Hi there,
I've bought the Better You 'Vit B12' and 'Vit D + K2' sprays and am wondering if I need to wait 4 hours after taking my levothyroxine to use these as with ingested vitamins...?
Vitamin Sprays: Hi there, I've bought the Better... - Thyroid UK
Vitamin Sprays
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pandacat2
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SlowDragonAdministrator
No
They are absorbed in mouth. Perhaps leave an hour
Only start one at a time. Probably vitamin D first
How low is your vitamin D?
Retest levels after 2-3 months
B12 ...full dose is four sprays a day (I think?)
Suggest you start with one spray...add another later in day.
First time you use it, if do four sprays all at once you might get aching tummy
Better You make vitamin D that also contains vitamin K2
Over on the Pernicious Anameia Society there is extreme doubt that B12 gets absorbed in the mouth whether from sprays or any other form.
Seems that research doesn't see any different absorption using one of the sprays or so-called sublingual products as against just swallowing. Which indicates that little to none is actually absorbed in the mouth.
(Otherwise you would expect blood levels to increase by a greater amount as some is absorbed in the mouth and the rest from the gut.)
For more information, have a look here:
For example:
healthunlocked.com/pasoc/po...
Many of us without PA find sublingual B12 or B12 mouth spray do raise levels
Personally I got sick of the taste of B12 spray, preferred sublingual lozenges by Jarrow
If you have PA you would need injections
How do you know you absorb in the mouth and not the gut?
Well if you are only spraying in mouth.....I guess you might swallow a small amount
I found Vitamin D mouth spray works much better than tablets for me.....with Hashimoto’s and gluten intolerance I have poor gut function
From PAS:
All the studies that compare them say that you absorb about 10 mcg from a 1000 mcg dose.
That strongly indicates that B12 is not absorbed sublingually.
The studies show about 1% of an oral dose of 1000 mcg is absorbed across the gut.
If 10 mcg is absorbed sublingually, then 990 mcg is swallowed. It becomes an oral dose. So you would expect about 1% of that dose to be absorbed from the gut, to give a total of 19.9 mcg absorbed. But you don't - you just get the same 10 mcg as if you'd swallowed all of the dose. The simplest interpretation is that you have swallowed 100% of the dose and none of it is absorbed sublingually.
In an amazing coincidence, the maximum amount of an oral dose of B12 that people without any absorption problem can absorb (using Intrinsic Factor) is about 13 mcg. Which is almost exactly what people with PA are supposed to be able to absorb passively and almost exactly what is supposed to be absorbed sublingually.
Occam's Razor says that the obvious explanation is that all of those studies have measured the absorption of oral B12 via the IF method.
I shall point out this recent paper:
Comparison of sublingual vs. intramuscular administration of vitamin B12 for the treatment of patients with vitamin B12 deficiency
link.springer.com/article/1...
The paper is poorly titled as they included oral tablets - not just sublingual.
And they determined no significant difference between sublingual and oral.
Patients were randomly assigned to receive eithersublingual therapy (500μg) or one of two oral preparation regimens: one daily tablet of 500μg orally, or two tablets daily of a vitamin B complex each containing 250μg cobalamin,100 mg thiamine, and 250 mg pyridoxine). Their results showed that in all groups, the sVB12 levels increased significantly and there was no significant difference in the level sVB12 between the treatment groups.
I cannot see any advantage in B12 sprays over tablets - to be swallowed or to be allowed to dissolve/disperse in the mouth.
I wonder if this might be due to the enzymes in our saliva. Saliva enzymes kick off the digestion process. Spray in mouth will mingle with saliva before slithering down our throat into the gut, hence better end result than swallowing a tablet straight down.
I currently use B12 patches...they seem to work for me
"Better You" B12 spray also works... but patches are easier!
No problems with either.
But how do you know you absorb orally rather than in your gut?
One explanation!
Research into B12 patches has been, shall we say, patchy! 
Straight slap B12 onto skin has very poor results.
But there might be somewhat better results with a system which uses micro-needles. And it is not impossible to consider some transporting substance which carries B12 through skin or elsewhere.
Do bear in mind that my comments have been expressly about B12. Not vitamin D or anything else.
Added Vitamin D and B12 results above.
Already tried them both yesterday 'D & K2' is three sprays, B12 is four sprays. Didn't hurt my stomach so all good on that front. I was just wondering if the reason for waiting 4 hours to take supplements is because of gut or blood stream processing of the levothyroxine.
