Pregabalin, gabapentin, AED, epileptic drug interactions with B12 processes

[Duncan80]

Hiya,

Does anybody have information on why long term use of AEDs like Pregabalin and gabapentin affect B12. I am deficient as a result of ileum and large intestine surgery, not pernicious anaemia and IM inject myself daily. If the issue lies in intestinal/stomach absorption then I am inclined to continue in the interim (because I am in so much pain) as I don’t yet have an official diagnosis. However, if the issue relates to some kind of interaction in the blood that affects the loading dose of B12 I am injecting I may likely reconsider.

I am on full codeine and paracetamol daily dose and have already tried amatryptaline which was ineffective. Pain is so bad in the top of my thighs/hips I am often unable to weight bare. My GP has refused stronger opioids because she is concerned about augmentation.

Any information would be gratefully received and any pain meds suggestions. Thank you

[fbirder]

As far as I am aware there is no interaction at all between B12 and those two drugs.

[Duncan80 in reply to fbirder]

Hi,Th pernicious anaemia society information pages is where I got the information but no explanation is given.

Thank you for replying

[Gambit62 Administrator]

Sorry to hear that you are in so much pain.There may have been reports of interactions but I am not aware of any clear or significant trends having been identified, so the reports could just be co-incidences.

It seems unlikely that the pain is related to the B12 injections.

Any pain medication can come with side-effects so don't necessarily suit people - I lasted less than 24 hours on gabapentin when it was prescribed for some nerve damage issues.

Have you tried looking at other pain management strategies - some people find that mindfulness works. It might be worth a try.

[jacwright]

Hi Duncan. Just read your post and it mirrors mine, I've been searching for answers for 10 years. I first went to GP with pain all over ,diagnosed with polymyalgia and put on steroids. Wrong, its fybromyagia. The B12 d was diagnosed 2-3 years ago and the fibro confirmed by two neurologists and a rheumatologist, is a symptom and caused by B12 d and because of the steroids, despite my arguing it was fibro I now have Cushings syndrome. I take Pregabalin, amitriptyline and Remedeine (dihydrocodeine/paracetamol) just started a new pill I read is helpful with pain etc all fibro and B12d symptoms. Was your bowel resection due to Crohns? I'm a retired colorectal nurse endoscopist. about the amitriptyline don' give give up on it its a good drug for gut motility it not only calms down the brain it calms down gut spasm as in IBS oesophageal cramps. Keep going with the B12 injections essential to avoid long term neuro problems as with the pain if it is fibromyalgia when I've had daily quota of remedeine I go on to Merlot it just hurts picking the glass up Hope you feel better soon and get on top of the pain best wishes Jac xx

[Purplegirl2]

Seems like there is evidence that it does affect absorption. Here is the study I read:

pubmed.ncbi.nlm.nih.gov/212...

I also have anecdotal evidence (Take with grain of salt), I believe that my use of PPI along with Lyrica is why I am so deficient with my b12 and iron, but I haven't ruled out PA yet.

Fortunately I am going off of both meds.

I am sorry to hear about your pain and surgeries! Seems like you are really struggling right now. I don't have any pain recommendations unfortunately. I hope you can find some solutions to your chronic pain issues soon.