B12 levels

[Minimouse1]

Hi, I am going to try raise my B12 level as it's currently low. Sublingual B12 along with a good B complex was suggested by Admin on this site. I did a bit of research & joined the a B12 group too. They are advising that the uptake from B12 supplements is minimal & B12 injections should be used. I'm wondering if anyone has much experience of this - are injections really necessary? How would we know if we actually had absorption issues as opposed to just poor quality of diet??? Also it was said that as B12 levels increase iron or ferritin can go down so do we then need to supplement that too??

[SlowDragon Administrator]

Unless someone has Pernicious Anaemia, B12 sublingual supplements usually work fine

taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.

B12 sublingual lozenges

amazon.co.uk/Jarrow-Methylc...

cytoplan.co.uk/vitamins/vit...

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

[Minimouse1 in reply to SlowDragon]

Would indications of PA show up on a full blood count test or is a specific test for PA required?

[SlowDragon Administrator in reply to Minimouse1]

Your B12 isn’t low enough for PA

PA is a separate autoimmune disease

[helvella Administrator Thyroid UK in reply to Minimouse1]

There is no test for PA.

An Intrinsic Factor antibodies test can give a positive diagnosis but a negative result (which is common) does not mean you do not have PA.

[Minimouse1 in reply to helvella]

Confusing! So you could have an intrinsic factor antibody test which shows negative but if so it does not necessarily you don't have PA? So, so how do people get a correct diagnosis?? Did I misunderstand your message....

[helvella Administrator Thyroid UK in reply to Minimouse1]

That is quite right.

That really IS the problem.

In years past there was the Schilling test but for several reasons that is no longer available. It was expensive, required care and attention in being administered, but was quite good.

Test serum B12. Test Active B12. Test MMA (methylmalonic acid). Test homocysteine. Take into account symptoms and patient history. Trial B12 injections.

I suggest at least some of this thread (link below) might be of interest:

healthunlocked.com/pasoc/po...

In turn, that thread (thanks to fbirder) links to this document:

hey.nhs.uk/wp/wp-content/up...

[Minimouse1 in reply to helvella]

My B12 level was 375ng/L (211-911) & Serum Folate 8.6 (5.4-20). GP didn't test my Ferritin level. Think my confusion has come from joining a B12 group who advised getting an MMA urine test & asking GP for B12 injections. I thought it would be as simple as taking supplements! also the B12 group advised to watch iron levels, apparently as B12 rises iron can go down adding another complication! I have no reason currently to think I may have PA.

[Minimouse1 in reply to helvella]

B12 group sent me this article - b12-vitamin.com/urine-test/

[helvella Administrator Thyroid UK in reply to Minimouse1]

Yes - quite a bit there. But still no definitive way of identifying Pernicious Anaemia in those who are not positive to an Intrinsic Factor antibodies test!

[thyr01d]

Hi Minimouse1, I do know about this a bit so can offer some advice because I am vegan and there is no B12 in a vegan diet unless we eat foods that have had it added, which I hardly ever do. I therefore supplemented B12 only to be told when referred to an endocrinologist that my B12 was very high. For some years now I have been taking just B complex and no extra B12 unless I think I need it for some reason and my B12 levels remain within normal range.The thing that I think is most important is knowing that if we take too much of one of the B vitamins that can deplete others. Many B complex supplements contain generous amounts of the cheap B vitamins and a paucity of the expensive B vitamins. I therefore check the RDA of each of the B vitamins in the complex to make sure they are as close to each other as possible, ie all around 50% of the RDA, or, all around 100% but not some at 100% and others at 50%.

Hope that helps.

[Minimouse1 in reply to thyr01d]

Yes, the B12 group I joined seem to indicate that as B12 levels rise iron/ferritin can go down - not sure how we keep track of all these levels without spending a fortune on regular vitamin tests. My GP didn't test my ferritin level so I don't have a starting point!

[thyr01d in reply to Minimouse1]

Thank-you Minimouse1, you have given me another important piece of information. Good luck on your journey back to health.