I am looking for a little guidance. I have the kind of Dr. where one is better off armed with as much information as possible.
I was recently diagnosed with PA. I am given monthly injections and have had one with no side effects. However, the oral B12 ( 1000 mcg) seems to be reeking havoc with my gastrointestinal system. I read in the Comments that someone was taking folic acid along with B12 and getting relief from nausea. My folic acid levels are within normal limits but I would like to hear more about it's use.
Thanks so much.
Written by
Branwynml
To view profiles and participate in discussions please or .
Do you mean oral over the counter supplements? They are most likely the Methyl form of B12 and if you are in the UK the injections they use are Hydroxy so it's a different type and you can have a reaction to one and not the other. Tablets need digested whereas injections bypass that process.
Folic acid should be taken with b12 treatments as it will drop as will ferritin levels as well.
Have a look at the PA / b12 support group of Facebook - lots of resources and information there for tackling your GP.
not everyone will need additional folic acid - depends on the person
potassium levels can drop in the early stages of B12 treatment - particularly if anaemia is present but I've never come across anything to imply that ferritin would be reduced.
I;'d be inclined to look at what exactly is in the tablets you are being given as seems to me that it is more likely to be a response to something else. If they contain magnesium then I'd suggest trying to switch to a brand that doesn't contain magnesium.
Not actually aware of anything on folic acid (B9) relieving nausea - did come across something on B6 relieving nausea in pregnant women
Do check the other ingredients in your B12 supplement and the type of B12 it is. I find I can take adenosylcobalamin but not methylcobalamin and I have not tried the form in injections. Many of the over the counter pills or liquids contain either fillers or flavourings which cause me problems. I get my B12 just in water with nothing else from metabolics (metabolics.com) and it is very cheap although I take much higher doses than recommended (it is not possible to overdose). You might find this link about different types of B12 helpful veganhealth.org/b12/noncyan.... Good luck
Did you have the first loading dose? Monthly injections seem a little drastic if you have? Do you take the oral via tablet or spray under the tongue? I wouldn't think you would need oral b12 with monthly injections. My initial bloods we're extremely low in B12 but I've never had monthly injections. I've had six weekly but I was allergic to the preservatives in the injections we get in the UK so I use a different type of b12 in a sublingual spray when I'm a bit low, with 10 week injections.
Lots of questions I know but I can't take tablets of B12 because my stomach can't deal with B12 I can't absorb it so it gives me diahorrea and sickness. Even b12 rich foods do the same. I also can't take iron tablets they do the same. I get symptoms of food poisoning if I have ferrous sulphate.
I was allergic to the preservatives in the injections we get in the UK
There are no preservatives. The only ingredients apart from B12 and water are sodium chloride and acetic acid (salt and vinegar) used to keep it at the proper pH. If you are allergic to small amounts of either of those then I think your health problems would be much more severe.
I was told this by one of the consultants who do the research on B12. There are preservatives that is why the B12 used in this country has a longer shelf life and is cheaper than the one used in the USA
Yes, of course I know that salt and vinegar can be used as preservatives - in large quantities. The teeny tiny amounts in your injection are just to make it isotonic and the correct pH.
As I said, if you were at all allergic to sodium, chloride or acetate you would be in deep doo-doo as there is large amounts of all three floating around the body - and all three are essential for the body's normal workings.
Sorry I didn't mean to sound rude but I do have issues with salt. My mouth and throat blisters and that's just with a small amount. My consultant is a researcher for the PA society and he says that the B12 we are given is a cheaper version than the one given abroad and it does cause issues if given more than the recommended dose , that's on the web site for the drug. I was being given it six weekly because my levels were so poor but I got migrain. Apparently they found this with some people when the did the tests. I find it better to have it ten weekly with a top up of the more expensive one which I buy.
the oral B12 ( 1000 mcg) seems to be reeking havoc with my gastrointestinal system
Have you stopped and restarted the oral supplements to check that it is them that is causing the GI problems?
People with PA nearly always have autoimmune metaplastic gastric atrophy. One effect of this is to kill off the cells that make stomach acid leading to something called achlorhydria (literally - no hydrochloric acid).
The acid in your stomach has many jobs - including breaking down proteins and killing bacteria that try to get into the stomach. Without the acid these bacteria can infiltrate places they're not supposed to be - causing GI problems.
