Can you teach me about B12 supplementation?

[Laurie4b]

My B12 was low normal (less than 300) and my dr. was reluctant to even test for it and said the result was "normal" so I don't feel like I can ask her about supplementation. 

 

I had asked before about normal levels on the board and got some rec's for supplements, but want to ask more specifically now that I've done some looking into what is available.

 

I do eat plenty of meat & fish, so I assume my level is due to some other factor. I am over 50 which is a risk factor for low B12.  There is Alzheimer's in the family so I really want to keep everything optimal for delaying any possible cognitive decline. 

 

I have never been tested for the MTHFR mutation. 

 

I looked at B12 supplements and they are like sky high way about RDA. Is that okay? 

 

Which brands are trustworthy? ( I couldn't find any with independent lab verification of B12 content) 

 

How would it matter if I did or did not have the MTHFR mutation in terms of which supplement to use? 

 

Since I take in enough B12 in my diet but it doesn't show up in bloodwork, am I better going with a sublingual brand? Those would go right into the bloodstream, right? 

 

Recommendations as to brands are most welcome!

Edited April 17, 2016 by Laurie4b

[Guest]

I don't know the brands, but both doctors who have prescribed B12 for me (over past 15 years) have given me sublingual, one in a quick-dissolve pill and the other in drops.  So yeah, sublingual, based on that experience.  I don't have much else to add, though, other than to say that you don't want to O-D it, and what is "normal" is a statistically derived number, meaning that you, as an individual, can be a complete outlier and still be normal for YOU.  So experiment a bit, and keep track of the effects (if any).  But use the numbers as an indicator, not a rule.  My doctors told me that, too.  :0)

 

[Carol in Cal.]

What effects are normal/expected?

[VeteranMom]

Are you taking any medications that interfere with b12 absorption?  Do you have problems with food allergies or sensitivities?

I have to take injections.  My original level was 151.  I believe nexium and metformin affected my ability to absorb b12.  If you ingest too much b12, it's excreted in your urine.  Vitacost sells b12 sublingual drops.  Those might be a better way to get your levels up quicker.

I'll refer you to the book "Could It Be B12".  It helped me a lot.   

[Laurie4b]

I don't know the brands, but both doctors who have prescribed B12 for me (over past 15 years) have given me sublingual, one in a quick-dissolve pill and the other in drops.  So yeah, sublingual, based on that experience.  I don't have much else to add, though, other than to say that you don't want to O-D it, and what is "normal" is a statistically derived number, meaning that you, as an individual, can be a complete outlier and still be normal for YOU.  So experiment a bit, and keep track of the effects (if any).  But use the numbers as an indicator, not a rule.  My doctors told me that, too.  :0)

 

Yeah, but they have correlated low normal levels (as well as below normal US levels) with Alzheimer's. So while it may be "normal" for me, I want to optimize it in case it helps. 

 

When you say, I don't want to OD it, that is a concern b/c of how high the dosages are but I've also read that an upper limit hasn't been set because it's generally not toxic at high levels. 

 

Did you take a prescription brand or a store brand? If store brand, which one?

[Laurie4b]

Are you taking any medications that interfere with b12 absorption?  Do you have problems with food allergies or sensitivities?

I have to take injections.  My original level was 151.  I believe nexium and metformin affected my ability to absorb b12.  If you ingest too much b12, it's excreted in your urine.  Vitacost sells b12 sublingual drops.  Those might be a better way to get your levels up quicker.

I'll refer you to the book "Could It Be B12".  It helped me a lot.   

 

No, not taking any meds that should interfere. 

 

I'll look for the book. 

[gardenmom5]

I take the usrda with an enormous grain of salt.  e.g.  the usrda for vitamin d (they do NOT specify d3, but that's the form you want) is *still* only 400 IUs.. . . back when they were only concerned with vitamin d to prevent rickets.  rickets is a risk with a d3 level below 7 . . . today,  50 is considered a minimum for a healthy d3 level, and d3 has been reclassified as a hormone. (came up in one of dd's pharm classes)  I was taking 4,000 IUs (10X the usrda) - 6,000IUs for six years and my d3 level *still* never hit 50.  the oil  used as a base affects absorbancy.  so, I won't buy any more supplements from costco.  I've switched to a high quality brand - so I'm interested in what my d3 level will do.

 

so - onto b12.

methylcobalimum is the most bioavailable molecular form.

 

the  most effective delivery method is via injection into  fat every other day. the syringes and needles are very tiny - I believe they are the same used for insulin.  (if you pee red - you didn't get it into fat.)

 

the 2nd most effective delivery method is sublingual.  dissolves underneath your tongue.

 

dudeling won't cooperate with the injections rx by his naturopath - so, we do 1mg sublingual every morning.  I use NOW brand because I'm okay with their quality for the price.  there are better quality brands.  (brand must be certified to contain what it claims.  there are a lot out there that simply do not contain what you are paying for.)

 

for mthf mutation - you want methytetrahydrofolate.  aka: mthf.  the ONLY brand I will buy  otc is Thorne. (it's the brand almost every ND will recommend.)  I have used the rx form deplin - Thorne is better.  My ND found a pharmacy that uses the same source as thorne,  so I tried theirs, switching from the deplin.  I noticed the difference in three days.  and it's cheaper than the thorne.  (more than deplin, but I feel  better than with the deplin.)

[Laurie4b]

I take the usrda with an enormous grain of salt.  e.g.  the usrda for vitamin d (they do NOT specify d3, but that's the form you want) is *still* only 400 IUs.. . . back when they were only concerned with vitamin d to prevent rickets.  rickets is a risk with a d3 level below 7 . . . today,  50 is considered a minimum for a healthy d3 level, and d3 has been reclassified as a hormone. (came up in one of dd's pharm classes)  I was taking 4,000 IUs (10X the usrda) - 6,000IUs for six years and my d3 level *still* never hit 50.  the oil  used as a base affects absorbancy.  so, I won't buy any more supplements from costco.  I've switched to a high quality brand - so I'm interested in what my d3 level will do.

