I require the assistance of a PAS member more knowledgeable about different synthesises of B12 and german suppliers, please. The photo below shows some b12 injections from Germany. Anyone able to shed light on whether this is hydrooxocobalamin?
A bit of context, I've found an aesthetic nurse locally who offers B12 injections. She sent me this photo of packaging.
I'm only in my first 3 months since loading injections with gp after PA diagnosis. They won't give me an injection more than 3 months. Symptoms have returned as intense as before and making it realky hard to live life well. So am exploring different options.
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DocAJB
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Hydroxocobalamin is the B12 that you would have received at your surgery . It is supposed to stay in the body longer than Cynocobalamin. ..It is honestly so easy to self-inject once you have got over the fear that it might engender in you ( well it did in me 8 years ago , but now it’s routine !) You will find out by trial and error how often you need to inject to keep those horrible symptoms at bay. We are all different , and require different frequencies of injections . You cannot overdose on B12 . You can also take a daily modest Folic Acid tablet 400 mcg. It works with B12 .
Here are some tips should you decide to try self-injecting . It’s really cheap to self-inject . About £1.00 for an injection , and that includes the B12 depot Hydroxocobalamin ampoule , the syringe , the withdrawing needle , the injection needle , and the swab . And you do need a yellow sharps bin to dispose of needles .
HELP FOR PERNICIOUS ANAEMIA/B12 DEFICIENT PATIENTS AND OTHERS WISHING TO SELF-INJECT B12
ALWAYS MAINTAIN STRICT HYGIENE WHEN SELF-INJECTING .
WHERE TO OBTAIN SINGLE-USE B12 DEPOT ( Hydroxocobalamin) AMPOULES
As B12 ampoules are strictly prescription only items in the U.K. we have to obtain our ampoules from reliable German online pharmacies, which are strictly controlled by the German Health authorities . These ampoules are an over-the-counter ( OTC) item in Germany ( thank goodness for their wisdom!) But only obtainable from pharmacies .
Every pharmaceutical item has its own reference number on the pharmacy site , so it’s easy to use those numbers to get straight to the item you need ,without searching .
Depending on what you want to order, here are the reference numbers to use in your search .
PANPHARMA ( previously known as Rotexmedica )
A packet of 10 ampoules of B12 Depot ( Hydroxocobalamin)
1mg x 1ml Ref no. 16199653.
Panpharma do not sell the 100 ampoule packs any longer.
HEVERT -Packet of 10 ampoules 1mg x 2ml ref no 06078368
HEVERT Packet of 100 single-use ampoules 10 x 10 packets ref no. 06078380
PASCOE -Pack of 10 ampoules 1.5 mg x 1ml ref no 07568672
PASCOE Pack of 100 ampoules ((10 x 10 packs) Ref no 07568695
Here are German online pharmacies that will ship to the U.K. by courier usually DHL FOR €9.89 no matter how many you buy .
versandapo.de ( it is in German , so you might need Google Chrome or a translation app)
It’s really best to register . You will save time with subsequent ordering ,and they have a points system if you register . 200 points when you first order , and one point for every Euro that you spend . When you have 250 points , that represents €2.50 which you can use against your next purchase .
You register and subsequently sign in by clicking on the head and shoulders silhouette top right.
When filling out the address it is important to FIRST OF ALL SELECT YOUR COUNTRY FROM THE DROP-DOWN LIST. The U.K. is shown in German as VEREINIGTES KÖNIGREICH . So click on that and then the computer will accept your postal code and the rest of your address . If you don’t do this , your address will not be accepted .
You need to pay with PayPal ( easily obtained online ) or bank transfer. Free of charge with online banking . £25.00 at your bank !Versandapo.de does not accept card payments from U.K.
juvalis.de is another German online pharmacy that will ship to U.K.
These sites are in German so you might need Google Chrome or a translation app.
amazon.de ( German Amazon) is available in English ( click on the globe to change language) On my iPad it is at the bottom of the page.
You cannot use the Pharmaceutical reference numbers on amazon.de
amazon.de does not supply Panpharma ampoules.
They do supply HEVERT and PASCOE .
When you get the ampoules, they need to be kept dark and under 25 Celsius .I keep mine in the top shelf in the door of my fridge . It’s the warmest spot . On no account should the ampoules be frozen .
NEEDLES, SYRINGES , SWABS AND YELLOW SHARPS DISPOSAL BINS .Obtainable from ———————-
I don’t use one , but you could enquire about it from members . I know that some do use this device .
There are others , but I don’t have any information. But don’t buy needles or syringes if you are thinking about it .The device takes specific sizes for different sizes
If you are sensitive , a numbing cream is obtainable from Amazon .
