Dummies guide to self injecting please!

[Itchyislander]

I am due my prescribed injection on the 25th. When there I am going to ask the nurse about self-injecting. The Doctor seems reluctant to up my dose to 2 monthly, and I am only to have them for a year from my loading doses.

So, I am going to try and self-inject.

I've searched on here and found links to buying from Germany etc. But I am confused as to what I need to buy. Methylcobalamin? Hydroxocobalamin? Cyanocobalamin?

I like the look of buying from vitaminb12online.com as they come in kits. When I see how I get on, I will look to buy items in bulk. From the return of my symptoms I think monthly should do me.

Can I do it in my tummy or thigh? Does the needle size depend on my BMI?

Is there any harm in self-injecting? My test for PA was negative, but 2 months after my last injection symptoms are returning. So in my mind it must be an absorption issue. Self injecting can't hide any other under lying issue? My doctor is likely to test me for B12 again, should I confess to self injecting as it will be 'falsely' high.

Can I over dose on B12, I am pretty sure I have read I cant- but just double checking!

Thanks in advance and apologies for all the (probably silly) questions.

[wedgewood]

First of all , that Intrinsic Factor Antibody test is notoriously inaccurate ( about 50% ) when it comes up negative . You could have P.A. Also had a quick look at your previous posts and saw that you have the tummy problems that come with P.A. - due to low/ no stomach acid (Hypochlorhydria/ Achlorhydria). Do the bicarbonate of soda test for stomach acid to get an idea about that -google it )

There are no problems with self injecting, except for the first time — I shook like a leaf with fear ! After 3 years it’s just routine . I inject every week . You find out by trial and error how often you need to inject . You need an injection often enough to keep those awful symptoms at bay ! I inject I.M. into alternating thighs - into the outer middle third portion , where the muscle comes nearest to the surface . For this I use a 25G needle which is 1inch long.If you have a thick layer of fat there, you may need a longer needle. To withdraw the B12 from the ampoule , I use a longer needle 1 1/2 inch and 21 G needle ( gets blunted in the withdrawal process )

You can inject sub-cutaneously ( sub-cut) also. It’s your choice . That needs a shorter period injection needle , and goes into your abdomen . Look for videos on utube . Some are good some not so . I’ve never done sub-cut , but I hear that it works OK. If your GP follows the guide-lines , he will not be testing you for B12 once you have started injections , as it’s useless . I told my GP that I was self-injecting —— to be told it was “toxic” to inject more often than 1 every 3 months , which we all know was either an untruth or proof of ignorance .

We mostly all use Hydroxocobalamin here on this forum . It’s what the NHS uses . Methylcobalamin is much more expensive , more difficult to obtain , and isn’t so stable . OK, get your first kit from B12 online if you like , but you will find that buying from German online pharmacies and medisave is cheaper . But to kick-off it’s a good idea .

Don’t forget -supplement with a folic acid tablet -say 400mcg a day . It works with the B12 . Very best wishes 🍀💉

[mountainice in reply to wedgewood]

Hi wedgewood, I am ordering my supplies - well, trying to for first time SI. Managed the B12 after a struggle yesterday. Today the rest of the supplies. Looking at a list I ran off from a forum it says Blunt Filter needles for drawing up but they are £59.99 plus postage. Do I need these? You just seem to recommend two types of needle (as above, to draw up and then inject). I can't decide whether to try sub-cut first or SI. I tend to think sub-cut - I've read somewhere that one or the other goes more slowly into the body - ?? I have another note (as below post) that says for Sub-cut use Orange needle, 25G x 5/8". Are you allowed to show links please?

[wedgewood in reply to mountainice]

I have never used those expensive filter needles , and I don’t know anyone who does . I think in theory at least , there is a possibility that a tiny shard of glass can fall into the B12 when the ampoule is broken . The filter withdrawing needle is to safeguard against it being injected . . . In over 3 years I’ve never used them .

You need to decide if you want to use sub-cut or I.M. method . I use I.M.and a 25G x1 inch needle into my thigh( middle outer third ) . .I don’t know what needle is used for sub-cut. I think that orange just indicates the fineness of the needle , not the length . I believe that the B12 gets into the system faster by I.M. method , but that’s not really important . You need to use the method that you are comfortable with . I used I.M. because that’s what the doctor uses . Also using the thigh gives a large injection area , which can be alternated each time, which is good . You have done the most difficult thing — ordering the B12 — great ! I’m afraid I don’t know how to give you links to exact needles . Best wishes and good luck 🍀👍💉!