Then the undigested protein can pass through the small intestine, into the large intestine. The bacteria that live there are unused to such bounty - so they make merry in a huge party. That can lead to bloating, flatulence and diarrhoea.
Many of us find a bit of acid with meals (vinegar, lime juice) and a daily dose of a probiotic (Symprove and Bio-Kult are favourites - or organic raw sauerkraut) fix those horrible symptoms.
Good advice from FB above branwynml. I can vouch for the efficacy of organic sauerkraut - better than any other probiotic I've tried. This, as well as avoiding gluten has relieved all long standing digestive issues and, hopefully, healed the little brushes (microvilli) that allow absorption of all essential nutrients, including B12.
Researchers believe 'leaky gut' to be the ground zero of autoimmune disease.
Hi Polaris. Where do you buy your organic sauerkraut, or do you make it yourself? I've never had much luck making it; despite best efforts, it developed mould.
Hello Hillwoman. Afraid I'm too lazy to make it myself. LIke you, I tried it once with the same result 🤔
I buy Biona Organic pasteurised sauerkraut infused with juniper berries from the local health food shop (£2.09 for large 680g. jar).
I'm told unpasteurised is even better but this works well for me - a spoonful first thing in the morning and before meals has solved gastritis, reflux, bloating, h/pylori and IBS, issues.
I'm going to try the sauerkraut route! I live in the US, though, and Biona doesn't distribute here from what I've researched, so maybe I'll try Whole Foods here. Thanks for the tip!!!
If you are prescribed oral B12 by your GP, it will almost certainly be Cyanocobalamin, which is almost useless.
Methylcobalamin is a better option but you will probably have to buy your own. Many find Jarrows Methylcobamin taken sublingually effective (good reviews on Amazon for neurological symptoms) or there are also patches and nasal sprays.
You might be interested in this extract of a response by Dr Wilhelmina Rietsema to a discussion on the various forms of B12:
"Strictly speaking, the term 'vitamin B12' has been defined as cyanocobalamin. This form does not occur in vivo. Nutt correctly states that cyanocobalamin releases a cyanide group for every molecule of B12 that is used. However, it is incorrect that hydroxocobalamin is the active form of the vitamin.
There are two active forms of the B12 enzyme in the human cell. First, Methylcobalamin acts as a co-enzyme for the conversion of homocysteine to methionine. Methionine then acts as a methyl-donor to a great number of reactions that need a methyl group, including the synthesis of myelin, serotonin, dopamine, noradrenalin, DNA and phospholipids.
Second, Adenosylcobalamin is a co-enzyme for the conversion of L-methylmalonyl-CoA into succinyl-CoA which feeds into the citric acid cycle.
Is it important which form is used in treatment? In most people, it does not matter. They can convert cyano- and hydroxo-cobalamin into the active forms needed. However, I have recently reported a case in which it did matter. The severe vitamin B12 deficiency, including dementia and psychosis, responded to treatment with high dose oral methylcobalamin, but not to equally high dose oral hydroxocobalamin. [1] "
1. Rietsema WJ. Unexpected Recovery of Moderate Cognitive Impairment on Treatment with Oral Methylcobalamin. Journal of the American Geriatrics Society 2014;62(8):1611-12 doi: 10.1111/jgs.12966[published Online First: Epub Date]|.
I have daily b12 with no issues. So monthly is hardly excessive as you cannot overdose on the stuff.
You can buy b 12 spray - applied to the skin which is new so another way to bypass the stomach.
My b12 is whatever I am supplied and I have taken 4 different types and several brands. Yes some are so much more effective and they come from many different countries but the standard ones all contain alcohol. One in particular stings like mad.
My understanding from my specialist is that tablets should only make you feel sick if you have low stomach acid or are allergic to the fillers in the tablets. Are you thyroid and adrenal levels ok?
Check the other ingredients in your B12, I once bought one that I thought would be better because it only had 2 other ingredients, well one was lactose and it brought on gastrointestinal, issues so once I stopped those and took ones without lactose , the symptoms went away. I also the lactose out of diet completely since I am now allergic or sensitive to it. Hope that helps.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
GP stopped my B12 injections after nearly 40 years
How to take B12 injections....
B12 injection
Excess Folic Acid and Vitamin B12 Deficiency: Clinical Implications?
B6 and B12
