The most useful video on B12, with or without PA

[Pickle500]

youtu.be/7s76YDCAREY(Not working as expected?)

[Nackapan]

It's good.Pity it didn't mention b12 jections though.

[Technoid]

To respond to this idea of "optimum nutrient intake/allowance", it is useful to first revisit the Dietary Reference Intakes and how they are developed and set. The following text are segments from the US Institute of Medicine publication : "Dietary Reference Intakes", linked below and available free online. It is a large document of some 500 odd pages so I am excerpting the relevant material, but if there is any doubt on context you can reference the original text.

-----excerpt-----

Collectively referred to as the Dietary Reference Intakes, the DRIs include four nutrient-based reference values that are used to assess and plan the diets of healthy people. The reference values include

(1) Estimated Average Requirement (EAR)

(2) Recommended Dietary Allowance (RDA)

(3) Adequate Intake (AI)

(4) Tolerable Upper Intake Level (UL).

The Estimated Average Requirement (EAR) is the average daily nutrient intake level that is estimated to meet the nutrient needs of half of the healthy individuals in a life stage or gender group. Although the term “average” is used, the EAR actually represents an estimated median requirement. As such, the EAR exceeds the needs of half of the group and falls short of the needs of the other half. The EAR is the primary reference point for assessing the adequacy of estimated nutrient intakes of groups and is a tool for planning intakes for groups. It is also the basis for calculating the RDA.

The Recommended Dietary Allowance (RDA) is an estimate of the daily average dietary intake that meets the nutrient needs of nearly all (97–98 percent) healthy members of a particular life stage and gender group. The RDA thus exceeds the requirements of nearly all members of the group. It can be used as a guide for daily intake by individuals, and because it falls above the requirements of most people, intakes below the RDA cannot be assessed as being inadequate. Usual intake at the RDA should have a low probability of inadequacy.

If sufficient or adequate scientific evidence is not available to establish an EAR and thus an RDA, an Adequate Intake (AI) is usually derived for the nutrient instead. An AI is based on fewer data and incorporates more judgment than is used in establishing an EAR and subsequently the RDA. The setting of an AI usually indicates that more research is needed to determine, with some degree of confidence, the mean and distribution of requirements for that specific nutrient.

The Tolerable Upper Intake Level (UL) is the highest average daily nutrient intake level likely to pose no risk of adverse health effects for nearly all people in a particular group. As intake increases above the UL, the potential risk for adverse effects increases. The UL is not a recommended level of intake, but rather the highest intake level that can be tolerated without the possibility of causing ill effects. For some nutrients, not enough data were available to set a UL. However, this does not mean that consuming excess amounts poses no risks. Instead, it indicates a need for caution in consuming large amounts.

The values for the EAR and AI are defined by using specific criteria for nutrient adequacy and answer the question “adequate for what?”. For example, values for vitamin C were set based on the amount of vitamin C that would nearly saturate leukocytes without leading to excessive urinary loss, rather than the level necessary to prevent scurvy"

-----excerpt-----

from nap.nationalacademies.org/c...

[Technoid in reply to Technoid]

So from reading a little about how the DRI's, including the RDA, are set, it can be seen that the claim in the video that RDA's represent the minimum value needed to prevent disease is not correct and does not fairly reflect how the RDA is developed. He claims specifically that the RDA is the amount necessary to keep us alive and "prevent the onset of diseases like rickets". This is exactly what the document from the Institute of Medicine says is NOT the case about the RDA, as you can see above. So he is either ignorant about how the RDA's are developed or is deliberately misleading viewers here.

The Whitney/Rolfes textbook on nutrition (Understanding Nutrition) had this to say:

"1. Estimates of adequate energy and nutrient intakes apply to healthy people. They need to be adjusted for malnourished people or those with medical problems who require supplemented or restricted dietary intakes.

2. Recommendations are not minimum requirements, nor are they necessarily optimal intakes for all individuals. Recommendations target most people and cannot account fully for individual variations in nutrient needs."

