B12 tablets

[Pikachu74]

Hi everyone I can see many of you are struggling to get your injections so just a little advice that may help. I found out a little while ago you can now take a daily tablet instead of having the injections as my injections run out quite quickly so I have been on them for quite some time now so may be worth having a chat with your gp’s and seeing if that would be a possibility for you 🤞😊 xx

[wedgewood]

I’m afraid most people with diagnosed Pernicious Anaemia cannot benefit from oral supplementation, due to lack of intrinsic factor and stomach acid .

[Gambit62 Administrator in reply to wedgewood]

wedgewood PA does not mean that there isn't any passive absorption

We have at least one person with a confirmed diagnosis of PA on this forum who finds that sprays do help them clivealive . It is true that passive absorption is very variable from individual to individual. This literature review shows that this is common to a number of conditions that cause problems absorbing B12 and is not unique to PA

see table 3

[wedgewood in reply to Gambit62]

I did state “ MOST people with P.A. cannot benefit from B12 oral supplementation “. Whilst fbirder wrote that” people with P.A. cannot absorb B12 from the gut , so tablets are useless . “

[Gambit62 Administrator in reply to wedgewood]

but wedgewood , if you read the article and look at table 3 you will see that it isn't most (ie >50%) - but it is a significant number of people who don't benefit - regardless of the cause of absorption problem. Passive absorption happens along the gut outside the terminal ileum and will only work if high dose is used - >1000mcg - possibly much higher.

[fbirder]

You are very fortunate if tablets work for you.

Unfortunately, people with Pernicious Anaemia cannot absorb B12 from the gut. So tablets are useless.

[JanD236]

You are very lucky that with a B12 deficiency you find that tablets help.

If you read through the posts on this forum you’ll see that this is contrary to the experience of very many people, myself included.

[wedgewood in reply to JanD236]

It does depend on the reason for the deficiency.—- P. A. patients cannot absorb the tablets .

[Nackapan]

I'm really pleased that work for you. Atd they as well as I jectilns though . Toh say injections dont last long. ?

I've tried tablets sprays ect. Ivr no diagnosis of PA . I can not absorb them .

[Nackapan]

Have the tablets replaced all injections ?

If so how lovely.

Wont work for many though including me without a diagnosis of PA

[Xena2202]

What I have read about this is if you don’t have intrinsic factor, the only way you can absorb b12 is through passive diffusion, which generally is said to be about 1% of the total dose. So if you take a 1000mcg tablet every day for a month, you absorbed a max of 10mcg a day, or about 300mcg for the month. The problem is that this is not guaranteed to happen and it’s likely you could be absorbing significantly less than that. Whereas a shot is 100% absorbed and even though a lot is excreted quickly, it’s still much more efficient at delivering a therapeutic dose for b12 deficiency.

[fbirder in reply to Xena2202]

If you could absorb 20 mcg a day, by taking two tablets, then you wouldn't need injections at all. Indeed, it would be better than injections. Because you would have a constantly high level of B12 in your blood.

An injection gives you a massive amount, which then drops to a low amount. That's why researchers are looking for a slow-release injection.

[Xena2202 in reply to fbirder]

Based on the research I can find, even with no parietal cells you should be able to absorb about 1% of an oral dose through passive diffusion. I am actually thinking about trying tablets because what I’ve read is promising about this, I know a lot of people have said they don’t work but research so far says it does. I’ve never tried it before so why not

[Retteacher in reply to Xena2202]

What research? Only two small number of patients studies are quoted which were and are no proof at all.

[fbirder in reply to Xena2202]

You'll have to provide a link to that research. Because almost all of it is in in people with a B12 deficiency. Not in people with PA. They make no effort to determine if the subjects had a dietary deficiency, or were taking PPIs or metformin.

It is highly suspicious that these studies find that about 10 mcg of a 1000 mcg oral dose in absorbed 'passively'. Yet studies in people who do not have PA find that about 10 mcg of a 1000 mcg oral dose is absorbed by the IF method.

Surely those people should absorb 10 mcg via IF, plus 10 mcg passively.

But every study I've seen has shown that if you put 1000 mcg of B12 in somebody's mouth they will absorb about 10 mcg. Why do people without PA not absorb 20 mcg?

[Xena2202 in reply to fbirder]

I tried just using tablets for about 4 days bc I was out of injections anyway, and it not enjoyable. I’m going to keep taking sublingual every day just bc, but I think you’re right that it’s not a viable treatment for pa. I think the fact that my stomach has trouble digesting things hinders the passive absorption if there even is any

[Xena2202 in reply to Xena2202]

Immediate relief upon IM injection

[Nackapan in reply to Xena2202]

I've tried. I cannot take enough tablets to keep enough b12 in my system

I dont know the science bug I know my body

[Cherylclaire Forum Support]

Glad that you have had success with B12 tablet.

We all seem to be very different - from symptoms experienced to the frequency of B12 needed. It can make diagnosis and appropriate treatment difficult. Stabilising this condition long-term can be a bit of a nightmare. With folate, ferritin and vitamin D issues too, even more of a tangle, especially initially. Many people here also have other autoimmune issues to contend with: thyroid, psoriasis, vitiligo etc.

I have never had any improvement at all from Boost spray.

Never yet had a day without symptoms in five years either, but still working towards that as a goal.

So, no miracle cures for us - but plenty of personal trial and error to find a balance.

I would agree with Xena2202 - I'd need something more reliable in terms of treatment.

I doubt if a tablet would be sufficient for me, particularly since there is also evidence of malabsorption of other vitamins and minerals.