Bariatric Surgery

[Freezeframe]

I ran into a friend yesterday who I hadn’t seen in a long time. He told me that 10 years ago he had bariatric surgery and was taking B 12 sublinguals since. Really ? I was under the impression that if you had bariatric surgery the only way was B12 injections. Am I wrong ? He said that his wife who is a nurse has been trying to get him to stop b12 altogether because “ an excess of B12 can cause bone thinning ? She said she read that from a research article. Double REALLY? Any comments? I need to send this poor soul some information. He looked horrible !

[Nackapan]

Is he b12 deficient? I realise his nutrients will be limited . Just wondered if he has had bloods done to actually know what he is lacking. Surely the hospital that did the procedure would give guidance with after care and diet .

I've never heard of b12"thinning bones? ??

[fbirder]

It depends on the surgery. Some bariatric surgery for weight loss using the Roux-en-Y technique. This tends to leave the upper parts (fundus and corpus) of the stomach intact and it's these areas that contain the gastric parietal cells which release Intrinsic Factor.

As for too much B12 causing bone-thinning. Totally the opposite. Too little can cause low bone density - sciencedaily.com/releases/2...

There is no evidence at all that high doses of B12 are harmful - stichtingb12tekort.nl/weten...

[Freezeframe in reply to fbirder]

Thank you. I have come to respect your knowledge 🙂

[Sita505USA in reply to fbirder]

Fbirder

Do you have any recent journal articles that say this same thing?

Many thanks, Sita

[fbirder in reply to Sita505USA]

Do you mean the osteoporosis?

Here's a few from the last five years - scholar.google.co.uk/schola...

Consensus seems to be that high homocysteine is a likely cause.

[fbirder in reply to Sita505USA]

Ah! I'll bet she is talking about this study - jamanetwork.com/journals/ja... - that found a small increase in hip fractures in women who took high dose suppleemnts of both B12 and B6.

They specifically state that "a high intake of vitamin B12 and a low intake of vitamin B6 were not associated with increased risk, which is in agreement with a meta-analysis of [randomized controlled trials] giving vitamin B12 and/or folic acid alone (without vitamin B6)."

But a lot of secondary sources seem to have read 'B6 and B12 causes hip fractures' as 'B6 or B12 causes hip fractures'. They obviously do not understand logical operators -

A bit like the logician who told her husband that she was popping down the shops to buy a loaf of bread. The husband yelled out "Excellent. If they've got any eggs then bring back a dozen". Husband was confused when wife returned with twelve loaves of bread.

[Sita505USA in reply to fbirder]

Thanks so much for the articles. I want a journal article that generally states that high dosing and levels of B12 are not in any way harmful even over years.

BTW, if it is not intrusive, I was wondering what occurred with your trying to get your doctor to increase your B12 injections. I am hoping that it went well for you. Sita

[fbirder in reply to Sita505USA]

In this study they gave people with Peripheral Neuropathy intravenous doses of 25,000 mcg a day for 10 days, then 25,000 mcg a month for five months. They were assesed after a year. jstage.jst.go.jp/article/in...

"Intravenous ultra-high dose MeCbl treatment is a safe and potentially efficacious therapy for patients with peripheral neuropathy and chronic axonal degeneration."

Note that 25,000 mcg is about 2,500 times the amount of B12 that your friend will be getting into his body as only about 10 mcg of a 1000 mcg sublingual dose is absorbed.

[fbirder in reply to Sita505USA]

I told my doctor I was self-injecting. After I'd explained how B12 is prescription-free in Germany (and all Germans with PA get theirs online), that syringes and needles were available on Amazon, and that the nurse had shown me how to inject myself (because I wanted to save the NHS some money) he calmed down.

Then I showed him the graph I'd done that showed how my fatigue levels changed between injections. He agreed that every three months wasn't going to work and suggested monthly. I suggested weekly. We agreed on fortnightly. That is what I get prescribed. I haven't mentioned that I top up so that I'm injecting twice a week.

That GP has now left the practice. I'm expecting to have a battle with the new one. But I think her first moan will be to try to get me back on drugs for my blood pressure - even though they make me faint.

[Sita505USA in reply to fbirder]

Thanks for both the study and for the personal update. So you had some success, good for you! Too bad that you will have to battle yet again! I wish that a celebrity would bring light to the B12 disorder!

It is insane that we have to be feeling like death and then battle doctors!

Sita

[wedgewood]

Your friend needs B12 injections . The sub-lingual B12 can sometimes help people between injections ( but did not help me one iota .) But the most efficacious method to get B12 , is by injection . I was shocked to read that your friend’s wife , a nurse , believed that an excess of B12 could cause bone thinning . She is horribly mistaken . She must have got mixed up with something else .

It is often difficult to get enough B12 injections from your GP. I am forced to self-inject to keep well. They are really cheap . ( about £1.20 , everything included ). There is no danger at all in overdosing . Any excess is excreted in the urine . Also folate, found in leafy green veg works together with B12 . In tablet form it’s called folic acid ,and your friend would benefit from a modest 400 mcg tablet , along with B12 injections . He should first have loading doses - 6 over 2 weeks . Then he should be offered one injection every 2months, but more often if necessary .

You could do your friend a huge favour by persuading him to go to his GP and arranging to get B12 injections . It sounds really urgent .

[titania2019]

Hi Freeze Frame,

Not all UK hospitals insist on post op B12 injections post bariatric surgery but you do have to have regular blood tests to check levels. I had B12 deficiency pre op so mine were continued but had to become more regular 8 weekly. More and more hospitals are introducing post op B12 as it is less likely to be absorbed. It sounds to me like he needs a check up for bloods. I would be useless with out my jabs. It really is important as I am sure you know. :