Does anyone have information about the possibility of being unable to replenish the B12 store in the liver? I have been self administering hydrocobalamin and methylcobalamin shots for over a year now.
I also went from a plant based to a carnivore diet (mostly lamb and eggs, frequent herring)
If I wait longer than a week to take a shot, I start getting symptoms again. (mostly agitation, concentration/cognitive issues).
Will I have to take shots every week for the rest of my life? I appreciate any input!
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HappyMonk
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Hi Nackapan. I understand how we can’t absorb from food but can you tell me through how we can’t use liver stores please? I want to understand it to argue with my GP if necessary…
If you have Pernicious Anaemia you will need shots for life . B12 that is stored in the liver of PA. patients , is of no use if you have P.A. as it cannot be absorbed in the stomach , due to lack if Intrinsic Factor and low or no stomach acid
Thank you. To be honest I am just glad I found something that works. I was pretty close to the edge for a while! But I was hoping to maybe be able to stop needing shots so often. But if that's what it is, I'm ok with that. 🙏🏼
I am happy for you that you see improvement. It's such an essential vitamin! Lately I have been experimenting with castor oil packs. These are compresses with castor oil, often placed on the area above the liver. Regular practice of this for 60 mins a day is said to improve liver function, stimulate the lymphatic system and blood flow to the liver. It's also very soothing and facilites a shift from the sympathetic to the parasympathetic nervous system, in other words, it brings about deep calm. It's also said it supports healing from fatty liver disease. There are ample resources online about the benefits of Castor packs. All the healing and best to you 🙏🏼🙏🏼🙏🏼
The b12 that is stored in the liver doesn't just stay there. It's part of the enterohepatic cycle, meaning it goes back into the small intestine, has to be absorbed again, goes back to the liver, and so on. So if you can't absorb b12 via intrinsic factor at all, you don't have a liver store.
If we have no B12 issues at all, we need only sufficient intake of B12 to replace the losses. Given that enterohepatic recirculation is incredibly efficient, that means something of the order of 3 micrograms a day. (Exact numbers vary.) Anything which affects the efficiency rapidly increases the amount of B12 that we need to absorb.
Reminds me of the energy store - ATP. Astonishingly, we make of the order of our own body weight of ATP every day. And use that up. But the constituents are very efficiently recycled.
Thank you all for your replies. I was not aware of the science of not being able to utilize B12 stored in the liver. I did determine by being aware of how my body reacts to supplementation that I need a constant supply of B12 supplementation.
Yes, concur with the other responses. Your liver stores a 2 to 3 year supply of B12 so it would seem, as my doctors told me, that once you build up liver stores you should be able to go for years without an injection. NOT True! The only B12 stores you have if you've been diagnosed with PA is that B12 currently in your blood serum, hence the need for frequent injections.
B12 is absorbed in the Terminal Ileum which is the last part of the small intestine. In order for those ileal receptors in the Ileum to accept and absorb B12 the B12 must be bound to Intrinsic Factor (IF) Protein. This binding takes place in the Duodenum which is the first part of the Small Intestine where also the Bile Duct is located and also where B12 from liver stores is secreted. For those with PA the B12 malabsorption problem is due to no Intrinsic Factor. When B12 from the liver is secreted into the small intestine via the bile duct and there is no IF then there can be no IF-B12 binding just as if you had ingested B12 orally. In other words the recycled B12 from your Liver stores just washes out through your urine right along with the B12 from the wonderful steak you just ate.
Thanks, Rex. I was unaware of this process. I thought the inability to absorb B12 had no impact on the ability to store B12. I don't have an "official" diagnosis of PA but seeing that I need weekly shots to function stably, I'm assuming it's the case. I suspect my history of substance abuse is the most likely culprit seeing I had no problems when I was younger.
I might however make an appointment with a local B12 clinic to see if I can confirm if I indeed suffer PA.
Well PA really doesn't affect your Liver's ability to store B12. Trust me your liver is storing away and that reservoir, most likely for all of us that are injecting, is at maximum. It's just the recycling part through the small intestine that is broken.
Also, you may want to consider getting a confirmation on PA or really Autoimmune Gastritis (AIG) as it's important to know to affect proper treatment. Maybe ask your doctor to run Parietal Cell Antibody (PCAB) and Intrinsic Factor Antibody (IFAB) tests.
Ah yes, of course. Now I get it. So it's stored but my body fails to get it in the blood stream through that route and intramuscular shots do reach the bloodstream and thus the cells that need B12.
Is it hard on the liver to store all that we inject (Note: I know b12 at high levels is safe)? Is there some sort of mechanism that makes another choice when that 'reservoir' is filled up?Curious.
Excellent question Litatamon which I've tried to answer myself. In all my research I've found reports that I believe state correctly that once your liver stores are at capacity any remaining B12 is just secreted in your urine. B12 has no toxicity at high levels because it is a water soluble vitamin unlike Iron which your body tightly controls the uptake as too much iron is toxic and not readily disposed of by the body. Additionally, although in some countries there are high levels of the population that are B12 Deficient, other Western Countries have populations that have a diet high in B12 containing foods such as seafood and beef. This population has high levels of B12 liver stores with little known adverse affects.
I must note that I'm certainly not an expert on liver but I have at least made myself comfortable that there is no toxicity.
I second (third) this question! I've periodically wondered about it myself. I like HappyMonk & Rexz's answers.
Personal anecdote - after nearly 7 years of 2x daily injections, my liver enzymes are the best they've ever been. Actually they've been good already for several years & they stay good. If excess b12 would harm the liver i'd be dead by now 😂
First of all , you are right , the inabulity to absorb B12 has no impact on the ability to store B12 in the liver . But those stores are of no use to you . You cannot make use of them without Intrinsic Factor. , ,
Also , it is very common for older people to get P.A. - nothing to do with substance abuse — So dont beat yourself up! I got P.A. when I was older - no substance abuse at all .
Getting a diagnosis is not easy because about 50% of P.A. patients get a negative result. Apparently the offending antibodies can appear and disappear in the blood ! Can take several tests to show up positive .
I was lucky -showed up first time . Good luck to you .
I got a positive result to the intrinsic factor antibodies test on my second test, but a note from the lab said the test result was less reliable for someone who was injecting B12. (Sorry, l don't remember the exact wording.)
So in an attempt to get even a false positive IFAB test to shove in my doc's face, i've injected an hour before the test and another time the night before (2 different labs) and they were STILL negative 😤
There's a paper - i'd have to look it up on my computer - that compares 5 of the most modern IFAB & GPCAB testing platforms and they are all extremely robust against FPs except one had slightly worse performance. So it seems the latest systems have a very low / almost nonexistent FP rate, but it depends on how recent the lab's protocols/machines are i guess.
The way I understand it, they set the bar for positive really high so that a positive result definitely means a positive result. Some things apparently can still skew the results, such as injecting B12, but they are able to print the caution on the report.
The one lab where i tested before starting injections , i had a result of '2' where the range is >6. I went back there last year, and injected the night before as i normally do 2x daily, and it was still '2' , same range . Lots of other labs don't even bother giving a level. Anyway now i'm just rambling. 😂
Hello! My maintenance dose is weekly and it has taken years to settle on that schedule. Like you, my symptoms creep back in if I don’t inject weekly. It took some time to deal with this fate but I am just very grateful that I was able to be properly diagnosed, eventually properly treated while not suffering any permanent effects. I will always envy those who can absorb B12 but such is life! Best of luck to you!
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