B 12 deficiency

[orexi]

Just had routine bloodwork & my B12 was 63. Dr. told me to take sublingual supplements. Is 5000 mcg too much? Also, I have been on 40 mg of Nexium for years. I am beginning to believe this is the cause. Would appreciate any imput! Thanks

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[pvanderaa]

I take 2x 5000 mcg methylcobalamin sublinguals twice a day to fill in between jabs or as needed. I have partial absorption in my gut.

You cannot overdose on B12. It is a water soluble vitamin.

The more you work, or the more stressed you are, the more B12 is used up in the cells of your body.

If your body doesn't have a functional recycling mechanism, like intrinsic factor or the gut itself, the used up B12 goes down the drain.

At 63 (pg/ml?) you are very low and should be on injections. Faffing about with supplements will just cause additional neurological damage.

Once you are on B12 injections, then get folic acid supplements and multivitamin to support B12.

After this, If you still feel you need it, then fill in with B12 sublinguals, etc.

You should not be low if your gut and recycle mechanisms are working correctly. Taking supplements requires the gut to be working correctly.

[orexi in reply to pvanderaa]

Thank you for your input. I am a 67 year old female. I just recently lost my husband to Alzheimer's. A lot of stress the past few years. But, I think the 40mg of Nexium have really ruined my gut absorption. I will start the 5000 mcg sublingual tomorrow & then contact my Dr. next week about injections & also question the Nexium dosage for so many years. All of my other bloodwork was good including my thyroid which I take meds for. I have been extremely fatigued & just assumed it was stress & depression but at least now I have an answer. How long does it take to start having some energy? Thank you again!

[clivealive Forum Support]

Wow that is low orexi Do you have any of the symptoms of B12 Deficiency?

Anaemia

Fatigue, sometimes severe

Feeling of heaviness in arms, legs and head

Muscle weakness

Depression and despondency

Easy bruising

Sleep disturbances and insomnia

Hormonal imbalances

Elevated liver enzymes

Diarrhoea, constipation or other digestive woes such as nausea, vomiting, loss of appetite and/or bloating

Red, swollen tongue

Bleeding gums

Pale skin

“Brain fog,” problems concentrating, memory loss

Shortness of breath on even mild exertion

Numbness or tingling in extremities (neuropathy in severe cases)

Headaches and migraines

Ataxia (lack of balance, may affect gait)

Dizziness and light-headedness

White spots on the skin of the forearm (may be misdiagnosed as Vitiligo)

Irritability and extreme mood swings

Tachycardia, skipped heart beats, irregular heart rhythm

Eye twitches and tics

Irregular periods, heavy bleeding, infertility

Decrease or disappearance of normal reflex responses

Some people report pain in their ring finger and palm

It may well have been caused by the Nexium as this is a Proton Pump Inhibitor which affects acid levels in the digestive system.

Do you know whether your iron and Folate levels were tested?

What sort of diet do you have?

I'm not a medically trained person but there are others on here who will be able to give you good advice.

I wish you well

[orexi in reply to clivealive]

I am on a regular diet. I mostly have fatigue. Sleeping several times during the day. Every now and then my heart beats a little faster. I also am a severe migraine sufferer. I have had them since I'm 18. I take Imitrex for those. I also believe I might be depressed. It could be a combination of fatigue & depression. I just have no energy!

[clivealive Forum Support in reply to orexi]

As other's have said you really do need to have B12 injections as your age, thyroid problems and history of PPIs increases your risk of deficiency.

Treatment of cobalamin deficiency

"Current clinical practice within the U.K is to treat cobalamin deficiency with hydroxocobalamin in the intramuscular form outlined in the British National Formulary, BNF,

Standard initial therapy for patients without neurological involvement is 1000 μg intramuscularly (i.m.) three times a week for two weeks, then every three months.

The BNF advises that for Pernicious anaemia and other macrocytic anaemias patients presenting with neurological symptoms should receive 1000 μg i.m. on alternative days until there is no further improvement, then 1 mg every 2 months.

However, the GWG recommends a pragmatic approach in patients with neurological symptoms by reviewing the need for continuation of alternative day therapy after three weeks of treatment"

Above are the guidelines you doctor should be following.

I'm sorry to read about your husband as the stress, worry and sorrow will also have contributed to your B12 deficiency.

Please also ask your doctor to check your Folate level as this needs to be healthy to work with your iron and B12.

Take care now.

[jbun]

I had horrible stomach acid for years. Switched between omeprazole and nexium. Amount fluctuated but most often I was on 40mg. I finally discovered I had PA this past year and once I got on b12, with in a month my stomach acid gradually lessened to the point I no longer needed the acid reducers any more, and I've been off of them since. I had been on them consistently for at least 5 years prior. Since I had symptoms of PA long before I had stomach acid problems, I presume it was the progression of PA that led to me needing the acid meds at all, and that it was finally getting the b12 that my body needed that resolved the problem.

I didn't have much luck with regular b12 sublinguals. I take ones that also contain intrinsic factor, and those seem to work the best for me.

[orexi in reply to jbun]

Can you please tell me the name of them & the dosage.

[jbun in reply to orexi]

I recently switched to a different brand due to issues that I was having with the previous ones, so I can't really say yet if these new ones are as effective, so probably shouldn't say the brand until I'm sure they are actually helpful.

I agree with what others have said, that it really is the best thing to get started with injections. You also should see more immediate improvement with injections than with oral supplements. When I first started oral supplements, it took over a month before I saw real improvement. Much better to get your levels up right away with injections and then go from there. Hopefully your doctor will be helpful and work with you.

[Steap]

Was your doctor wearing big floppy shoes, a red nose and a flower that squirts water?

Without a doubt they should of started you on a course of injections to rapidly correct your deficiency.

It's such a shame that we all get treat like this. In fact its criminal.

I'd maybe go back and see a different Gp at the practice.

[mrsm49]

Id try to get injections before you supplement as yr supplements will skew yr results and if they want to retest you will then say you dont need them. Hopefully someone here will give you a link to the nhs guidelines for treating b12 deficiency as yr gp certainly doesnt seem to know what they are! Yr b12 is extremely low, I had neuro symptoms (numb hands etc) at 280.

[Gambit62 Administrator]

orexi - where are you based?

your B12 is extremely low and most treatment regimes would recommend loading shots to correct that rather than oral tablets.

high dose oral can be effective for maintenance but with the levels you had its likely to take a while to bring your levels up to where they need. Oral can be effective as a route but it certainly doesn't work for everyone.

Also, the stomach acidity problems could well be low stomach acidity rather than high stomach acidity as the symptoms are pretty much the same - and low stomach acidity will cause problems absorbing B12 and lead to a deficiency.

[orexi in reply to Gambit62]

I am in Florida

[Gambit62 Administrator in reply to orexi]

thanks - high dose oral is used as a treatment in the US but that doesn't meant that it's going to be the best treatment for you.

might be worth asking if shots would be considered as an alternative.