I was already taking 500iu / day of Vit D when i took this test. Spoke to doctor and she suggested i increase to 1000iu-2000iu
GP will only prescribe to bring vitamin D levels to 50nmol.
ouh.nhs.uk/osteoporosis/use...
But improving to around 80nmol or 100nmol may be better
ncbi.nlm.nih.gov/pubmed/218...
vitamindsociety.org/pdf/Vit...
Once you Improve level, you will probably need on going maintenance dose to keep it there.
Test twice yearly via vitamindtest.org.uk
It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average
Government recommends everyone supplement October to April
gov.uk/government/news/phe-...
Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamins
betterbones.com/bone-nutrit...
medicalnewstoday.com/articl...
livescience.com/61866-magne...
sciencedaily.com/releases/2...
Bone pain
easy-immune-health.com/pain...
naturalnews.com/038286_magn...
Vitamin K2 mk7
betterbones.com/bone-nutrit...
healthline.com/nutrition/vi...
Vitamin D mouth spray by Better You make a version that also contains vitamin K2 Mk7
B12 and folate on the low side. Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial.
chriskresser.com/folate-vs-...
B vitamins best taken in the morning after breakfast
Igennus Super B complex are nice small tablets. Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks
Or Thorne Basic B or jarrow B-right are other options that contain folate, but both are large capsules
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results
endo.confex.com/endo/2016en...
endocrinenews.endocrine.org...
Low B12 symptoms
b12deficiency.info/signs-an...
Low vitamin D and low B vitamins may be linked as explained here
drgominak.com/sleep/vitamin...
In YouTube video...vitamin D at 40ng/ml (USA units) is equal to 100nmol (UK units)
Dr Gominak
SlowDragonAdministrator
How much levothyroxine are you you now taking?
Previous post showed you needed dose increase in levothyroxine
I went to doctors on Tues cos new NHS blood test results (was on 100mg Levo) managed to get them to test T3!
TSH 1.46 (0.27-4.20)
T3 3.6 (3.1-6.8)
T4 16.5 (12-22.00)
Doctor thinks that these are completely normal, however from what I've learnt here I know they need to be improved as I have Hasimotos. I convinced her to allow me to increase dose to 100mg x 5 days, 125mg x 2 days. Only just started this, personally think it should be more but have agreed to see how it goes and restest in 8 weeks. Feeling much better but it's still a bit up and down.
Something i haven't mentioned here or to doctor is I suffer muscle pain and foot pain. I know that being 6 months into treatment and only just getting to nearly adequate dose I can't really expect this to have gone away yet, I'm just wondering if it's potentially vitamin related
Plantar fasciitis is often linked to low vitamin D and/or low Ft3
Clearly your conversion of Ft4 to Ft3 is currently poor and dose of levothyroxine still inadequate
Ft4 is currently only 45% through range
Ft3 only 13% through range
Helpful calculator for working out percentage through range
Looking to increase levothyroxine so that Ft4 is at least 60-70% through range....ideally Ft3 at similar %
Improving low vitamin levels helps improve conversion of Ft4 to Ft3
Strictly gluten free diet can help too
Have you had coeliac blood test?
Are you on strictly gluten free diet yet?
Get bloods retested in another 6-8 weeks
Bloods as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
Remember to stop taking vitamin B complex 5-7 days before test
Post re how to push for dose increase in levothyroxine
healthunlocked.com/thyroidu....
NICE guidelines
nice.org.uk/guidance/ng145/...
1.3.6
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
BMJ also clear on dose required
In my experience, there is nothing wrong with the Better You sprays, in fact the Vitamin D spray was the ONLY thing that worked to raise my dire levels from 4 to 100. I could not absorb/tolerate Vit D in any way due to severe gut issues...they even gave me a course of Vit D injections, but the results were very poor. In fact I read a letter that was in my medical notes to my Dr suggesting that a high ranking professor/researcher had recommended Better You spray as the best and most effective method of raising levels. I'm not sure why that would be the case if they were known to be poorly absorbed.
I also had serious problems with B12 deficiency, [I had every symptom except diarrhoea] as my folate was BELOW range for over 20 years, but I wasn't told, and the B12 spray worked very well to alleviate my symptoms, while I waited for orders to arrive...I take Jarrows sublingual B12 5,000 some days as well, and my levels are always over 2,000, and I'm symptom free. I also take a B complex and some extra single B's, as it took a while to sort out exactly what I needed due to the long term deficiencies. Perhaps if you have PA it's different, but for me, the Better You sprays are a real life saver...I use almost all of them!👍 x
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