What type/dose of Vitamin B12 do I need?

[amasufindme]

I have been scrapping at the bottom of the range 196 [175-190] for years and so I self-prescribed 1000mcg cyanocobalamin as my GP wouldn't help and just chirped "you 're in range". This took the value up to 380ish. I stopped taking cyanocobalamin as I have gut dysbiosis/damage and didn't feel it was being absorbed efficiently. I am on a mega SIBO dietary/treatment protocol now and popping supplements including HCL/Pepsin/ACV with mother for my hypoclorhydria.

As I have Hashimotos thyroiditis and need to be in the top quarter of the range I decided to start taking 5000mcg Jarrows Methylcobalamin sublingual about 4 months ago (and Jarrows Vitamin B Complex) and my last two Serum Vitamin B12 results were 439 and 398.

My plasma homocysteine is 4.4 umol/L [<12] so I have been told by my nutritional therapist that my methylation pathway is OK ??? Does that mean I should be able to metabolise the methylcobalamin?

Is hydroxy/adenosyl better?

Does anyone have any suggestions about what to do to get to the top quarter of the range and where I can source a 5000mcg Vitamin B12 please? I take 42 supplements per day and really don't want to be taking 1000mcg x5 tablets if I can help it

Thank you everyone

[mightydrunken]

From your more recent b12 serum and homocysteine results it looks like the B12 supplements are being absorbed. Have you felt any improvements once you started taking them? If not maybe you there is no point taking them for you.

You can get 5mg B12 supplements on Amazon.

[amasufindme in reply to mightydrunken]

Thanks mightydrunken, I have felt improvements and bought Jarrows 5mg Methyl from Amazon, but perhaps I need a good source of hydroxy or adenosyl as even the higher dose of methyl is not pushing the range up or if I am absorbing some methyl (which it looks like I am from the results) then should I go for methyl/adenosyl combination or simply double my Methyl Vit B12 dose to 10mg?

[liznjojo]

Tht seems reallygood results highest iv been with injections is 290.if levells are there n tired mayb look at iron and folic

[Gambit62 Administrator]

Unfortunately B12 is a very personal thing - so it really is a case of finding the right form and the right delivery method for B12 that suits you personally.

On average 1% of sublinguals/oral tablets get into your blood stream, 3% of nasal sprays, and just about 100% of an injection.

The amount in your blood is only part of the equation and going by the results of serum B12 test can be really difficult.

You can get sublinguals in different forms etc. The people I use to source my non-injectable supplementation are detox-people - a very broad range of products.

[amasufindme in reply to Gambit62]

Thank you Gambit62 brilliant information... I shall check out Detox People - Seeking Health - I have heard other good stuff about them too!

[taka Administrator]

Do you have symptoms of a B12 deficiency? Why are you taking 42 supplements? That is a heck of a lot!

You have had repeated B12 tests which are all in range and indeed increased somewhat when you took high dose supplements. So far so good. You have also had a homocysteine test done which was also was well within range. Providing this test was carried out correctly this would most likely mean that you have enough B12 sloshing about at a biochemical level to mean you do not have a current B12 deficiency.

Another test to double check this would be MMA (methylmalonic acid) as this is elevated by a B12 deficiency but unfortunately it is a test that can also be raised if you have small bowel bacterial overgrowth so may not be helpful for you to have at the moment.

Have you had anti-intrinsic factor antibodies checked to help elucidate whether you have pernicious anaemia? This may be the reason for your low B12 prior to supplementing though it is also very possible that it is your SIBO that is also affecting how much B12 is available to be absorbed from your gut so is why your levels were so low. H pylori may be an idea to test for too.

As you have been supplementing with very high dose supplements (and have managed to raise your B12 levels enough to no longer be borderline), I'm sorry to say, it may well be very hard to convince your GP that your B12 absorption is an issue which needs treatment via injections.

UK treatment guidelines: pernicious-anaemia-society....

Re which cobalamin to use. In theory it doesn't matter which you take - your body should be able to use them all. Anecdotally around here many have preferences for 1 kind over others - it is trial and error working out which is best for you. Some come in sprays (mouth and nasal) if you would prefer that? If you something like PA then you will only ingest a small fraction (though to be ~1%) of the dose from supplements.

Why exactly do you want your results to be in the top quarter of the range? I have to say I'm a bit confused by this comment to be honest, sorry!

[amasufindme in reply to taka]

Thank you for this brilliant information taka, I have a number of health illness including gut dysbiosis/damage which has led to significant vitamin/mineral deficiencies. As a hypothyroid person with hashimotos thyroiditis, it is best to have Vit B12 in upper levels. Also I have adrenal fatigue.

I think after I have finished my SIBO Jacobi Biphasic diet I shall look more deeply into Vitamin B12 tests (H. pylori negative)...I would have thought that jumping up to 5mcg Methyl would have pushed me further up the range by now...so perhaps it is an absorption issue and I should try sprays.

Best wishes