How effective is sublingual B12?

[pslmt]

Hi, Does anyone know of studies showing what percentage of sublingual b12 is actually absorbed and utilized? Thanks!

[fbirder]

I've not seen any studies done in people with PA or another proven absorption problem. As a significant amount of the B12 will be swallowed that means an unknown amount will be absorbed from the gut rather than across the membranes of the mouth.

What needs to be done is a study where they compare sublingual with a straight oral dose in the same people.

[Heavensent2021 in reply to fbirder]

What if you have lots of gut problems

[Gambit62 Administrator]

this study compared sublingual and oral and found very little difference

ncbi.nlm.nih.gov/pmc/articl...

[ellj in reply to Gambit62]

Well that is interesting, I doubt my GP has read it but if he did he would certainly continue to force tablets onto me as opposed to the injections which I need imo.

[Gambit62 Administrator in reply to ellj]

what strength are the tablets - the ones in the study were 1000mcg and 2000mcg - the ones prescibed on the NHS are much less than this - 50mcg - so certainly wouldn't be effective at all in treating an absorption problem - they are intended to be used where the deficiency has been caused by a dietary deficiency

[ellj in reply to Gambit62]

My tablets are 1mg Cyano. No PIL...They are dispensed in a brown plastic bottle like we had years ago.

I am certain they do nothing for me..Given them a few months and have got sicker and sicker.

Have asked if I am on some kind of trial etc etc no info.

I have PA.

[Gambit62 Administrator in reply to ellj]

have you joined and contacted the PAS? The treatment you are getting certainly isn't the normal UK regime and should not be forced on patients - and if your GP is giving you 1mg then that's acknowledging you have an absorption problem.

Whilst oral can be effective it certainly doesn't work for everyone and it really shouldn't be forced on people.

[pslmt in reply to Gambit62]

No its not being forced. I am self injecting and supplementing with sublingual. The question was simply how effective is the sublingual form?

[Gambit62 Administrator in reply to pslmt]

sorry question was a meant to be addressed to ellj

[ellj in reply to Gambit62]

Gambit62 thank you for your comment, yes joined contacted and following advice from PAS.

Awaiting response from gp.

Ellj

[pslmt in reply to Gambit62]

This study assumes you do not have pernicious anemia. Meaning, an oral tablet swallowed would not be the equivalent of sublingual due to the absorption problem we have. Not apples to apples comparison. I was meaning, how much (percentage) sublingual is taken into the bloodstream.

[Gambit62 Administrator in reply to pslmt]

the study is looking comparing the efficacy of using oral v sublingual to correct a B12 deficiency caused by an absorption problem - of which PA is one so not sure why you are saying it assumes that you don't have PA.

The study also refers to a sub-group that had abnormal results on Schilling Test - which was the test for PA but is no longer available.

The dose being used is much higher than one that would be used to correct a deficiency caused by diet.

I have come across comparison studies in the past that showed that the absorption from sublingual was not much different from oral - meaning that it is around the 1% mark on average - implying that most is actually going through the gut rather than through the membranes in the mouth.

Unfortunately I couldn't find one of those particular studies last night and hadn't book marked them.

There are also studies involving nasal administration that give about 2-3% - so slightly better but still not much difference from the amount that would be expected from passive absorption in the gut.

[pslmt in reply to Gambit62]

Thank you for all your information!