Our parents live in Europe and are B12 deficient (130pgml 77 years / 210pgml 70 years old vegans). GP told them that the levels are fine (slightly low), that at max they will be a bit lethargic, but that's OK. One is unable to look up (as he gets dizzy and feels sick) and both have vertigo. One of them has anxiety as well, plus issues with tinnitus and sleeping. Their GP is hopeless, but they don't want to switch to another one because they would have to travel to a different town.
I believe, that their symptoms could very well be connected with the damage to their myelin layer and B12 deficiency.
We live in UK and have bought Hydroxocobalamin B12 injections from Versandpo.de and now we're wondering about correct dosage.
So, start injecting every other day with 1mg/1ml (we will probably tell them to use one pack of 10 doses or until symptoms improve)
But how often after that? once a month do you think? The problem is that they can't even get a blood test done as the GP says they don't need it.
They are vegans for about 3 years and recently they have started supplementing with Methylcobalamin tablets 1x 1000mcg a day. Before they were supplementing with multivitamin (50mcg which wasn't probably very good)
BTW I presume whilst injecting for those first two weeks they don't have to take tablets.
But after that, should they take the tablets daily? Even though they will be injecting once a month?
Do you think that this protocol could be a correct dosage?
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130PGML
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If you have time I suggest searching forum posts using the name of country where your parents are.
There are forum members from all over the world here and there may be someone from the same country that your parents live in who has useful info.
Some European countries sell B12 ampoules for injection over the counter. I know Greece does but not sure which others do. Might start a thread asking this question.
Try to track down any national or regional guidelines on treating B12 deficiency for the country your parents live in.
Your parents are well into the age range where it is likely that dietary B12 won't be enough, unless it is really high doses and they aren't going to be very effective in raising their B12 levels though they may be good for increasing levels. This is because stomach acidity drops as you get older and absorption of B12 needs an acid environment. If they were taking 50mcg and are now deficient, even though they are vegans, that would have been enough to prevent and correct any B12 deficiency unless they had an absorption problem.Ideally, at the very least, their first doses should be under medical supervision because of the very very small risk of anaphylaxis (allergic reaction).
It can be very difficult to distinguish symptoms of B12 deficiency from a large number of other medical conditions.
If they have been tested previously for B12 and their levels were much higher (>20% higher) that would point to a B12 absorption.
Could they try pointing their GP to the area of the PAS website specifically geared towards helping medical professionals improve the diagnosis and treatment of PA (and other B12 absorption problems).
When I was training back in the late 60s - 70s, I distinctly remember the 'wisdom of the day' that providing the individual was normal in terms of stomach function, then deficiency of B12 was unlikely unless due to PA.
However, following a vegetarian diet was likely to result in a lower B12 level. The levels, whilst low in terms of the reference range, might not be the cause of the symptoms. The GP could even be right!
Anyone following a vegan diet is likely to be 'challenged' for B12 as the normal source of B12 in the diet comes substantially from animal sources. We've learned a great deal more since then, and it's accepted that the older we get, the more likely we are to develop B12 deficiency due to changes in stomach acidity etc. I don't see any reason why oral supplements shouldn't help, and if they start injecting then that will raise their B12 levels. If they continue swallowing the 1 mg B12 tablets they won't do any harm.
I realise that I may have offended some with dredging up my historic training, but that has not been my intention.
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