Vitamin B12

Response to Vitamin B12 and Folic Acid in Myalgic Encephalomyelitis and Fibromyalgia

Björn Regland*,Sara Forsmark, Lena Halaouate, Michael Matousek, Birgitta Peilot,

Olof Zachrisson, Carl-Gerhard Gottfries

Gottfries Clinic, affiliated with Institute of Neuroscience and Physiology, Gothenburg University, Gothenburg, Sweden



Patients with myalgic encephalomyelitis (ME, also called chronic fatigue syndrome) may respond most favourably to frequent vitamin B12 injections, in vital combination with oral folic acid. However, there is no established algorithm for individualized optimal dosages, and rate of improvement may differ considerably between responders.


To evaluate clinical data from patients with ME, with or without fibromyalgia, who had been on B12 injections at least once a week for six months and up to several years.


38 patients were included in a cross-sectional survey. Based on a validated observer’s rating scale, they were divided into Good (n = 15) and Mild (n = 23) responders, and the two groups were compared from various clinical aspects.


Good responders had used significantly more frequent injections (p<0.03) and higher doses of B12 (p<0.03) for a longer time (p<0.0005), higher daily amounts of oral folic acid (p<0.003) in good relation with the individual MTHFR genotype, more often thyroid hormones (p<0.02), and no strong analgesics at all, while 70% of Mild responders (p<0.0005) used analgesics such as opioids, duloxetine or pregabalin on a daily basis. In addition to ME, the higher number of patients with fibromyalgia among Mild responders was bordering on significance (p<0.09). Good responders rated themselves as “very much” or “much” improved, while Mild responders rated “much” or “minimally” improved.


Dose-response relationship and long-lasting effects of B12/folic acid support a true positive response in the studied group of patients with ME/fibromyalgia. It’s important to be alert on co-existing thyroid dysfunction, and we suspect a risk of counteracting interference between B12/folic acid and certain opioid analgesics and other drugs that have to be demethylated as part of their metabolism. These issues should be considered when controlled trials for ME and fibromyalgia are to be designed.

More information at

research Sally Pacholok on Vitamin B12 deficiency the book is on it's second edition

15 Replies

  • Vitamin B-12, or Cobalamin, is the largest and most complex vitamin currently known to man. A slight deficiency of vitamin B-12 can lead to anemia, fatigue, mania, and depression, while a long term deficiency can cause permanent damage to the brain and central nervous system. Vitamin B12 can only be manufactured by bacteria and can only be found naturally in animal products, however, synthetic forms are widely available and added to many foods like cereals. Vitamin B12 can be consumed in large doses because excess is excreted by the body or stored in the liver for use when supplies are scarce. Stores of B12 can last for up to a year.

  • Trawled the discussion most of what I picked out was meat against vegans bad mouthing with dumb arguments. Food that I can eat without bad reactions chooses a big chunk of my diet does get same old then I think how taking a chance works out. Good nutrition is what your body wants allergy testing keeps you safer than the looking for a gas leak with matches that is picking food on high B12 numbers.

  • I think there is evidence that most of us metabolize our diet poorly so that taking in the recommended 1000mcg does not replace depleted stores or keep up with amounts required. Using amounts that treat the symptoms alongside the best diet we can tolerate as a safe guard against demyelination of the nervous system.

  • 1 Blueberries. 'Antioxidant' seems to be the new buzzword

    2 Almonds. Almonds are truly one of nature's miracle foods. ...

    3 Whey Protein. Whey protein

    4 Salmon. ...

    5 Psyllium Husk. ...

    6 Spinach. ...

    7 Turkey. ...

    8 Oatmeal.

    Boost your metabolism !

  • Oatmeal starts my day around taking my drugs with food

  • Searched on Sally Pacholok more researching education

  • Thanks Halflife was a name I heard talked about in a good way.

  • Have use sub lingual Methylcobalamin B12 5000mcg after breakfast for the last two years. Guess taking supplements is the same as taking advil how bad would life have been without taking anything.

    Cheap compared with drugs and no bad side effects which is a big plus because if there were any I usually have a piece of the action.

    Folic acid, Ferretin,Magnesium Sulphate and Coenzyme Q10 are all in the supplements that cover the Nutrition in SHINE protocol.

  • The Shine protocol is news for me thank you for sharing something that is working for you Stormchaser.

  • Taken a download of the SHINE protocol thanks Stormchaser back with questions later LOL

  • This is helpful Feroglobin B12 liquid from Holland and Barrett has been working well for me that is one site I haven't been on.

  • Have you a before taking blood work up against now my early stage was around bloods / hair sample on levels that came in low.

  • Glad that you have found something that is making a positive difference for your symptoms msBrightside.

  • One more hidden disease B12 deficient a doctor has tested my cholesterol given healthy heart advice, advice on losing weight not one word on B12