B12 Questions

AranthosF

Hi all,
Long story short:

I have been feeling quite tired as of late (over a year or so) and so decided to go check my thyroid.
Went to get a blood test and the doctor said they would run a few other ones first to see if my problem might be caused by something else.
There's not much back apart from slightly low B12 level (210).

I am vegetarian (7 yrs), so this is the most probable cause however I do eat dairy products so... Perhaps not?

Anyway - I'm 23 excercise moderately (3 times a week... Nothing too crazy) but the tiredness is starting to annoy me more and more and is becoming a neusance.

My sleeping patern is quite solid - 9 hours a night as well as my diet is quite good (ehh... Aside from possible lack of B12 intake!)

The GP (not my regular) suggested I take supplements for it.

However they failed to fill me in on any more info (dosage! frequency,.. What they actually do!! - practice seemed to be more interested in quantity rather than quality)

So - to my question(s)
I've read a small bit online about possible ways to get B12.
From what seem excessive 40,000% a day oral tablets to injections.

From the report around 750\800 is the high side of the levels of B12 you should have and 180 on the lower end.
However ... It seems like this is the sort of vitamin your body doesn't mind having enough of so - wouldn't it make sense to aim for the 750\800 or am I missing something when the doctors not too pushed at 210?

Also:
If I were to take a supplement (say 100%+) a day - how long would it be before it starts to increase to a more comfortable level? (Even mid range 400/500)

Thanks for any help you can give!

locum-motion

What do you mean by "...40,000%..." and "...100%+..."?

AranthosF

locum-motion wrote: »

What do you mean by "...40,000%..." and "...100%+..."?

The options to take B12 range from taking high dose tablets (which seem unnecessarily excessive (Some liquid tabs I've seen as high as 80,000%!) to just taking 100% of your allowance for the day.

locum-motion

I have never before seen a dose of anything expressed (primarily) as a percentage of the RDA.

Doses are expressed as milligrams (mg), micrograms (mcg) or International Units (IU).

Sometimes a package of something might also specify how much the dose corresponds to as a percentage of RDA*, but this is very much incidental.

Perhaps for the avoidance of confusion, you shouldn't try to re-invent the wheel and should stick to normal convention.

*for example, from the package of Cytacon Tablets:

Cytacon Vitamin B12 Tablets
Each tablet contains: %RDA
Cyanocobalamin (Vit B12) 4mcg 100%

Stick to describing it in mcg, please.

locum-motion

Anyway:

Vitamin B12 is present in most non-vegan foods, so therefore virtually everybody who isn't vegan should get sufficient through their diet. Vegans need B12 supplementation, and that's what the Cytacon I mentioned above is for.

However:

Some people - despite taking what should be sufficient B12 in their diet - are unable to absorb it from their gut. In these people, taking a Cytacon tablet isn't going to be of any use - if they can't absorb it from their food, they can't absorb it from a tablet either. The main reason why a person might fall into this category is a disease called pernicious anaemia, where (due to a genetic malfunction) the person lacks the ability to produce a chemical called Intrinsic Factor. No Intrinsic Factor = no absorbtion of B12. Another possible reason is medication - there seems to be a link between acid-reducing medicines for ulcers and problems of B12 absorbtion, for example.
For people in this situation, the usual practice is to give the B12 in injection form. This bypasses the gut entirely, so the problem of absorbtion doesn't arise.

That being said, it's not quite as simple as that. When I explained the above to someone else here on Boards a couple of years ago, another poster came back to say that if people - who ordinarily can't absorb B12 - take a large enough dose, some of it gets into the bloodstream. However, I'm only repeating what a poster here said - I've never seen/heard/read that from any other source.

Finally, I remain convinced that some doctors are a little bit less than 100% ethical about diagnoses of B12 deficiency, although this is less of a problem than it used to be. I am sure that some people are or have been prescribed B12 injections purely so that the doctor can bring them back month after month to administer the injections. At a charge, natch! Many years ago, there was one GP (since deceased) close by where I used to work whose private patient population appeared to have approximately a 15x greater incidence of pernicious anaemia than the remainder of my patients. Funnily enough, though, it wasn't anything like as prevalent in her Medical Card patients.

miss no stars

If you're a 23 year old your levels should be way, way above 210. I was 21 when my levels went that low and was told that the range is huge, but for my age I should ideally be around 900-1000. I got 4 injections of it and noticed some difference after the first and a mega difference after the second. If it was me, I'd be going to another doctor or nurse who can be bothered and asking what your best course of action is right now to get your levels back to normal, but you also need to be thinking longer-term about why your levels got so low to begin with.

I was told it takes 7 years to burn through your body's reserves of B12. You say you've been vegetarian for 7 years and now run out of B12. That sounds like more than a coincidence to me. If you stop getting enough B12 from your diet it takes years for clinical symptoms to show up. Humans are omnivores. Not by choice but by evolution. The human body has evolved to need a certain amount of B12 and that's most easily gotten from meat sources. Not even in huge amounts - 2 chicken breasts a week would be plenty of B12 to maintain healthy levels. You obviously have a reason for being vegetarian, but if it was me I'd be looking hard at that choice. In order to get B12 from dairy products, the dairy products need to be milk or very soft cheese. B12 is water soluble, so hard cheese really doesn't have much in it at all. I dunno OP, going veggie goes against millions of years of evolution. If I for whatever reason refused to eat potatoes or oranges or any decent source of vitamin C and I ended up deficient, I'd be more inclined to have a baked potato twice a week than supplement with pills.

Arataki

I was a vegetarian for 6 years and always had trouble with my B12 levels. According to my GP your levels should be at least 200 and he recommended injections over tablets.

George Vitaminb12

Hello, I'm looking for a doctor that really understands Vitamin b12 as my GP does not seem to have up to date knowledge of this. Can anyone recommend someone?

The_Conductor

The main doctors who encounter issues with B12 on a regular basis are those who have significant numbers of patients who have trouble absorbing it. This would include any gastroenterologist in the country. However- they are consultants- rather than GPs. Aside from gastros- any good haematologist will have a good idea too (though normally you'd be referred to a haematologist by a gastroenterologist- with a specific list of concerns.

People who have trouble absorbing B12- very often have trouble absorbing other things too- so it is something you need to have monitored/dealt with.

You need to get your GP to do a full spectrum of blood tests- and refer the results to a haematologist. Some hospitals include a lot more tests in an FBC than do others- it would be helpful to try to get as many tests done as possible- as it may help with uncovering the underlying reason for this......

George Vitaminb12

Thanks for the information, I feel that there is a long road ahead of me with this and I'm only beginning to understand the issue properly, having received a very unpleasant wake up call recently when I experienced a dramatic deterioration after a surgery (it seems that nitrous oxide is not a friend of B12). This time, I want to get effective treatment and will push for tests and referral. Now that I have a better understanding of just how severe symptoms can become, I'm shocked at what seems to be a quite dismissive attitude of most of the medical profession towards b12 deficiency.