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B12 Dosage and Tablets whilst injecting for vegans?

130PGML profile image
5 Replies

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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5 Replies
Nackapan profile image
Nackapan

Firstly I woukd get them to point out to their Gp they have been supplementing. Thus is why b12 in blood level up bit.

Secondly b12 injections shoukd first be given in s medical setting.

Get them to ask fir loading doses based on their symptoms.

Mt friend was a vegan by proxy as on some detox which was just eating out of a box of delivered veg.

She got ill.

B12 borderline.

Impressed if wax evr tested!

Loadjng doses were given

She now had b12 tablets daily but does include b12 rich foods again. She 2as lucky ax caught in time abd escaped regular inhrctikbd as dietary

The Gp should treat.

As diet related hopefully Eil St least get loafinv doses in s medical practice judg incase they have a rare Anaphylaxis

Shock

Or pay for loading doses.

Dosing regime should go by symptoms.

BNf guidelines

NHS guidelines

Neurological symptoms.

Every other day until no more improvement.

Treatment shoujd start as soon as possible

Sleepybunny profile image
Sleepybunny

Hi,

I hope your parents get the help they need.

Patterns of treatment for B12 deficiency across Europe may vary from treatment patterns in UK.

Sometimes type of B12 used can vary.

NHS in UK tends to use hydroxocobalamin for B12 injections, some countries use cyanocobalamin. It's also possible to get methylcobalamin.

Link about "What to do next" if B12 deficiency suspected

b12deficiency.info/what-to-...

PAS (Pernicious Anaemia Society)

Based in Wales, UK. Has some members in other countries.

pernicious-anaemia-society....

There is a helpline number that PAS members can ring.

Link below mentions some B12 deficiency support groups in Europe.

b12deficiency.info/very-use...

B12 Institute in Netherlands

b12-institute.nl/en/home-2/

Dutch B12 website below has some excellent articles in English.

stichtingb12tekort.nl/english/

Link about vegans/vegetarians and B12 deficiency

b12deficiency.info/vegetari...

vegansociety.com/resources/...

It's possible they could have more than one cause of B12 deficiency at the same time.

Risk Factors for PA and B12 Deficiency

pernicious-anaemia-society....

b12deficiency.info/what-are...

b12deficiency.info/who-is-a...

Two B12 books I found useful

"What You Need to Know About Pernicious Anaemia and B12 Deficiency" by Martyn Hooper

Martyn Hooper is the chair of PAS (Pernicious Anaemia Society).

The book below is available in Dutch, Polish and another language I can't remember besides English.

"Could it Be B12?: An Epidemic of Misdiagnoses" by Sally Pacholok and JJ. Stuart (US authors)

Very comprehensive with lots of case studies.

Films and videos about B12 deficiency and PA

PAS conference 2019

pernicious-anaemia-society....

Films about B12 deficiency

b12deficiency.info/films/

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.

Sleepybunny profile image
Sleepybunny in reply to Sleepybunny

Could it Be B12 book is also available in Spanish. Think the title is "La vitamina B12".

Gambit62 profile image
Gambit62Administrator

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).

pernicious-anaemia-society....

FlipperTD profile image
FlipperTD

Scientist. Not medic.

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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