B12 Oral/Sublingual Spray - is it any good?

[Barneyboy48]

I was originally having B12 injections every 12 weeks. I was feeling really tired after around 7 weeks after the injections, so I was advised to go every 6 weeks, which has continued for sometime now and I feel fine.

Two weeks ago one of the GPs at the practice phoned me and stated that they were making an effort to reduce the number of face to face appointments due to the continuing covid pandemic and that he intended putting me back to 12 weeks.

I was a little taken back. It was an unexpected call. After all, it was the surgery that recommended the need for more regular injections, not me.

He asked me how I felt after 6 weeks and I told him I invariably felt "knackered".

He instructed me on to a 12 weekly regime and to go to Holland & Barrett and purchase a sublingual/oral spray by the name of B12 Boost.

After the call was ended, I started looking the spray up on the internet. I found it at H&B at £12.00 a pack, although the price does reduce depending on how many are purchased, but not by much. Reading the instructions, there are 48 doses and it is recommended that it is administered 4 times daily, so there's enough for 12 days.

I have spoken to another patient with similar problems as I, although she hasn't had to have heart surgery, necessitating inhibitor drugs to protect her stomach from the other medication I have to take daily. It is largely because of these inhibitors that I cannot absorb B12 through my gut.

She was also pushed onto the same spray. She claimed it was largely ineffective and having had her intervals changed from 8 weeks to 12, she felt really ill.

I'm already carrying around another spray in case of emergency, (Glyceryl Trinitrate, in case I have a cardiac episode. I am very concerned that I am being asked to not only carry more medication/supplements in my pockets and having to remember to take it, but also being expected to pay for my own medications when they were previously prescribed free.

My questions are:

How effective is this spray?

Is it a waste of money?

Having been diagnosed as needing more regular injections, should I stick to my guns and demand them instead of being fobbed off, (which is how I feel)?

[JanD236]

I’ve tried the spray and it did nothing for me.

There’ve been quite a few posts on this forum regarding the use of sublingual sprays and from what I remember, the B12 molecule is too large to pass through the mucus membrane and so you’ll swallow the dose. If you’re unable to absorb B12 through your gut (apart from possibly a tiny amount through passive absorption) then you won’t receive any benefit

It might be worth searching for previous posts on the subject and in particular the replies given by fbirder.

[Nackapan]

It did nothing for me either I think you know tiu need 6 weekly injections. Tell them it's not possible to absorb enough to keep you well.

[Nackapan]

Stick to your guns and say you have managed on the treatment they have prescribed and want to stay well.

[music501]

I was on an injection every 8 weeks, this also stopped because of covid, the first pills didn't agree with me then the Pharmacist changed it a different make, on the first pills , it was like the days before I was diagnosed with PA, I have been told to take 2 x 100gr daily, but these are for if you have 12 weekly injections, and I know that I sleep in very often, I'm going to bring it up on my next visit to the GP.

[Babette]

My mum was unable to get her B12 injections for months and really struggling. The GP prescribed her the Solgar sublingual tablets and, although her bloods looked fine (they were happy to carry out 3 blood tests but not give her a B12 injection!), she said she didn't feel they worked as well. She uses the Better You spray as a top up between injections but says that's no substitute either.

[Barneyboy48]

I've just come off the phone. One of the GPs from the practice phoned me, but not the one who put me back to 12 weeks.

She was a little more sympathetic. Plus, I think, less cost conscious, which I sense is the direction I was being led. It's happened before where a more costly statin, (that I was comfortable with) was replaced with a cheaper alternative (that I felt awful with) without consultation. I had to go see a locum to be put back on the original statin.

I am now back on 6 weekly injections.

The stuff I've read from a previous contributor, was very interesting. It concerned the ingestion rate into the bloodstream comparison between injection and sub-lingual spray. 100% of an injection gets into the bloodstream, obviously. Only 1% of a sub-lingual spray gets in to the bloodstream. There is a certain amount of dissipation. quite a lot really, I think around 40% with the jab, so logically the sub-lingual would be affected too. So hardly any getting into your system, so waste of time and money.

Another interesting point was made about the B12 molecule size being to big to get past the mucus membrane. Not sure how that works, but I'd like to learn! basically it doesn't enter the bloodstream at all via under the tongue, unlike the Glyceryl Trinitrate emergency sub-lingual spray I am armed with everyday of my life. So it is swallowed. If you cannot absorb through the gut for any reason, then it goes down the toilet with all the rest of your output, not having performed any useful purpose whatsoever on the way through!

I apparently cannot absorb through my gut because I am on an inhibitor (Lanzaprozol), which is needed to protect my stomach against all the heart medication I'm taking.

May be you need to go in armed with some scientific ammunition. The comeback will be that they'll tell you not to self-diagnose on the Internet. Just ask them what alternative they can provide in that case, because in my view they are failing in their duty of care.

The GP I spoke to today is more of a friend and less standoffish. I know I can have a laugh with her. I asked her if she'd got the number for the Portwenn Surgery so that I could make an appointment through Morwena with Doc Martin. I couldn't stop her laughing!

[fbirder]

There is no way that B12 can be absorbed sublingually. The molecule is just too large.

[Ronsville2]

Its an amazing situation. They treat this disease so badly. They never appear to treat diabetic patients in this fashion. After al, both have bodily deficiencies !