Oral B12 Maintenance dose

[Riseup01]

I heard a lot about B12 injection loading doses and then the maintenance dose ( which goes on every 2nd/3rd month) but what should be the maintenance oral doses ( if they are working)

I know there are a lot of misconceptions whether or not oral dose work in PA. For lot of folks it work as good as injection.

[fbirder]

If they work then they will be better than injections.

Assuming you have no absorption problems then you'll be able to absorb around 10 mcg from a single dose. The recommended amount of B12 is 2.4 mcg a day. So one tablet every 4 days should be enough.

However, that 10 mcg is for somebody with no absorption problems. Just to make sure I would take one tablet (containing at least 10 mcg of B12) a day. There's no need to take the stupidly high doses that are popular.

Studies show that about 1% of a 1000 mcg oral dose is absorbed in people with no B12 deficiency. Studies show that about 1% of a 1000 mcg oral dose is absorbed in people with a B12 deficiency. Studies show that about 20% of a 50 mcg oral dose is absorbed. Studies show that about 10 mcg is absorbed if you have a B12 deficiency and if you have a B12 deficiency.

What's very strange is that people supposed to have PA absorb about 1% of a 1000 mcg dose, and people without PA absorb about 1% of the same dose.

You would think that people without PA would absorb X% passively + Y% via IF. And that people with PA would absorb only X%.

But studies show that X+Y = X. Suggesting that zero is absorbed via IF. But we know that isn't correct.

So an assumption must be wrong. Either people with PA absorb more passively or the people assumed to have PA didn't have it but were B12 deficient for other reasons.

I cannot think of any way that PA could cause more to be absorbed passively (and, coincidentally, by exactly the same amount as normal people absorb via IF).

[Emmalee045]

I take oral doses for my vitamin b12 deficiency. I take 1000mcg per day and the tablets I take are released slowly throughout the day rather than all at once. This treatment was decided for me after long discussions with my GP as I had neurological symptoms but I was going abroad at the time of diagnosis so injections would be impossible on the NHS. It works for me but I do have to take that massive dose every day. Otherwise my neurological symptoms come back within 24 hours.

[Gambit62 Administrator]

if you have PA you will need to take high dose oral if using oral as you will be relying on passive absorption which occurs outside the ileum. There is rather mixed evidence around the usefulness of high dose oral in patients with B12 absorption problems - they can help to maintain levels but you need to take at least 1000mcg per day - and possibly more. All you can really do is try and see what happens - and that might mean trying taking several in a day to see what happens.

The fact that they don't work for everyone does not appear to be specifically related to PA but reflects how much variation in passive absorption between individuals generally - the average is 1% but some people have much lower and possibly even no passive absorption so oral really won't work for them.

[Riseup01]

Thanks ! I am taking 1500 MCG B12 oral everyday along with folate and alpha lipoic acid.

Hope daily use of this tablet doesn't cause any trouble in long term, I may have to take this forever it seems.