Intrinsic factor

[Jcilom]

If one doesn't have an intrinsic factor, will vitamin B 12 tablets be absorbed by the stomach?

[clivealive Forum Support]

Hi Jcilom it is thought that "treatment by orally administered cobalamin (1% of free vitamin B12 is absorbed passively, independently of the Intrinsic Factor and of its receptor [cubilin]), a therapeutic scheme has yet to be definitely validated, given the present state of knowledge".

The above is a quote from "Professor Andres who is a member of the National Commission of Pharmacovigilance. The data developed herein are solely his personal opinion. He is responsible for the Centre de Competences des Cytopenies Auto-Immunes de l’Adulte (Competence Center of Autoimmune Cytopenia in Adults) at the University Hospital of Strasbourg".

If only 1% is absorbed passively the oral dose would need to be massive but I don't have the brains to work it out.

I am not a medically trained person but I've had P.A. (a form of B12 deficiency) for more than 45 years.

I wish you well

.

[Johnathan in reply to clivealive]

If Jcilom is using 5000mcg methylcoboamin B12 lozenges (these are freely avaiable) and passively absorbing 1% (as per Professor Andres) - that is 50mcg per lozenge. If he/she needs 1000mcg (1 mg) per month into the blood stream, that is 20 lozenges if my arthmetic is correct. That is 100,000 mcg taken 1000 mcg (1mg) absorbed. 20 lozenges does not seem all that difficult as a treatment protocol and it is not all that expensive. Has anyone tried this - or am I missing something?

(I must admit that I have niggling doubts about the 1% passive absorbtion. If this really is the case, why are injections ever necessary and why do we see so many people for whom patches and lozenges do not work).

[deniseinmilden in reply to Johnathan]

For some of us, even if we get it directly into us by injections, our cells seem unable to take it up unless we have huge amounts and then there are some where our immune system seems to actively eliminate it rapidly too.

[Johnathan in reply to deniseinmilden]

That must be VERY difficult for you. There must be a biochemical reason at cellular level that is causing this. This is obviously not an absorption problem in the classical sense (absorption by the gut). It is could possibly be a vitamin or mineral deficiency that is causing a rather obscure biochemical pathway not to work properly - possibly a trace element (like boron, chromium, manganese, selenium, molybdenum etc). If you do not have the chemical wherewithal to make the necessary enzyme/hormones this mal-absorption would occur.

If I could find the enzyme/hormone pathway that moves cobolamin into the cells this might give a clue from the structure of the molecule/s involved. I will see what (if anything) I can find. If anyone on this site has any info on the biochemical pathways for cellular absorption it would be much appreciated as it would save me a lot of digging.

[deniseinmilden in reply to Johnathan]

If you could work it out you will literally be a life saver. I'm getting a bit desperate at the moment because the methylfolate that I was using to excellent effect has just become significantly less efficient (I'm getting folate deficiency symptoms) and therefore my B12 is also not working properly!

I have found by Googling (but I'm sorry I haven't saved the links) a really in depth Krebb's Cycle and by deconstructing that I saw the interaction with the other vitamins and minerals required to effectively release energy.

There is an aspect of cobalamin being used in DNA and what it's role is in nerve function, beyond energy release and cell replication, that I am unsure of.

[Johnathan in reply to deniseinmilden]

Denise

I will have a go but cannot promise anything. This is playing a bit of a wild card. I know chromium is involved in energy production but do not know where yet. It is 7 years since I did any biochemistry but still have the text books. I will have a dig around and see if I can see anything that looks promising. This may take some time but it is something well worth chasing up.

If there is a genetic component that makes you unable to propely synthesise a key enzyme or hormone that would be pretty much impossible to address. However - "faint heart never won fair lady". There is nothing to lose by having a damn good look at how cobolamin enters the cells and what is needed to effect that.

[deniseinmilden in reply to Johnathan]

Hi Jonathan - thank you so much for even trying.

It's interesting about the Chromium... the BetterYou B12 Boost Spray has Chromium in it, presumably to aid uptake.

I expect I do have a genetic glitch as my father became B12 deficient as he became older and several of my family on his side have odd deficiencies, especially vitamin D and potassium. Needing methylfolate rather than folic acid also suggests a genetic disorder.

But that said, I quite like being alive (! 😁) and if I can get around the problem it would be good!!!

I had been improving significantly over the last 3 years and needing less supporting supplements but following a sickness bug in January, a course of Trimethoprim and a few stressful events I'm struggling again.

Don't feel under any pressure of course - the last thing I'd want - but if you have any ideas I would obviously appreciate them!

Thank you!

