Advice for temporary alternatives to ... - Pernicious Anaemi...

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Advice for temporary alternatives to injections?


After the usual argy-bargy I got my GP to agree to follow the guidelines and give alt-day injections until symptoms are gone (or at least as gone as they can be). Been on them for three weeks now - mentally, vastly improved, tiredness improved and possibly, just possibly, a minor improvement to numbness in my feet (okay just one foot so far!). I know that it will take a long time and would like to continue the injections (Hydroxo) but ....

I am going to South Africa and Namibia for two months at the end of March. I could, in theory, self inject there but I really don't want to start self-injecting for the first time miles away from medical care (I realise risks are minimal). I don't want to face the possibility of customs finding 30+ needles and 30 vials of "drugs" for which I won't have a prescription and the daytime temps are likely to be pretty high for storage. So I need a temporary alternative.

Any suggestions on what would be best? Sublingual? Nasal spray? Nasal drops? Hydroxo? Methyl? Dosage?

I realise that there may be many opinions but, hopefully, a few experiences will let me sift through and work something out.

8 Replies
clivealiveForum Support

Hi Cankita I cannot advise you about self supplementing B12, there are others on here who will, but can I ask if you know what your Folate level is as this gets "used" processing the B12?

Cankita in reply to clivealive

HI Clivealive - Had a blood test today so should know my folate level next week. Have been prescribed folic acid alongside the B12 so should be okay (at least better than at the start). Before I started the injections folate was 1.7 and B12 was 195. Don't get me started on why it took two years to find that out!

clivealiveForum Support in reply to Cankita

Well done Cankita have a good and safe trip

I would take sufficient gear to self inject once a week. That would give you a much more certain chance of having enough inside you. I would also take a supply of the sublingual B12, either spray or lozenges. Dosage is a bit 'suck it and see'. Personally I found that none of the alternatives worked at all.

Customs shouldn't worry about you not having a prescription as you wouldn't have one if you were coming in from Germany.

Storage should be ok. I would ask at each place I stayed if they could keep the ampoules in a fridge overnight. Hydroxocobalamin should be stored at 25°C or lower. South Africa and Namibia in the autumn will get up to around that temperature. But fridge-chilled ampoules, insulated in your bag (wrap socks around them) shouldn't get too warm for too long.

Take a solid, secure, container for used syringes and needles rather than throwing them in the general rubbish.

Practise injecting with water and an orange, than have a go with B12 on yourself. The only real risk with self-injecting is an anaphylactic reaction. But you're pretty sure that's not going to happen - because it hasn't happened so far.

Whereabouts in Namibia are you staying? I went there 10 years ago and it was great. I had planned a self-drive holiday there, but health problems (first my friend, then me).

Cankita in reply to fbirder

Thanks for that but I had to turn round half way to the docs this morning to get the B12 out of my fridge so I am 100% sure that at some point someone would find a few doses of B12 in their fridge! The docs is only 15 minutes from home but I will not be turning round after 100 miles of Namibian gravel roads! I will think hard about SI (i'd happily practice on myself and eat the vitamin C!) but I'd prefer my wife to dish out the pills as she's good at that. She's got the malaria tablets anyway. I am going to be far too busy with all my camera gear!

It's a self drive in Namibia in a circle from Windhoek down to Fish River then up the coast to the usual places, through the Skeleton Coast to Damaraland up to Opowu then through Etosha and back through Waterberg Plateau and Okanjima.

Such bad luck about your health but that's why we are doing this now in case things get worse. Despite two years of non-diagnosis I am lucky to be a lot fitter than most with symptoms I can live with at the moment.

fbirder in reply to Cankita

Even if you can't store it in a fridge overnight, I really doubt that a few days above 25°C would degrade it to any large extent.

What camera gear do you have? Make sure you've got something fairly long but very wide. Some of the camps in Etosha have floodlit waterholes which can afford great opportunities if you've got something good in low light.

Oh! Make sure you do a boat trip out from Warvis Bay. One of the best mornings of my life.


It is possible that you might be able to get B12 injections at a pharmacy whilst you were there, ie it may not be prescription only - I really don't know but it is a possibility.

perhaps travel agent might be able to find out for you - or you could contact the relevant consulate.

Cankita in reply to Gambit62

Thanks for the thought but see reply above. It's a packed itinerary and I don't think I'll have time to add pharmacies to the SatNav!

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