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Pernicious Anaemia Society
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can anyone help with info please

a friend kindly gave me a web site to look for the guidelines as to how b 12 should be given, it was a bsch site, but the pdf is so longand I cantsee for looking for whati am looking for. he suggeste di printoff how b12 should be given as I havehad no loadingdose, and very tired, and do not absorb b12 at the cellular level, I had a fight to get it from a haemo arrogant doc and I want to take a guidline printout back to her to tell her how I should have it- just one injection every 3 months she prescribed, without anyloading dose. my folate is 900iug ad range is 150- to 650, --thanks in advance.

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I found pages 8 and 29 particularly useful from the "BCSH Cobalamin and Folate guidelines".

Page 8 gives details of UK b12 treatment for those with and without neuro symptoms, it mentions loading doses as well.

Page 29 is a diagnosis flowchart that shows the recommended process a medic should go through with someone they suspect may have B12 deficiency.

Do you have a helpful friend who could go through the document for you and find what you want?

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unfortunately no hence my posthere thankyou so much for that sleepy bunny, thatis whati am every day a sleep bunny.


Tell the doc to get out their copy of the BNF (British National Formulary) where it says -

Pernicious anaemia and other macrocytic anaemias without neurological involvement

By intramuscular injection


Initially 1 mg 3 times a week for 2 weeks, then 1 mg every 3 months.

Pernicious anaemia and other macrocytic anaemias with neurological involvement

By intramuscular injection


Initially 1 mg once daily on alternate days until no further improvement, then 1 mg every 2 months.

How were you diagnosed as being unable to absorb B12 at the cellular level?


I don't have P.A fbirder, my endo picked up last year I was low on iron, but folate was a bit high so I was sent to haemo hospital. the doctor discharged me as she said itwsnt worth bothering with even tho I was allways dogtired no energy and balding, so I did a gene test and alth I have sufficient in bloo d stream nutritionist who understood gene result told me I didn't absorb b12 at cell level or vit d. methyl prob, so I took the findings to the haemo doc and she reluctantly prescribed one inject each 3 months bit am am so tired andhighfolate-


Was this nutritionist a doctor?

Have you had B12 levels measured?

Do you know what gene test it was?


yse b12 was 525 and nutritionist is not a doctor but could be a doctor, she is very knowledgeable she works at two hospitals andalongside my endo. 23 and me gene tests

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Hi bp,

Are you supplementing Folate?

J πŸ€


hi jose I have just looked on the bottle that I am taking -Active b12 with L-5 mthf and it says folate 800mcg

vit b12 1000mg.


Ok bp,

Your Folate is too high, as you know and your B12 is too low.

If you only Supplemented with B12 5000 for a few months and dropped the Folate, hopefully your levels would balance.

Are you taking a B complex?

J x


There's a lot of misconceptions about genetic testing and B12, so I hope you don't mind if I give some clarification.

I'm going to guess that the gene that your nutritionist said affected B12 absorption at the cellular level was MTHFR. In fact this gene has nothing to do with B12 absorption, at the cellular level or higher.

The gene makes an enzyme (also called MTHFR) that controls a process in the cell that makes something called methylfolate (which is the L-5-mthf in your supplements - which is why your folate levels are slightly high).

This gene can undergo a mutation, called C677>T, which makes the enzyme less stable. People carry two copies of this gene. If one copy is bad (heterozygous) then the enzyme works at about 80% efficiency - which won't be noticeable. Two bad copies (homozygous - like me) means the enzyme works at about 30% efficiency.

Even at 30% the body has ways of getting around the problem - like making more enzyme. A small proportion of the population will still have problems and they might find supplementing with methylfolate will bypass the MTHFR reaction, thus neutralising any problem.

But you're already doing that, so the MTHFR problem shouldn't really be a problem.


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