Different forms of B12

[CDALY474]

Sorry yet another question! I thought I read somewhere on here but now cannot find it. If getting hydroxocobalamin injections you needed another form to help absorb? I cannot tolerate Methylcobalamin would AdensylCobalamin be okay? I could be mixing everything up. Just looking for guidance. Thanks!

[JanD236]

No you don’t need another form of B12 to help absorb hydroxocobalamin.

You will need adequate folate (from green leafy veg for example) or by a supplement of folic acid. 400mcg a day is normally thought to be adequate.

[CDALY474 in reply to JanD236]

Even if my folate/folic acid is in range on labs? Sorry I’m so new to this.

[JanD236 in reply to CDALY474]

If you’re in range you probably don’t need the folate/folic acid supplement.

I only supplement on the days I haven’t eaten much folate containing food (most of the time I do eat enough) and this keeps my folate level towards the top end of the range.

[Gambit62 Administrator]

JanD236 just to clarify

Folate and B12 are used together in a lot of the processes that go on in your cells so deficiencies in the two have a lot of the same problems. It is possible that when a process that hasn't been running properly because there wasn't enough B12 starts to run properly there may be a temporary call on more folate but that should be temporary.

On the other hand, if you have a problem absorbing B12 then you are also likely to experience problems absorbing other micronutrients - most commonly folate and iron. The best sources of folate are dietary but if you have absorption problems it may not be possible to get all that you need from dietary sources in which case 400mcg daily of folic acid is a good substitute.

The doses for correcting a folate deficiency are higher than this and are taken for 1-2 months only. Amounts over 1000mcg a day of folate can cause problems and should never be taken without medical advice.

If in doubt speak to a pharmacist.

[Bellabab in reply to Gambit62]

B12 is a very large molecule and thats why we need a system (that is destroyed in PA) to get it across the cell walls before our efficient gut wizzes it down and out. Most micronutrients and other vitamins are no where near as large so are still readily absorbed - you do need to ensure that you eat acid fruits or drink acidic fruit drinks as hydrochloric acid is also reduced in PA.

[Gambit62 Administrator in reply to Bellabab]

was this a reply to my comment Bellabab? if so I am not sure what you are trying to say.

[Bellabab in reply to Gambit62]

PA only stops B12 absorption and some reduction in stomach acids. There are no problems absorbing other vitamins,

[Gambit62 Administrator in reply to Bellabab]

sorry Bellabab but the fact that patients with PA have reduced stomach acidity does affect the absorption of other micronutrients.

folate is often affected because it is also absorbed in the ileum.

folate and iron are the most common deficiencies experienced by people with PA. Eating fruit and acid drinks isn't always enough to prevent these problems. That isn't to say that everyone has those problems, just that PA really does make you more likely to suffer those problems.

[fbirder]

No, hydroxocobalamin works perfectly well on its own.

If you do have PA then the lack of stomach acid that accompanies it can cause problems with the absorption of iron, Vitamin D and/or folate. So keep an eye on those levels and supplement iron and/or folic acid if yours are low.

The NHS recommends everybody supplements with low-dose Vitamin D during autumn and winter as there's not enough sunlight for us to make our own. The recommendation extends to periods of lockdown.