B12

[Rocco44]

Anybody taking Singular 10mg , wondering does it effect your b12 levels or effect having injections of b12

[Gambit62 Administrator]

10mg is a high dose even for a sublingual and yes it could affect B12 levels whether or not you have a B12 absorption problem. If you don't have an absorption problem then it will almost certainly raise your blood levels and could take a while to clear.

I am not clear what exactly you mean by 'effect having injections' - it could certainly make interpreting results of testing to investigate a B12 deficiency caused by an absorption problem extremely difficult.

Generally you would need to refrain from supplementation for 3-6 months at least before testing.

[Rocco44 in reply to Gambit62]

I’m on Singular 10mg for my sinus problems it’s nothing got to do with B12

Singular is usually for Asthma suffers or like myself chronic sinus trouble

Feel the Singular may or DOES have myself fatigued

Wondering if anybody knows if Singular effects your b12 levels

I got a b12 injection 2 weeks ago and I felt great or at least better for about 5 days , then it seemed to have no effect .

The second injection 2 weeks later ( yesterday ), I got no effect like last week .

Actually felt more tired .

[Foggyme Administrator in reply to Rocco44]

Hi Rocco44. Ah ha...was just going to ask for clarification about this 😉...did you mean Singulair 10mg (rather than singular) which is used for the treatment of asthma (or used 'of licence' for sinus congestion). From your reply above, it seems you did 😀.

So...the patient information leaflet for this drug makes no mention about the drug impeding the absorption of vitamin B12:

medicines.org.uk/emcmobile/...

Here’s a list of drugs that do impede the absorption of vitamin B12 (though this may not be exhaustive):

umm.edu/search-results?&sk=...

So...no indication that Singulair impeds the absorption of vitamin B12.

About treatment with B12 injections: people here often report that they feel worse before they start to feel better once injections have started - something to do (we think) with the repair that is taking place and the way the body has to reinterpret stronger signals now getting through to systems of the body that are suddenly being awakened and repaired (sorry, it a not a good explanation - bit short of time - but sure you'll get the drift 😉).

A couple of thoughts:

Did you have the recommended six loading dose injections of vitamin B12?

Do you have neurological symptoms? If so, you should have been prescribed injections every other day until no further improvement (after the six loading doses).

The fact that symptoms returned five days after your first injection indicates that you probably need more frequent B12 injections.

Certainly worth having a conversation with your GP about this to see if the frequency of your injections can be increased. Any doctor who is well informed about B12 deficiency and it’s treatment won’t have a problem with this. But unfortunately, many are not - and are resistant to prescribing a B12 injection regime that a) is in accordance with the guidelines and b) works for the individual (we're all different and require different frequencies of injection regime to get and stay well).

Have you had information and links to the relevant treatment guidelines? If not, let me know and I'll post some for you....they may help you if you want to approach your doctor for more frequent injections...or if you need to be put on the correct intensive regime of B12 injections for those with neurological symptoms.

Good luck 👍

[Rocco44 in reply to Foggyme]

All I’ve had is one two weeks ago and one yesterday

GP said every 10/14 days for the first 5 injections .

What ever suits myself .

Think GP said 5 injections then a blood test then one every 3 months if bloods come back at acceptable levels and I’m starting to feel the benefits.

Just strange the second one had no effect like the first one ?

Looking at the list of drugs that can impede the absorption of b12

I’ve been in Fluticasone ( Dymista nasal spray for years )

Only went off it recently and just used Singulair 10mg

Trying to stop using Singulair as well , just feel the fatigue factor out-ways the postive effects on my sinus and chest ( hot shower can be as good )

My GP is very Open to any input but likes myself to keep off google as he thinks I just worry myself reading to much .( which can be true in my case )

Any Advice welcome

[Foggyme Administrator in reply to Rocco44]

Hi Rocco44. Are you in the UK (treatment regimens are different in other countries)?

Sorry, will ha e to be brief here:

Bloods at acceptable levels - once injections have started serum B12 levels will (should) be high - because you’ve been injected with it. Testing following injections is only necessary to check for low levels. Your doctor should be focusing on symptoms, not serum B12 levels. If you still have symptoms (or your symptoms return before the next injections is due, then abate once you’ve had an injection)...you need more frequent injections.

Your injections should not be stopped simply because your serum B12 levels appear in the 'normal' reference range following injections (this range no longer applies to those on injections).

