I visited my GP with stack of evidence

to help provide B12 injections he didnt really go through much of it but he summed up my symptoms and agreed on the loading dose as have been waiting a year to see if it went down ,which it did so good result to be taken seriously.

I got some some B12 Sublingual 1000mg Cyna (too small to read)

When is the best time to take sublungual B12 ?

i have seen articles that mention this is the worse and better brands available also articles that say B12 sublingual dont work as the have done clinical trials but i thought i will give them a try while i wait for the injections and see if helps my symptoms any thoughts from others here?Thanks in advance

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21 Replies

  • Hi Advice1 I'm not medically qualified but am interested to know why, if your doctor has agreed loading doses (presumably of hydroxocobalamin) you have got B12 sublingual Cyanocobalamin tablets.

    Are they what the doctor prescribed or did you source them yourself?

    Also, do you know what your Folate level is as this needs to be "healthy" when you start the B12?

  • Hi clivealive to answer your question i had a recent B12 included in

    FBC but i dont see Folate

    The Sublingual was just spur of the moment thing

    on my part .So you think it important to get folate level

    checked before B12 injections next week?Although i do have a few symptoms from lack of B12 discussed with GP? thanks for your reply

  • Hi again clivealive i found

    my folate result from May

    2015 12.2 ug/L

    range 4.00-20.00ug/L

    would this be healthy?


  • Folate from May does not say anything about your current level as it is not stored in the body very long. Get it re-checked and add also ferritin and antibodies IF/PC (see for info our Pinned Posts on the homepage of this forum) to test for pernicious anaemia. I would wait with the sublinguals, just in case the dr wants to test something B12 related first, you don't want to interfere with that.

  • HI PAS-admin my B12 loading injections are already booked for next week,

    so what you mean is i need to test for PA with blood test for Folate and Ferritin and antibodies IF/PC this would confirm PA and if levels are fine i would not be needing B12 Injections or do i have to get, by supplements,, a good level of Folate before the GP can give injections?

    thanks for you kind reply.

  • No, I mean that it's best to test antibodies before injections as too close to an injection can possible give a false testresult (in case of certain testmethod) It's testing for the cause (pernicious anaemia) not if you have a deficiency, cause that is clear already. The antibodies tests can be negative, and then you still don't know anything about the cause (you have a deficieny, that's clear and needs no further testing) but if it's positive, you have PA, and that will give a clear diagnosis, and the doctor will be less hesitant to give you the proper treatment. And it's good to know in general for several reasons.

    And it's good to have a level of folate and ferritin before starting B12, to see if you need to add those as well, otherwise it will feel like the B12 is not doing much.

    and why no sublinguals yet? Because you never know if the dr comes up with another test and then your level will look ok, and you run the risk of not getting injections at all. It's just a few more days so I wouldn't take the risk.

  • Hi PA admin Thanks for your quick reply and explaination

    So i should get onto the GP now to get the Folate test etc

    and may have to cancel the booked Injections as it could take a while to get a blood test and also waiting for the result.

    Can there be other causes , if not PA?

    Thanks for your help

  • There are many causes..any stomach or bowel disease (like Crohn, coeliakie, parasites, Helicobacter-infection etc), some medications, GBP, pancreas insufficiency...and of course lack of B12 in diet. PA is, probably, the most common cause.

    Why would it take time to test? Won't they just give a form, you get blood taken and straight after you can have your 1st injection (sorry, not so familiar with UK procedures) If it takes much time then leave it till after the loading dose, and just take some extra folate.

  • thanks for explaining the details of other causes

    Here in the UK my GP Surgery does not do blood test on site they send you to another GP practice

    (HUB) which is not always quick they normally give you an appointment for 1 week or 2 weeks


    And not easy just to get an appointment about this with my local GP either that could be another week due to high population in the area.

    So it may ,like you say, be best to take extra folate now and then in the future after the B12 Loading dose get the Folate Ferritin and antibodies IF/PC after a few months just before the 3 monthly coming injection?

    Also what type of Folate would you recommend to start taking now please,

    Thanks for all the kind advice much appreciated too.

  • Yes, might be better then. But if you have neuro-symptoms you'll need more than just the 6.

    Folate: just a normal 400mcg will do fine. Start after the 1st injection.

  • I was curious as to why i need to wait to take the folate does it work better with the injections sorry for my ignorance

    thank you

  • Folate should not be taken when there is no B12 to metabolize it. It can increase neuro-symptoms.

  • Hi PAS admin thank you for your reply thats something else i have learnt from your Brilliant advice too .

    Best wishes

  • The B12 loading dose started today and

    but i cant get hold of Folate as the health food shops nearby doesn't have this .

    I do have Folic acid 400ug (mcg) would this be near as good to start taking today with B12 injection to metabolize B12 ?

  • Of course, folic acid is perfectly fine for 98% (or so) of the people :) It's not needed to metabolize B12, other way round, B12 needed to metabolize folate. But they kind of belong together the two, so during loading doses (and when folate is low of course) it helps to take both together.

  • Thank you for your kind advice i will take the folic acid .good luck

  • Goodluck and get well soon!

  • As I say Advice1 I'm not medically qualified so please note what PAS-admin says above.

    I wish you well.

  • Thank-you clivealive for your kind help

  • hi new user

  • Hi whatever 12

    Welcome to you too!

    Good place to get support on B12

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