The concept of specific values for "optimum nutrient intake" or "optimum nutrient allowance" has, as far as I could ascertain, no credible sources or scientific papers supporting it. It seems to be, as shown above, based on a misunderstanding of how the RDA is developed. The only references to it I could find were on the websites of chiropractors or naturopaths. There seems to be no such concept in nutritional science, although the nutrition textbook does grant that individual variations in nutrient needs mean that the optimal intake for individuals might vary significantly

I speculate that the concept may have originated with Patrick Holford's "Optimum Nutrition Bible" and/or its sequels, which was a popular health and diet book from way back in the day, since I recall reading some similar ideas there.

I think that the DRI's provide generally appropriate guidance but of course must be adapted for individual needs or circumstances. As for B12 , the way to meet the RDA is better understood imho by thinking about the absorption mechanisms along with frequency of intake, thus the 100mcg a day single minimum maintenance dose meets the 2.5 mcg RDA via 1.5mcg intrinsic factor (saturated) + 1 mcg by passive absorption. That doesnt mean that more might not be useful in some circumstances, especially in B12 deficiency and PA which usually have a whole host of issues which change the calculus - no intrinsic factor, broken reabsorption mechanisms, need to re-establish adequate B12 levels in tissues in initial treatment, probably others we dont really understand yet (there is unfortunately almost no good medical literature on why B12 injections are needed more regularly than any available B12-related test can determine).

But a proposed daily ODA (optimal daily intake) of 10,000 mcg for B12 (as he suggests) is just crazy, nobody even on an omnivorous diet with plenty of B12 containing food would come anywhere close to that kind of intake without supplementation. There's no physiological basis for such a recommendation and although those with PA, a B12 deficiency or neuropathy from same, may need huge amounts this is quite a special and unusual case with no applicability to the general population. If nobody could thrive without meeting this 10k mcg figure we would not expect any centenarian to be healthy and thriving without an "optimal" intake of 10k mcg of B12. This is patently ridiculous and makes me wonder about the motivations for suggesting such a figure, to sell supplements maybe?

If we check his youtube video description we find:

"Dr. Coppola and Dr. Monteiro also developed a neuropathy product line called NUPHORIA cm designed specifically to help their patients recover faster from neuropathy. Once available only to their patients within their clinic, NUHORIA cm is now available to the public at: (link to buy supplement here)

Just because he is selling these supplements doesnt invalidate his information but it does introduce a potential conflict of interest IMO.

Of course I have no disagreement that b12 is safe at extremely high dosages (there is no tolerable upper limit set for a reason) but this concept of an ODA thats 4 THOUSAND times higher than the RDA sounds like bunk to me. There are no references under the youtube video that attempt to support this wild claim. A reasonable discussion might be had about the B12 RDA in the direction of ~ 6mcg say but nothing like this 10,000 mcg nonsense. This is deficiency correction or special dose treatment where medical conditions warrant it which has nothing to do with optimum intakes for most people.

[Technoid in reply to Technoid]

I just noticed at the end of the YouTube video text that it explains that both doctors behind the channel are chiropractors not medical doctors, although we know how much most medical doctors know about Nutrition also so we cant hold that against them too much! 😆

[Pickle500 in reply to Technoid]

Do you think they got 10,000mcg wrong ? Maybe they mean 10mcg?

They go on to say that up to 3,000mcg per day is needed for nerve repair. And like you say, no-one could get 10kmcg from their diet each day or find a supplement at that level.

cartersvillechiro.com/exerc...

This is the only other thing I could find on ODA for B12 which, ironically, is from a chiropractor.

I would wonder if excessive B12 supplementation in the thousands everyday could avert many age-related disease and neurological complaints. And I do agree that toxins like alcohol, smoking, and excessive stress are all risk factors for overloading B12 reserves.

