Absorption Causes

[Barneyboy48]

I am having to take Lanzaprozol which is a Proton Pump Inhibitor.

This drug is meant to protect my gut and stomach etc. from other medication that I have to take for blood pressure, heart, anti coagulant, (aspirin) and to prevent build up of cholesterol (Statins).

Unfortunately it prevents me from ingesting and absorbing B12 orally too.

If this is the only thing preventing me from absorbing, is there a way around it?

Obviously have to take something, but is there any alternative that would allow me to absorb B12 orally, then I can get away from the injections and the stress and battles with the GP who is trying to reduce my frequency?

The GPs aren't addressing it as a possible, but there again I don't think they are really prioritising my concerns anyway.

[wedgewood]

Injections , unfortunately are the best way to get the B12 you vitally need . You could try using B12 sub-lingual lozenges or b12 sprays ( nose/mouth Amazon .) which some P.A. patients find helpful , but not all do .

Also taking a PPI will also affect your absorption of other vitamins and mineral ( but not so seriously as B12 ) So I suggest a modest vitamin and mineral supplement .

Best wishes .

Note: edited by Admin

[Gambit62 Administrator]

You could try talking to the dispensing chemist about alternatives - they are in a better position to know about drug interactions than GPs.Sorry to hear that you are, like so many others having such a hard time with your GP.

If you are on injections then PPIs shouldn't be relevant as your B12 will be coming from the injections rather than food. Do you know why you were started on B12 injections in the first place. It would be unusual for someone to be put on injections just because they are taking a PPI, so the fact that you are on injections implies that you have an absorption problem.

It is worth trying high dose oral - but that is best started just after an injection. You aren't limited to just one a day but it isn't something that works for everyone though the evidence (from studies, including one larger scale study in Canada where about 2/3 of people actually prefered being on high dose oral) is that it does work for large numbers of people.

If you try it and it doesn't work then there are other options.

[Barneyboy48 in reply to Gambit62]

The deficiency was diagnosed from a blood test. No specifics. They just got me on injections straight away.

There was minimal monitoring which is the norm with our bloody surgery. I was in for something else and another doctor was looking at my notes and chanced to ask how I was doing. I stated that after around 6 weeks, with another 6 to go before my next jab, I felt knackered. So the same doctor placed me on a 6 week schedule.

Then the "other" doctor got hold of my repeat prescription on review and put me back on 12 weeks. No clinical justification whatsoever. I was clogging up his surgery which was unacceptable.

The fact that the waiting room is like the Marie Celeste is greeted with the self congratulatory comment that they are doing something right - unbelievable!

I'm fighting a losing battle with a doctor who is more than happy to see me, and others, feel ill for 50% of the rest of my life and because of the catchment area I can't move doctors.

[Gambit62 Administrator in reply to Barneyboy48]

well, you certainly aren't alone in not thriving on 12 weeks and, as I'm sure you have pointed out to the GP the BNF now says 8-12 weeks with no neurological involvement and 8 weeks with neurological involvement but even this is too long for many of us. Its a pity that your current GP over-rode the GP that seemed to be focused on meeting your requirements.Serum B12 is nigh on impossible to interpret once you are on injections so no monitoring would be the norm for a B12 absorption problem though you seem to have other things going on that probably do need some monitoring.

I'd suggest you try high dose oral to see if it helps - you need 1000mcg+

I take about 9000mcg per day and can just about manage on that.

Keep a diary of your symptoms so you can see if and when they are returning ... you can start trying oral at any point but I would suggest that you don't give up on it until you have tried it beyond the 6 weeks point. I actually found that I didn't really recover until I started using a nasal spray and then it took a few weeks before I really started to feel better. I went from struggling to walk to being quite comfortable perched at the top of a ladder pruning a grape vine in the space of a month at the outside. I now use high dose oral rather than the nasal spray.

If it doesn't work then that would be the point at which to look at other options.

[Nackapan in reply to Barneyboy48]

Is it possible to get to see the other doctor in the practice that prescribed 6 weekly? Of write in saying yiuf symkgkns are returning way before the injection is due

Bnf state in their guidelines 2-÷ monthly do sf least i weekly eoujf bd z start

J just krot pushing.

Went through all 6 gops in the practice

Finally got s prescription tk inject af home . Saves nurses time anc yours

Worth

a try?

Don't give up.

I buy it as well.

Needed the reassurance especially through lockdown.

[Forensic6]

I had been on omeprazole (a proton pump inhibitor drug) For many years. In recent years I developed neurological symptoms (Mainly neuropathy). Finally I was diagnosed with vitamin B12 deficiency. I now take 2 mg of oral vitamin B-12 each day and my serum B12 has risen to very high levels. Because I had neurological symptoms for many years before diagnosis, the vitamin B12 has not yet had any effect, in fact, as in similar cases, the symptoms have got worse. I hope that there will be some improvement in the next few months. Similar cases reported in this site have had better responses to supplements than I have.