So i am fully aware that those of us with PA don't absorb b12 through our diets, and that we ideally require treatment through IM injections. But i have also seen articles that suggest that it is at least 'possible' to get 'some' b12 from oral supplements. What do we think about this? I have copied in a link below to an article, though i dont think the link is going to work properly.
The most interesting paragraph from this link is this:
'Traditionally, vitamin B12 replacement is administered intramuscularly. However, it is believed that oral vitamin B12 can be absorbed passively independent of intrinsic factors. Passive diffusion accounts for about 1% of total absorption, and this route of absorption is unaffected in patients with pernicious anemia '
On the back of this i have just ordered a jar of 6000mcg per dose sublingual under the tongue drops(which apparently is better than pills). I dont expect this to be enough to sustain my b12 levels without the injections, but i want all the b12 i can get! Anyone else take oral supplements?
I have , in the past , taken huge quantities of normal oral tablets , sub- lingual tablets and nose and mouth sprays — all to no avail . But as you quote from the article , “It is BELIEVED that oral vitamin b12 can be absorbed passively , independent of Intrinsic Factors. “ Unfortunately it did not work for me . Only injections do .
But for some it does work , and I hope that it does for you . Best wishes .
In theory high oral doses work but in practice for many with PA they do not, or do not work sufficiently to avoid return of, or exacerbation of, B12 deficiency symptoms.
If you've already had all the B12 biomarker testing that's any use to you from the medical profession e.g. MMA or IFAB and PCAB tests for PA for example, then feel free to go wild on B12 supplements to see if they make a difference for you.
I don't have PA or absorption issues so I get by on a conservative oral dose of 130mcg a day 😅
They work for me. But I do have to take a lot. And I don't think that sublingual liquid is actually absorbed under the tongue - I think it is swallowed and passively absorbed. Please look at my previous posts which explains the situation in more detail.
After I was diagnosed and ordered up B12 and hardware to SI my wife bought me everything she could see. . . . . Only thing that even began to work was sublingual but the amounts needed were a real pain and unaffordable. . . . . We only need a few ug of B12 per day and even with injection we loose the vast majority of what is injected in our urine. . . . All research shows that and ye know by the colour of your pee. . . . . . Throw in the wastage of sublingual and ye need several 1000ug per day of that stuff . . . . . . Oral was a complete waste of time . . . . . SI was the only route to having any effect . . . . . And mind. . . . . Most of us do not become effected overnight so we dont really remember what feeling well was really like. . . . When we get our first loading injections we often feel a great relief when in reality we are only partially sorted. . . . . I got loading jabs for two weeks and once those stopped it was not long until I missed them . . . . . What I didnt know was that it would take lot more jabs than I ever thought. . . . . The great relief is far from being fit as such. . . . I read on here about people jabbing much more than I did in the past and I could not really understand how they could need so much Cobalamin. . . . . What I didnt know was that my idea of feeling good was only felling a bit better with a lot of road still to travel . . . . . I was initially put off quite a bit by quite severe kind of acme after a few jab close together .. . . . I solved the acme thing along with a couple of lingering symptoms and I can now use as I please but that took me at least two years of cautious trials. . . . . There really is no manual on this and I gave up paying for blood tests that at best were an educated guess as you will already gather so I operated on symptoms. . . . . We all suffer from placebo effects so everything we try has to run for several months to show us we are not simply imagining things. . . . . . SI is cheap-----ish or as cheap as you will find and after few 100 you will be able to keep whats needed in the car in case your body runs low and SI in a quiet spot where you sit. . . . . Not moving of course . . . . . I keep all I need in my little doblo van although I have only needed it a few times but it can creep up sudden like now and again. . . . . It was a couple of years before I could recognise the symptoms/feelings of that
Just thinking of something there now as I read some of this again. . . . . What about the 6x or 10x amount of cobalamin required and the processing. . . . . . It seems like only days since I read here about those concerned about cobalamin with better credentials. . . .
Passive absorption is a real thing but it is a bit hit and miss, Studies (generally small scale) imply it works for somewhere between 60-80% of people, at least in terms of amount of B12 circulating in the blood). This seems to be true whatever the B12 absorption problem. There was a large scale trial of high dose oral in Canada that showed a similar proportion of patients preferring high dose oral to injections.
High doses of sublinguals didn’t work for me. I actually supplemented orally during my very first injections because I crashed after the first week. After getting my bloodwork back and learning I had also been supplementing sublingually during the two monthly injections I received, the doctor could tell that I wasn’t absorbing the oral b12 and simply told me I’d have to go back on injections without any further explanation.
I knew nothing about b12 deficiency and was convinced the cause of mine was the use of a proton pump inhibitor. I believed I was cured because I had discontinued the use of that drug and went to high doses of methyl sublingual, no injections. In three months, I was so sick that I could barely drive myself to the doctor and was nearly out of my mind by that point. After a long journey to getting frequent enough injections, I have no deficiency symptoms with regular weekly IM injections of hydroxo.
I hope you find something that works for you as everyone is different!
Hi, if those 6000mcg are methylcobalamin and you haven't used that before as smaller doses can I please suggest that you try a lower dose one first and work up to those if you need to, and are getting on ok with methyl. Some people don't tolerate additional methyl groups well (can get hyper, irritated, nauseous, anxious even manic and just sometimes it can be a significant reaction). Others of us actually need more methyl groups, but always a good idea to start low and slow, changing just one thing at a time. I do use oral and sublingual and over the course of a day I take more than 6000mcg, but in three cobalamin forms and different makes. I started with about 500mcg methyl and had previously been on cyano. Cheers
I appreciate your advice, thank you. But I will probably go for it anyway. It is methylcobalamin. It has been delivered today and ill be home in an hour to try it out. I feel like death warmed up anyway plus i now have the weekend off. I don't currently have anything else to use. I will report back and you might get the chance to say 'I told you so!'
I wouldn't do that, and I hope you find it helps. It does for me, and adding methylfolate to it (in small quantities) made a big difference too - but I know I have problems with folate metabolism. Best wishes.
I take a methylcobalamin spray every 3rd day in addition to cyanocobalamin IM every 3rd day. I rotate: Injection, day off, methyl spray, injection day off, methyl spray, etc.
I do think the spray helps me some, at least keeps my B12 level higher. I don't take it every day because I think I have some trouble with overmethylation and I get some side effects.
Shortly after my PA diagnosis and battle with my GP who refused to comply with the NICE guidelines re. loading doses for patients with neurological symptoms I started taking Solgar methylcobalamin 1,000mcg sublingual tablets, one a day. I believe I had had decades of B12 deficiency but it did bring about some improvement. My main problem appeared to be with the additive mannitol which eventually caused stomach upsets. I also tried sublingual liquids but it just appeared to be swallowed anyway. Certainly the tablet was useful until I could pluck up the courage to SI. Good luck.
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