[Johnathan]

Denise

Biochemistry can be like "hunt the thimble" . There is no "one solution" fits all. Different people have different pre-dispositions. Some problems though are more common than others. As we grow older our ability to absorb nutrients declines. If you have an underlying genetic inefficiency in the absorption of a key nutrient it may not show until you age a little. That does not mean that it is hopeless. From where I am standing the experience of your father points in this direction.

If it is a deficiency and it can be identified you may be able to super-dose to bring your levels up. This at the moment is speculation. I have had a look in the past at the methylation cycle and know what is needed. As you need methylfolate and not folic acid, this points the finger at your methylation cycle. If this is not working properly you will not be converting Hydroxocobolamin into Methylcobolamin.

The methylation cycle is important in a number of biochemical pathways - so even if you had sufficient Methylcobolamin directly, you would not have completely fixed the underlying problem. Give me a couple or three days or so and I will see what I can dig out.

[deniseinmilden in reply to Johnathan]

Hi Johnathan!

You won't believe how good it is to hear you say exactly what the problem seems to be!! Just feeling that I'm not totally barking is good because I'm pretty level headed and knowing I'm still being true to type is good in itself!

When I was first trying treatments for myself 3 years ago I was at death's door so I had nothing to lose. I increased anything that I got a positive response to until I got no further improvement. This meant, especially in the case of potassium, I was taking well beyond the lethal limit every day just to reduce my symptoms so I knew there was a problem with absorption somewhere!

Over time, as the B12 worked and a lot of the damage due to the deficiency had healed, I was able to reduce the levels of the supporting supplements I took to high but reasonable levels.

It appears that the symptoms I have been experiencing recently have been due to the folate being [locked up?/depleted?/an additional absorption problem being created?] by the Trimethoprim and somehow now not being absorbed.

I have come to this conclusion over the last couple of days because I have been dissolving my methylfolate tablets slowly under my tongue and at last I'm feeling a bit better and I've gone spotty again - a sure sign (and a physical one that can't be dismissed as Placebo effect!) that my B12 is starting to work again.

I had tried doing second hydroxocobalamin jabs and, despite that taking my intake to 3mg/day, that hadn't produced any significantly positive effect so it would indicate a problem in the metabolism cycle: the B12 was there in non-limiting amounts, just not working!

I am interested in your suggestion about Chromium as I was getting a positive response to the BetterYou B12 Boost Spray which was why I thought another jab might be a solution.

Having got a positive response from the methylfolate taken sublingually I will now add in the additional source of Chromium by using the spray again and see if I get another positive response.

Any further suggestions will be very much appreciated - as is your reading this and your help so far!

Thank you! Denise

[Johnathan]

Denise

First let me apologise for the length of this post. This is a complex subject that needs some explanation. However it has a conclusion and a suggestion of what you might like to try. I am proceeding on the assumption that you have a problem with your methylation cycle from the info given in your posts.

This cycle is one of the most fundamental in your biochemistry. It is the transfer of one carbon atom and three hydrogen atoms (a methyl group). This is used in synthesis of all sorts of material (amino acids, proteins, cell energy, genetic expression of DNA, healing, nerve function, liver detox, function of the immune system etc). As you can see it is one of the most important processes in your body. If this fails your health will be badly impacted. Unfortunately the methylation cycle degrades with age.

In one of the papers I read it was claimed that one in three Americans have a genetic predisposition to a poor methylation cycle. This is likely to show up as you age as the efficiency of your system degrades.

Methylation requires two cycles to happen in balance: the SAM cycle (S-Adenosyle Methionine) and the Folate cycle. The SAM cycle is needed to donate the methyl group. The Folate cycle is needed to regulate the SAM cycle and to inhibit a run-away reaction that would use up the SAM precursor chemical (methionine). To synthesise methionine Vitamin B12 is needed together with ATP (Adenosine Tri-Phosphate). These create SAM the key donor in the methylation process.

For the Folate cycle certain precursors are needed for it to work properly. These are:

* Folic acid

* Methyltetrahydrofolate (MTHF)

* Vitamin B6

* Vitamin B12

* Nicotinamide Adenine Dinucleotide Phosphate (NADPH) (Vitamin B3)

Vitamin B12 and folate are particuarly important for the production of the methionine synthase reaction. However - as you seem to have specific problems with the folate cycle it is possible that you are not absorbing the other reagents efficiently from your diet and you may need to consider supplementation. All the precursors set out in the bullet points above are available over the counter as supplements. They are safe and as they are water soluble they do not build up in the body.

Can I please council you (assuming that you choose to go down this route) to read up first about Vitamin B3 (NADP or NADPH). If you take too much it can cause temporary but unpleasant flushing of the face and itching. You will have to balance your dose short of flushing.

If you want to dig deeper into the biochemistry, let me know and I will send you the source material. If you give the supplementation a try and need to finesse it - please feel free to come back to me. I would be interested to stay in touch and see how it works out.

All the best