B12 injections don’t always have the same effect for me either - sometimes I get an instant effect, sometimes not. No idea why. In terms of the first one, it could be that your body had been so starved of B12 that it was reacting to the sudden influx- a bit like a power surge (for want of better words st the moment).

Also - hope your doctor is trying to identify the cause of your deficiency.

Another also - hope,your doctor has checked your folate levels. Floate and B12 work together so if you are deficient or low in folate, your body wont be able to utilise B12 properly.

And do be aware that you need much more frequent injections if you have neurological symptoms (and nerve repair takes a lot longer than other forms of repair).

Here’s some links to information that outline some of the basic details about B12 deficiency, from whatever cause, including pernicious anaemia. Most are only one page long so please don’t be put off by what looks like a lot of reading. The BSH guidelines for the diagnosis and treatment of cobalamin and folate deficiencies are a little longer but have useful summary sections.

The links are annotated to help you find what’s most useful for you so that you can read that first 😉.

Good luck and post again if you need more help or have any questions after the reading. Here come the links:

b12researchgroup.wordpress.... (Serious Caution Note about the use of Oral and Sublingual B12 Supplements)

bnf.nice.org.uk/drug/hydrox...

(BNF B12 Deficiency: Hydroxocobalamin Treatment Regimes)

pernicious-anaemia-society.... (PAS Symptom Checklist)

stichtingb12tekort.nl/weten... (BSH B12 Deficiency / PA Diagnostic Flowchart)

onlinelibrary.wiley.com/doi... in Haematology (BSH) Guidelines: Treatment of B12 Deficiency and Folate Disorders)

onlinelibrary.wiley.com/doi... (UKNEQAS B12 Treatment Alert, Neurological Symptoms and Risk of Subacute Combined Degeneration of the Spinal Cord – Immediate Treatment with B12 Injections)

stichtingb12tekort.nl/weten... (Problems with Serum B12 Test)

stichtingb12tekort.nl/weten... (Testing B12 During Treatment)

stichtingb12tekort.nl/weten... (Misconceptions About B12 Deficiency – Good to Know Before Seeing GP)

stichtingb12tekort.nl/weten... (B12 Deficiency: Neurological Symptoms Can Present Even When B12 is ‘In-Range’ and Without Macrocytosis (large red blood cells) or confirmed PA Diagnosis)

stichtingb12tekort.nl/weten.... (B12 Deficiency and Intrinsic Factor – Can Be Negative and Still Have PA)

stichtingb12tekort.nl/weten... (B12 Treatment Safety / Long Term Treatment for neurological symptoms)

bloodjournal.org/content/bl... (Haematologist B12 Treatment Review March 2017 – Includes Advice No Reason to Advise Against Self-Injection/More Frequent B12 Injections)

stichtingb12tekort.nl/weten... (B12 Deficiency and Neuropsychiatric Symptoms)

gov.uk/drug-safety-update/n... (Low B12 - Nitrous Oxide Contraindications)

ncbi.nlm.nih.gov/books/NBK2... (Gastric Autoimmunity: Heliobactor Pylori)

[Rocco44 in reply to Foggyme]

Thanks

I’m from Dublin .

When my sinusitis is ok I’m usually ok

But the sprays were a killer and the Singulair seems to cause fatigue and anxiety imo

[Foggyme Administrator in reply to Rocco44]

Ah ha...not sure if the treatment guidelines differ there...you could try an internet search to see if you can find any.

However, even if the treatment guidelines differ slightly, the principles about B12 deficiency and PA (as per the links above) remain the same. So they'll still be a useful source of information for you.

Good luck.

[KimberinUS]

Im wondering if your gp meant for you to get 5 injections over the following 10 to 14 days.

I know my memory and ability to comprehend info was exceedingly poor when I was deficient in B12.

[Rocco44 in reply to KimberinUS]

No one every 10/14 days

[Rocco44]

Had 3 injections now one every 2 weeks , found since I’ve stopped taking the Singulair 10mg for my sinus troubles I’m less tired and anxious.

Still having fatigue episodes but not as bad as I was six weeks ago

[KimberinUS]

Have you had your ferritin/iron levels checked lately?

Once b12 injections begin this can cause folate and iron stores to be used up. Deficiencies or low levels in either of these two nutrients will cause tiredness, brain fog, confusion, lack of motivation, xcetera.

[Rocco44 in reply to KimberinUS]

No blood tests at all

4 injections now , one more then every 3 months