B12? How much and how often?

[Propo]

Hi all! I'm interested in self injecting myself with b12-Neo (bought over the counter). Just seeking some advice with dosages and how frequent I should be doing it.

Any help or advice is much appreciated. Thanks

[Gambit62 Administrator]

if you haven't had a B12 injection before then I would strongly urge that you try to get the first injection done by someone who is medically qualified - or at least make sure that you have a friend with you as there is a very small risk of an allergic reaction.

The product should have come with a patient leaflet which will have recommended a treatment regime. The normal regime in the UK is 3x weekly for 2 weeks (or until symptoms stop improving i there is neurological involvement) followed by maintenance 3 monthly (or 2 monthly if neurological involvements. In germany loading doses would be monthly or as directed by a health professional.

Would the pharamacist that you purchased it from be open to advising you?

[Propo in reply to Gambit62]

My pharamacist suggested I get my nurse to do it but being in Australia you need to get a prescription from your GP.

The above regime is pretty much the same as the one on the leaflet which is inside the packet.

1000 mg every other day for 1-2 weeks followed by 1000 mg every 2 months.

I was leaning towards just doing a 1000mg shot once a month. Reasoning behind this is I'm a vegan and it's one thing we don't really get enough of from our diet.

Also is it true that you cannot overdose on b12? The body will just get rid of it through urine?

[Gambit62 Administrator in reply to Propo]

if you think that the problem is being vegan then I would strongly urge that you don't self inject but actually go for some oral supplements. You only need injections if you have an absorption problem and a dietary deficiency can be easily corrected by oral supplements of around 50mcg a day for a month or so.

I would caution against going for the injection unless the cause is an absorption problem because raising serum levels very high can cause a response in some people which then stops the b12 passing from blood to cells where it is needed, leaving you functionally deficient. Although this can be effectively treated by keeping blood serum levels raised to a point where they are so high that the reaction doesn't stop all of the B12 getting from blood to cells it seems a bit daft to possibly be condemning yourself to endless injections (which may need to be a lot more frequent than once every other month).

How long have you been symptomatic of B12 deficiency ... and how long have you been a vegan?

[Gambit62 Administrator in reply to Gambit62]

also, as far as I am aware injectable B12 is an over the counter medication in Australia, ie you don't need a prescription - though it may be the case that a nurse will be unwilling to administer without a prescription.

[Propo in reply to Gambit62]

Yes sorry that is correct, you can buy it over the counter but need a prescription to get a nurse to inject it.

[Propo in reply to Gambit62]

Ive been vegan for nearly two years now and one of my symptoms I find is tiredness throughout the day (most days). Even though I sleep 8-10 hours a night, eat well and drink plenty of water.

I was told by a friend that it could be a b12 deficiency, so that's why I've been looking into it. Recently got a blood test and waiting for the results, get them in a couple days. Doctor said could be due to a previous virus.

[Gambit62 Administrator in reply to Propo]

well GP is right - it could be a virus. B12 deficiency usually takes years to manifest so if you have only been vegan for two years then it's unlikely to be dietary B12 deficiency as there is lots of B12 stored in your liver - unless you hadn't been eating much meat/dairy/fish/egg for a long time before you formally became vegan.

Have you tried more conventional multivitamin type supplements?

Definitely not saying that it isn't an absorption problem and that it isn't B12 but just advising a bit of caution before assuming it is B12 -the symptoms you describe could be a lot of other things as well.

[Gambit62 Administrator in reply to Gambit62]

in some ways B12 injections is the nuclear option - it will always be there but best to check it really is the best option.

hope you get the test results back soon - and please do feel free to share them all when you have them. Interpretting serum B12 can be quite problematic as it isn't a gold standard test but GPs have a tendency to review the results as if it was.

[Propo in reply to Gambit62]

I'll get them in a couple days and I'll be happy to post in here. Thanks

[Propo in reply to Gambit62]

Got my test results back today.

B12 = 199

Active B12 = 101

[Gambit62 Administrator in reply to Propo]

do you have the ranges (and units).

B12 looks as if it is a low but can't tell how low without the units/ranges.

Active B12 is actually quite high.

sorry need to rush out now - may be late evening before I get back

[Propo in reply to Gambit62]

B12 = 199

pmol/L (135-650)

Active B12 = 101

pmol/L (>35)

[Propo in reply to Gambit62]

What's the difference between b12 and active b12?

[Gambit62 Administrator in reply to Propo]

B12 gets bound to 3 proteins as it goes through the body - each bond enables it to do different things. TC2 (also known as holo-T) is the form of B12 bound to the protein that enables it to pass from blood to cell - so pretty important part of the metabolism. In general the ration of TC2 in your blood is about 20% - yours appears to be a lot higher than this - which might mean there is some sort of problem going on with metabolising B12 once it is in your blood.

To know if you have a problem getting from your food into your blood you'd need to look at what has been happening with serum B12 over a period of time so not likely you can do this as you probably don't have earlier B12 levels to look at.

Next step would probably be to ask if your GP can look at homocysteine and MMA levels to clarify whether you have enough B12 at the cell level for everything that needs to be done. MMA and homocysteine are two 'waste' products that will build up if your body doesn't have enough B12 to recycle them into building blocks.

this is a link to an article that talks about the transportation and metabolism of B12 and some of the things that can go wrong - not suggesting that you try to digest it yourself but it might be helpful to pass on to your GP - talks about some of the genetics that can go wrong as well.

researchgate.net/publicatio...

[JMN2017]

I definitely recommend taking Gambit62 's advice and, as a Vegan, take oral supplements, ie Vit B12 tablets. Your deficiency will almost certainly be due to the fact that you won't be eating the foods which have B12 in them, hence the need to supplement.

Injections also have various risks attached, ie introducing infection being a main one so shouldn't be undertaken or considered lightly, and only if other routes are not suitable, ie as in absorption issues.

Tablets should be cheaper than injections anyway

Good luck