[JMN2017]

Hi Itchyislander

Yes, I inject sub-cut and have done for a long time now. I found it very difficult for me to relax my leg muscles and then took some mental effort to stick the needle in

So, I changed to SubCut, used Orange needle, 25G x 5/8". Regarding technique, most will pinch the skin up while sticking the needle in at 45 degrees but I prefer to hold the skin taut to put the needle in and then pinch up the skin for the injection. I've got plenty fat so it makes little difference to me LOL

Whichever method you use, ie IM or SC, the result will be the same - hence I go for the easiest

[Itchyislander]

Thank you. Time to bite the bullet and try it out.

I have had quite a few tummy issues. After my own research and advice from here I have found it’s likely to be low stomach acid. After having two prescriptions for omeprazole, I decided to stop half way through the second and start consuming more limes, ginger etc to increase the acid. Bingo, the rib pains and burping stopped. I wish Doctors would be more clued up on b12 as I think it could be the issue in a number of cases of anxiety/ibs etc.

I still have quite a bit of constipation, and I am being tested for celiac disease. If this is negative then I am off for a colonoscopy. While not something to enjoy I am looking forward to hopefully getting reassurance. Friday I met with a different Doctor, who was the first to put all my symptoms together rather than tell me I have, ibs (rib pain burping and constipation), anxiety (numbness, brain fog) and piles (blood in stool). From research I think most can be explained by b12 deficiency possibly brought on by gluten intolerance.

I am so grateful for this forum, if I feel anxious about symptoms I search on here and find out so much information which sets my mind and rest and arms me ready to quiz doctors.

[Ritchie1268]

I was also told I had IBS a few years ago.

Funnily enough, after being diagnosed last year with PA, the IBS, even though I still have digestion issues haven't happened.

Take onboard what wedgewood said, this person saved me from getting much worse & actually helped me to feel the best I've felt for many years, due to advise regarding self injecting.

Good luck 👍

[Itchyislander in reply to Ritchie1268]

I certainly do take on board advice from here. It has already helped me so much. The people on here are fantastically helpful.

[Ritchie1268 in reply to Itchyislander]

They really are & I can honestly say that I don't know where I'd be if it wasn't for the help I got from the likes of Wedgewood & the amazing people on here. (I'd probably still be sat with a needle in my hand passed out 😟😁)

My last order a few weeks ago as I was worried about this Brexit rubbish going on, was from apothke bodfeld which is a German pharmacy. All is in English, and apart my brain fog kicking in & not knowing how to select UK, all was great. It was then €5.90 for 10 Hydroxocobalamin, so I ordered 100 as I was worried, as most are how this current fiasco etc will effect us all.

I really hope you get on ok but, if you need any help with anything at all, everyone here will help all they can!

Good luck 👍

[Itchyislander in reply to Ritchie1268]

Thank you. I have family in France so hopefully I can get orders from Germany to France and then UK if Brexit does cause issues.

it is really kind of people to spend their time replying to everyone. I will always try to remember to post results at the end of any thread that I start because it is so useful when researching symptoms.

I'm glad you found the advice you were after and hope things continue to improve.

[Ritchie1268 in reply to Itchyislander]

Thank you.

Yes, I'd never heard of B12, Pernicious Anemia, Macrocytic Anemia or folate deficiency till my Dr said that's what I had last year. I only found out what it was all about from the PAS & great people on here.

I really hope you get on ok & your symptoms start to improve after you start to SI.

[Ritchie1268 in reply to Itchyislander]

Oh, and despite the many dr's who don't get B12 deficiency yet, my nurse who gives me my 3 monthly injections actually told me how & where to inject etc.

She actually said, if I was in a different country, I'd be getting B12 injections every other day due to my symptoms & said she was so angry regarding the stupid laws in this country, as she studied it as a trainee nurse! So maybe worth talking to your nurse as you said.

I'm going to see my nurse tomorrow for my next 3 monthly, (my surgery hasn't cancelled my injections yet) with a big bunch of flowers as a thank you for helping me & actually understanding so very much more about PA than most doctors do.

[Itchyislander in reply to Ritchie1268]

I will ask for advice. My osteopath was pretty informative and told me to look into the gastro symptoms related to b12 when I went to him to see if he could fix my rib pain. I honestly think if doctors or even pharmacists knew more about this deficiency it would help in many cases of anxiety and depression.

[Ritchie1268 in reply to Itchyislander]

You're right.

They don't know half what they should do about it.

Martyn Hooper who founded the PAS is an angel & it's thanks to him that the so called "Professionals" will eventually understand about it, hopefully & listen to their patients!?

When you read about people misdiagnosed with MS, depression, anxiety etc etc, just think how much the NHS could save if research was done into fully understanding how to diagnose a B12 deficiency & how much it could save.

Till that day, we're all hoping.