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Pernicious Anaemia Society
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Sublingual B12 Tablets

I have been hospitalized due to a B12 level that was so low it couldn't be measured. For the past year I've been on injections, 1000mcg, every 3 weeks. My B12 level remained at ~250 (range 198-982). Then I read this article ncbi.nlm.nih.gov/pmc/articl...

For the past 3 months I've been using sublingual B12 tablets. I started with 1000mcg/day, while continuing with my injections. My B12 level rose to 458. For the past 3 weeks I increased my B12 tablet level to 2000mcg/day, again keeping the every 3 week injections as well. My B12 level is now 528. I'm considering eliminating the injections and going with the sublingual tablets entirely.

I live in the US and don't have the issues that I'm reading about on this blog in dealing with the NHS. Read the article and try the tablets. In the US they are cheap, $9.00 for a 100 at the 1000mcg level and $15.00 at the 2500 mcg level. They are also available at a 5000mcg level.

I hope this helps.

8 Replies

Some of us, myself included, use sublingual lozenges. I use them in between shots and they are 5000mcg. I can take upto 10 a day when an injection is due. I take so many because I can only absorb a small part of it. I self inject too at times. It was because they made a difference to me that the haematologist prescribed injections.

Sublingual lozenges can help, but oral tablets, the type probably referred to in the article don't as they go straight to the stomach. The studies in the article only include a few with PA, it's mainly b12 deficiency. Interesting article.


Actually, the studies out there suggest that absorption from oral tablets is actually only a fraction worse than the absorption from sublinguals. The two mainly rely upon passive absorption - the small amount that is absorbed outside the ileum - just that if you take a lot of B12 the fraction that gets through is enough - 1% of 1000 = 10, so in theory 1000mcg tablet taken by someone who only has 1% passive absorption would give you 2-4x RDA.

Unfortunately it doesn't seem to work for everyone.


Maxparis, after you have a B12 shot your blood levels will be astronomic - off the measurable scale and they will then fall over time, so what is happening with the shots is that your kidneys are removing the B12 quite quickly leaving you with quite low levels - presumably measured at 3 months.

Tablets do work quite well at maintaining levels in some people, and this would appear to be the case for you, meaning that, in your case, they would appear to be a viable alternative to injections.

The proviso would be that serum B12 levels don't tell the whole story and you really need to go by what is happening with your symptoms, which, presumably, are well controlled on the doses you are taking.

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B12 is stored in the liver.


not quite sure what you are getting SusanLMcKinney

B12 is stored in the liver but the mechanism for releasing it depends on the same mechanism as is used to absorb B12 from your food so if you have an absorption problem you won't be able to access the store


When I take sublingual, I use the liquid and take the 5000mg daily and seem to do fine. Your levels should go up quicker. I went strictly on this for a year and did good. Hold it under the tongue for a minute. It says 30 seconds but I hold it there as long as I can.


PS, I also had no detectable B12 by the time they found out what was wrong with me. 1 shot of 1ml or 1CC (they are the same) a day. then two shots a week for a month, then 1 shot a week for a month, then one shot a month. Healing from nerve damage is a slow process and I continued to see slow improvement for over a year. I actually am lucky, I was in such a mess and was worried that more symptoms would be permanent. (and they can be if nerves are totally dead) My memory was worrisome and heart rythems have never been the same. I take carvedalol (probably spelled wrong) and it helps with that. If your blood levels were that low, then you cannot absorb via the stomach, you must use sublingual in big doses or shots. THE REST OF YOUR LIFE. In the past people died when they had cases like ours and they were put into insane asylums because people though they were crazy. In my case, twitching, memory loss, stuttering, rocking, crying, vision, vertigo, yawning due to lack of oxygen in blood, numbness, pins and needles, and the list goes on, even bladder infections because nerve damage to muscles causes the bladder not to empty. Take care!

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sublingual is under the tongue and it is absorbed much in the way cocaine is snuffed up the nose and absorbed through blood vessels. Only thing, it will be absorbed in the veins under the tongue. It gets to the liver via the blood stream.


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