What would be really interesting to see is the effect that excesses in these areas has on B12 reserves. For instance, we know that nitrous oxide abuse from whippets/nos results in B12 deactivation and that may be because the toxins have overloaded reserves.

Similarly with alcohol, if one goes on a binge of excessive drinking, it can leave the body deplete and may result in a form of 'alcoholic neuropathy'.

In these cases, would excessive B12 intake really make the difference or would these effects happen anyway? Alcohol is said to affect absorption levels too, so there is potentially a double-impact on b12 from alcohol in terms of reduced absorption but also depletion in the form of toxin clearance.

In which case, could 10,000mcg be a 'foolproof' safety net amount to take in case one is under stress or drinks alot?

Like you say, it's all marketing. But it's an interesting take to hear that more B12 is needed in times of stress, when drinking regular amounts of alcohol or smoking. More data and research is needed to explore these. And in the meantime we can't overdose, so go crazy and take 10,000mcg a day to be safe 😂

[Technoid in reply to Pickle500]

Def more B12 needed in the cases you mention but I'm not sure how much. More research needed, as you say. I dont know where they pulled this 10,000mcg figure from. I was hitting about 10k mcg per day when I first started treating my deficiency, but there's no way that's needed in normal circumstances.

[EllaNore in reply to Technoid]

It is at least nice that somebody is trying to clear up the misconception that too much B12 can hurt you. Unfortunately according to you he hasn't got everything exactly right. It's hard to know what to believe out there anymore. I sure would like to know for sure how much I could take to start repairing this neuropathy in my feet. It's getting very debilitating. And I need more B12 or something. I've been injecting two ml a day for the last 3 days to see if that changes anything. But my feet are getting really bad. I just don't know what to do about it anymore. Except for to take more B12. I know some people who take 4ml a day.

I don't know how much MCG equals how much ml. If I'm taking 2ml a day how many MCG am I taking? Thanks technoid.

[EllaNore in reply to EllaNore]

So 1ml is 1000mcg

[Pickle500 in reply to EllaNore]

That's the right amount of saline/liquid. But 1,000mcg is 1mg of B12. So a 1ml injection has 1ml of liquid but can have a different amount of B12, e.g. 1,000mcg aka 1mg.

This guy in the video suggests 10,000mcg which can be represented as 10mg of B12 per day. So that would equate to 10 injections of 1ml/1mg of B12. Alternatively I believe it's possible to get 5mg of B12 in a 1ml injection, so perhaps that could be viable to achieve 10mg per day.

Either way, it's an astronomical amount that couldn't be reached via diet, unless you want clogged arteries from excess meat.

[EllaNore in reply to Pickle500]

Thanks for that clarification pickle 500. I know what you're saying about the amount of B12. One of my ampules has more liquid in it than the others but it's still one ml of B12 yet the liquid in the ampule is almost twice the amount as my other ampules. It's quite a bit to inject. I'm doing two ml a day right now to see if it helps my neuropathy. I'd like to find a higher dosage (more concentrated) of B12 in a 1 ml ampule.

Isn't 10,000 MCG what they give you for malaria and cyanide poisoning daily?

[Pickle500 in reply to EllaNore]

Yes exactly, there's the other way around with the Hervert brand, i.e. you can get 1mg (1,000mcg) of B12 in a 2ml saline solution. So that's twice the liquid to inject and half the effect.

So yes, you could achieve better results with a higher more concentrated dose of B12 e.g. 5mg of B12 in a 1ml liquid injection or ampoule. Or, if you can absorb it, you could swallow 4 drops of sublingual at 3,000mcg each. Of course, that has a different absorption process so would not be the same as an injection.

The whole thing is so densely complicated. We really need medical science to spend some time on this stuff!!!