I use I.M.method for injecting. I use my thighs ( the outer middle third ) I swap thighs each time I inject.
If you wish to inject sub-cut , please look it up on the Internet ( I believe it’s the tummy fat and the whole front of the thigh)
If you are injecting with B12 for the first time , please have someone with you, in case of anaphylactic shock ( like some people have after a bee-sting ) It is really very rare , but I feel obliged to tell you .
Do not worry about overdosing on B12 . You cannot . It’s a proven fact .
I’ve been self-injecting for 6 years , but I still remember shaking like a leaf 🍃when I injected for the first time ! Now it’s just routine.
Remember to include a good quantity of Vitamin B9 in your diet ( green leafy veg) It works together with B12 . It’s called folate in food and folic acid in a tablet. You could take a modest 400 mcg tablet daily. ( these are recommended in pregnancy . ) You cannot overdose on folate in food , but you can overdose on folic acid in tablets .
TO INJECT INTRAMUSCULARLY
Flick the ampoule to get all the B12 into the bottom .Open it by either wrapping a swab around it to avoid cutting yourself , or use an ampoule opener . Break it at the weakest point , which is marked with a spot on the neck of the ampoule
Use a 2ml syringe .(with a 1ml syringe ,it’s impossible to get every last drop of precious B12 out of the ampoule!) Fix the withdrawing needle on the end of the syringe . Pull out the plunger on the syringe and SLOWLY inject air into the ampoule . Now pull out the plunger and all the precious B12 will be sucked up into the syringe . Now take off the withdrawing needle and replace it with the injection needle .. Now press out the air in the syringe , until a tiny bead of red B12 appears on the needle tip.
YOU ARE NOW READY TO INJECT INTO THE VASTUS LATERALIS MUSCLE. ( it’s nearest the surface of your thigh in the middle outside third of your thigh - look up info online .There are also diagrams of the thigh and the muscle ) Inject at 90 degrees .
For sub cut please refer to internet , as I’ve not used this method , or ask members on the forum .
After injecting please dispose of needles into a yellow sharps bin . When full, ask your local council how you can dispose of the full bin . Disposal varies in different areas . I can take mine to a local chemist .
Sometimes Pernicious Anaemia Patients suffer with “gut” problems , tummy pain and bloating etc . This happens because P.A. patients have low or no stomach acid . Hypochlorhydria/ Achlorhydria. ( due to the destruction of their parietal cells by antibodies ) The intrinsic factor is also destroyed . This low acid environment allows bad bacteria to flourish, which upsets the flora ( good bacteria ) in the stomach . Some P,A. patients find that taking an acidic drink like diluted organic cider -apple vinegar , lime / lemon juice with meals ,especially protein meals , really helps this .
The greatest help for my “gut” problems was a probiotic called Symprove , a water-based liquid . But there are probiotic capsules The probiotic encourages the growth of the good stomach flora . Also good to take after a course of anti-biotics , which destroy all bacteria good and bad .
Natural probiotics work well e.g. Organic sauerkraut , real yoghurt, kimchi and kefir .
Since getting the B12 treatment I need by getting adequate B12 injections, and the probiotic Symprove, the gut problems have disappeared . I no longer need Symprove ..
It is a good idea to eat smaller meals more often if one has low stomach acid ( as Pernicious Anaemia patients do ). Also chew food very thoroughly, giving the enzymes in saliva a good chance to start the breakdown of the food .
In severe cases of very low or no stomach acid ( Hypochlorhydria / Achlorhydria ) a capsule called Betaine Hydrochloric acid with pepsin will increase the acid in the stomach .( Amazon smile) Taken at mealtimes , can be used , but best to ask a nutritionist about dosage . It was uwill vary according to how much stomach acid you have . There are instructions about dosage online .
A modest multi-vitamin and mineral tablet can also be helpful , as a low acid stomach is not good at absorbing minerals and vitamins .
The Rotexmedica ampoules that you show have been taken over by a French company called Panpharma . The packaging is identical except that they are called Panpharma ., They are stillmanufactured in Germany .
You pack is Cyanocobalamin. Perfectly ok to use, just be aware it doesn’t last as long in the body as hydroxocobalamin.I get cyanocobalamin at my GP surgery (in UK) after pushing for more frequent injections. It’s a bit of a cop out that they’ve moved me onto cyano, but it’s licenced for use every four weeks, rather than the 8 or 12 weeks for hydroxo.
I’m not too bothered as I self inject hydroxo (from Versandapo.de, every four weeks as well.
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German Panpharma depot info sheet typo?
What exactly is Functional B12 Deficiency?
B12 Injections 
Seeing a biochemist to discuss maximising PA treatment...any ideas for questions?
