the little villi (damaged villi leads to gastric atrophy) in my gut which many researchers believe is the ground zero of autoimmune disease.

Thanks, Polaris. I know I need to do more but I just need to work out what! The specialist told me to 'go away and live my life and to come back when I had diabetes or thyroid disease'! So, he was no help at all. I see my GP next week and will collect all my researchto present to her. She, also, has not mentioned anything about supplements.

I have no Intrinsic Factor and antibodies to Gastric Parietal Cells so not sure how much absorption is happening.

Thanks, B

That's really unhelpful of the specialist !

Four in our family have Hashimoto's and B12 deficiency, so I do so sympathise and, as very few GPs here in the UK have any understanding of autoimmune disease, we've been struggling to find answers and have had to do our own research.

I would thoroughly recommend sauerkraut - it is better than any probiotic and has many other benefits too, including vitamin K2, which taken with vitamin D helps calcium go into the bones and not the arteries.

sa1234 in reply to Polaris

Hi Polaris,

Very interesting post!

I am hypothyroid and my doctor gave me iron+folic acid chewable tablets.I only took those tablets 2 times a week for 3 weeks.But I was drinking green smoothies regularly and when I had my blood test after 2 months,my folate was really high,iron was normal but low and b12 was too low.

I am taking 500mcg methylcobalmine injections now on alternate days and I have had just 2 so far.Do you have any idea what should be happening in my body if my folate is too high and b12 really low?

Should I ever supplement with folate ever again in future?

I am feeling more fatigued both mentally and physically when I take the injections.And also feeling more depressed.

Polaris in reply to sa1234

Hi sa1234

Very few doctors have adequate knowledge of B12 deficiency or autoimmune disease and are looking for anaemia, which they may then treat with iron and folic acid.

Your B12 was very low at 117 and, with your neurological symptoms, should probably have been treated with B12 only, as with high folic acid levels, you are obviously absorbing folate from food. High folate can also mask a B12 deficiency, so personally I would not supplement in the light of various info given above. At least your GP is willing to do injections but be aware that the BNF in the BCSH guidelines advises:

"The BNF advises that patients presenting with neurological symptoms should receive 1000 ug i.m. on alternate days until there is no further improvement".

There is also a lot of interesting info on folic acid in the Alyssa Hunt film on the B12deficiency site.

I'm sorry you haven't felt any improvement yet but it is early days and, if your levels have been low for some time, it could take a while to feel a difference. It sounds like you are doing the right things with good nutrition to help. Some people feel an aggravation of symptoms before they finally feel better, as though nerves are coming back to life! (Galaxie has good advice on the post 'How long before therapy works').

The above latest BMJ research document is supported by many research papers and has a useful summary. It also tells GP that, once b12 treatment is started, the test results don't mean anything and blood levels are not reflective of how effective the treatment is - it is the clinical condition of the patient that matters....

I hope all goes well.

Polaris in reply to sa1234

PS Sally Pacholok in the book 'Could it be B12?, recommends covering all bases with injections and supplements and our family find Jarrows Methylcobalamin 5000 mcg sublingually very effective (good reviews on Amazon for neurological symptoms).

sa1234 in reply to Polaris

Polaris,thank you so much for all the info and help. :)

So this means that I can take 1000mcg methycobalmine injections on alternate days and Mcb. sublingual supplement on days when not taking injections without any fear of overdosing.

Pls correct me if I am wrong.and thanks again for all your support. ...Take care :)

Polaris in reply to sa1234

I woud begin cautiously with supplements as some people have a reaction with Methylcobalamin injections I believe so it might get a bit confusing as to what's happening. My sister was severely deficient and on Hydroxocobalamin injections and added in the supplements later. Everyone is different so probably best to listen to your body.

I use the insulin /syringesneedles to inject under the skin, and find that works fine for me.

Thank you, that's a relief! The other injections looked lethal!

I hardly felt the intramuscular one that I had from a nurse, but didn't fancy doing one to myself.

sa1234 in reply to Hypopotamus

So you take these b12 injcs. just like a diabetic person takes his/her insulin injections i.e on the thighs or lower ab area?

My sis takes insulin so if b12 injections can be taken in the same way, I will ask her to help me injecting my b12. :)

Yes, exactly the same way. You can also find videos on You Tube showing you how people do theirs.

I would reccomend taking methylfolate first before injecting with your insulin pin, you may find the methyl process works too much and you need some good quality electrolyte, I use seeking health, it primes your body for the methylation, made me feel fabulous

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