[EllaNore in reply to Pickle500]

Thank you pickle 500. I'd love to find a concentrated double dose of B12 in a one ml ampule. Wouldn't that be sweet. I have absorption problems so I have to stick with injections although I am going to buy some methyl cobalamin sublinguals to see if I can absorb even a little bit of the methylcobalamin. Because that really helped me a lot. I don't know if you remember back when I accidentally took a month's worth of methylcobalamine in 5 days. I did get a bad headache and I did get insomnia but after it wore off a little bit I felt fantastic. I know the methylcobalamin made a difference. So I'm doing two times the dose of the cyanocobalamin to see if that helps me. I would really like to find methyl in an single dose ampule.

[Lincsangel1 in reply to EllaNore]

Pascoe hydroxocobalamin is a 1ml ampoule with 1500mcg of B12So 50% more B12 per injection 😀

[EllaNore in reply to Lincsangel1]

Thank you LincsAngel1, I believe I saw those ampules online. I wasn't sure what that all meant at the time. I will have to try those! 😊

[Lincsangel1 in reply to EllaNore]

I buy from versandapo.de It's the best price I've found

Only €83.99 for 100 ampoules.. in date for around 2 years too

I inject this daily

Yellow box

[EllaNore in reply to Lincsangel1]

Thank you so much for posting the link LincsAngel1. I sure hope they ship to the United States. I'm excited to buy some.

[Lincsangel1 in reply to EllaNore]

They ship worldwide When you have added to basket don't click on checkout... click either pay via paypal or amazon pay... that way you don't have to put your address on their website that's expecting a German address

[EllaNore in reply to Lincsangel1]

Ok thank you so much!!

[EllaNore in reply to EllaNore]

Here is a live link to it. versandapo.de/vitamin-b12-d...

Thanks for the info LincsAngel1!

[wedgewood]

A mistake in the video — that B12 cannot be overdosed because it is a water -based vitamin . This could lead people to think that other water - based vitamins can’t be overdosed , which is not the case . .

[Pickle500 in reply to wedgewood]

True

[Orchard33]

Very interesting and allays any concerns about taking too much.

[Delilahmy]

Thankyou Pickle500 great video

[WIZARD6787]

My take is the creators of the video believe they have specialized insight and do not. Not unlike a GP that refuses to follow the current science of 12 deficiency and will not prescribe B12 injections one milligram every other day. I believe it is an emotional defect and not a cognitive one.

[Pickle500 in reply to WIZARD6787]

I think you're right. Perhaps this exposes the reality that no-one, no medic or Doctor, really could say they understand B12 deficiency or even the process of absorption it goes through.

So perhaps this medic is suggesting that, at the bare minimum, someone could take an astronomical amount and not keel over or cause long term problems for themselves. That, at the very least, can be a universally accepted truth about B12.

[EllaNore]

Thanks pickle500

[WiscGuy]

I am skeptical of these people. It seems their main occupation is in sales, selling the products they market under their own label.

[Pickle500 in reply to WiscGuy]

I suppose my cynical and jaded view is that medics are also driven by money. Hence why they don't want to give out B12 injections easily but will happily prescribe PPIs or pain medications without running tests.Since this realization that medical support is not what I thought it would be, my mind is wide open to the reality that no-one on earth can say they're an expert in B12 and so a piece of data from here and another from there is the only way to make ourselves better.

Of course they are selling a product. But in the absence of sensible wisdom from anyone in the medical communities, beyond a couple of innovators, their advice in particular seems the most helpful Ive found for neuropathy treatment and general management of B12 deficiency.

[WIZARD6787 in reply to Pickle500]

I am slowly moving towards not caring why medical personal are the way they are towards preparing for when I have to see them and then shower after the appointment. Knowing I am going to be used.

In the USA I have access to their notes on a portal. I have read these notes and they are full of lies. It is common for them to distort what I actually say and common for them to write they said something when they did not in a successful attempt to avoid liability. They also lie for each other.

There is also a secret file only they get to see. I can not imagine what is in that file.

I do not think the behavior is limited to B12 treatment. I think it is systemic. Having read what I have read here I no longer feel I am being singled out.