Help with SIBO-D Diagnosis

[GGourmet]

Dear all,

I am expecting a positive diagnosis of SIBO-D this Thursday evening.

I currently have B12 (hydroxycobalamin) injections every 2 months due to neuro damage and take 2000 microgrammes per day of Methylcobalamin, as sublingual.

My concern is that if the diagnosis is confirmed and a course of antibiotics prescribed to 'cure' this, what might happen to ongoing B12 treatment? Should it be stopped? How do I prevent it from being stopped?

This is in light of it taking over a year to get treatment, in the first place.

Can anyone help with this, so I can be clear with the gastroenterologist about setting expectations of ongoing care?

[Foggyme Administrator]

Hi GGourmet. There is no reason why your B12 injections should be stopped because you are taking antibiotics.

However, oral/sublingual supplements can interfere with the absorption of Tetracycline, so if it's one of the antibiotics prescribed, perhaps best to avoid oral/sublingual supplements for the duration of treatment? Or you could discuss the use of an alternative antibiotic.

Chloramphenicol - when used long-term, this may reduce the effectiveness of B12 (from any source) and limit the body's ability to produce new blood cells. However, most people only take chloramphenicol for a short time so it's not usually a problem.

Some antibiotics can impede the absorption of B12 via the normal gastric mechanisms but this is not a problem if you are having injections.

If tetracycline has to be used and you have to stop taking the sublinguals, might be worth keeping an eye open for the return of B12 deficiency symptoms, in which case you could increase your B12 injections until symptoms are back under control or you are able to recommence sublinguals.

Not aware of anything else that can have an impact but, as always, discuss this with your doctor.

Having said that, no reason that I know of to stop your B12 injections, so, if for some reason this is suggested, ask them to show you the evidence - but in a nice way 😀

Good luck 👍

[GGourmet in reply to Foggyme]

Thank you. That's really helpful.