I know a 78 yo M who had 4.5 ft of ileum removed when he was a teenager, related to a ruptured appendix. He did fine for decades on once monthly cyanocobalamin shots. Then 8 y ago his doctor decided to take him off the shots, and put him on oral B12. Also he's been taking a PPI for "hiatal hernia" and cholestyramine to help control his diarrhea. Both these drugs reduce the absorption of nutrients. About two years ago he had bilateral carpal tunnel syndrome repaired with surgery, and the past year he's had worsening of his cognitive function, impaired memory, depression, walking/balance issues, and more fatigue. His doctor has agreed to check a MMA and homocysteine, but even if these are normal, I think he should start the B12 injections every other day for at least 5 weeks. His doctor prescribed cyanocobalamin 3x/wk for 2 weeks. Please share your thoughts and suggestions about this.
What form of cobalamin injections is ... - Pernicious Anaemi...
What form of cobalamin injections is best for neuro symptoms?
If his terminal ileum was removed he needs B12 injections.
just to add - this is because the terminal ileum is where B12 is absorbed.
Whilst high dose oral (>1000mcg per day) can be effective as a replacement therapy for some patients (relies upon passive absorption - a different absorption process) there are significant numbers of patients for whom this is not effective.
With such severe symptoms , I think that your acquaintance needs every other day B12 injections until the symptoms disappear or stop improving . Needed asap , because symptoms can become irreversible if not dealt with soon enough ( I know, it happened to me )
If doctor will not agree , then I would obtain B12 ampoules from Canada and self inject . You can self inject using the sub-cutaneous method , or Intra muscular .
It is sometimes said that Methylcobalamin is best for neuro-symptoms , but as he has been treated successfully in the past with Cynocobamalin, it obviously suits him
Best wishes .
It seems like medical negligence to perform bilateral carpal tunnel surgery on a patient who is 6 years post being taken off of B12 shots. With his medical history, the B12 deficiency should have been obvious. Why are there so many doctors in practice who don't know what they've doing??
What do I do for the best? B12 injections now to be denied?
What is the hugest dose of B12 you can take?
Metformin and B12 Levels