 

so - onto b12.

methylcobalimum is the most bioavailable molecular form.

 

the  most effective delivery method is via injection into  fat every other day. the syringes and needles are very tiny - I believe they are the same used for insulin.  (if you pee red - you didn't get it into fat.)

 

the 2nd most effective delivery method is sublingual.  dissolves underneath your tongue.

 

dudeling won't cooperate with the injections rx by his naturopath - so, we do 1mg sublingual every morning.  I use NOW brand because I'm okay with their quality for the price.  there are better quality brands.  (brand must be certified to contain what it claims.  there are a lot out there that simply do not contain what you are paying for.)

 

for mthf mutation - you want methytetrahydrofolate.  aka: mthf.  the ONLY brand I will buy  otc is Thorne. (it's the brand almost every ND will recommend.)  I have used the rx form deplin - Thorne is better.  My ND found a pharmacy that uses the same source as thorne,  so I tried theirs, switching from the deplin.  I noticed the difference in three days.  and it's cheaper than the thorne.  (more than deplin, but I feel  better than with the deplin.)

 

Is there harm in taking the kind fo mthfr if you don't have the mutation?  Since I haven't gotten tested, I might just want to cover that base...

 

And for the NOW brand is the sublingual same as the lozenges? And NOW is certified? (That is a concern of mine, too.) 

 

Just an aside, the Nature Made brand of Vit D is certified by an outside lab. It's pretty inexpensive. 2000 mg increased my d from 27 to 37, so I'm now trying 4000 to see if I can get over 50. 

[mom2samlibby]

Did you doctor check your iron level and your folate level also?  Without those in the proper level, your body won't absorb & utilize B12 properly.

 

The book Could It Be B12?  recommends that anything below 500 be treated.  Folate should be around 16 - 20 and iron close to 80.

[Laurie4b]

Did you doctor check your iron level and your folate level also?  Without those in the proper level, your body won't absorb & utilize B12 properly.

 

The book Could It Be B12?  recommends that anything below 500 be treated.  Folate should be around 16 - 20 and iron close to 80.

 

No, those weren't tested. She didn't quite roll her eyes when I asked to have the B12 tested, but gave that same kind of vibe. My hematocrit and red blood cell counts, etc. were good but she didn't order iron or folate. 

 

I do have "subclinical" neurological problems, which make me wonder even more about the B12. I've read older people can have neuro symptoms but not the anemia issues. 

 

The whole problem is finding a doctor who takes it seriously. 

[Crimson Wife]

There's a nose spray that is supposed to be better than sublingual if you can't find a doctor willing to write you a prescription for the injections.

[gardenmom5]

Is there harm in taking the kind fo mthfr if you don't have the mutation?  Since I haven't gotten tested, I might just want to cover that base...

 

And for the NOW brand is the sublingual same as the lozenges? And NOW is certified? (That is a concern of mine, too.) 

 

Just an aside, the Nature Made brand of Vit D is certified by an outside lab. It's pretty inexpensive. 2000 mg increased my d from 27 to 37, so I'm now trying 4000 to see if I can get over 50. 

NOW is certified.  I used to take naturamade b-complex. for years, - not anymore.  I only noticed it was helping when I had NOT taken it for a week.  Now, I use emerald laboratories b-healthy.  after a week, it was like someone flipped a switch.)  I also used NM d-complex (and the Costco brand), and my d3 level did rise, but I still couldn't get it above 50.  look at the oil used as a suspension. 

 

- are the lozenges to be dissolved under the tongue?  then it's probably just the binder.

 

mthf won't  build up.  your body will use it - or excrete  it.  so, it won't hurt you to take extra if you don't have the mutation.

 

if you do have the mutation, and you are symptomatic -it will affect your body's methylation cycle (as in - making it start to work when it hasn't previously) - and you can actually be  more sensitive to it.  I have two copies of the mutation, and  I've had to increase my doseage VERY VERY slowly  after 2 1/2 years, I'm currently at 8.5mg.  dudeling's ND had us start out at 1mg am/pm, and increasing another 1mg am/pm per week until he was up to 15 mg total per day.   watching for any contraindications.  (e.g. it  makes you feel odd/worse.)

 

 

 

 

 

[mom2samlibby]

No, those weren't tested. She didn't quite roll her eyes when I asked to have the B12 tested, but gave that same kind of vibe. My hematocrit and red blood cell counts, etc. were good but she didn't order iron or folate. 

 

I do have "subclinical" neurological problems, which make me wonder even more about the B12. I've read older people can have neuro symptoms but not the anemia issues. 

 

The whole problem is finding a doctor who takes it seriously. 

 

YES!!!!  That's why many self treat.  :(  I'd recommend getting the book mentioned - Could It Be B12?

[Guest]

Yeah, but they have correlated low normal levels (as well as below normal US levels) with Alzheimer's. So while it may be "normal" for me, I want to optimize it in case it helps.

 

When you say, I don't want to OD it, that is a concern b/c of how high the dosages are but I've also read that an upper limit hasn't been set because it's generally not toxic at high levels.

 

Did you take a prescription brand or a store brand? If store brand, which one?

Store brand but from a compounding pharmacy. Not from Rite-Aid, if you get my drift. I don't remember the brand.

[HS Mom in NC]

I lost the ability to absorb B12 at some point.  Sometimes that's genetic and sometimes it's a digestive system problem.  I had some symptoms that indicated anemia so they tested for that first.  They discovered my B12 was low and likely the cause of the anemia so they gave me shots.

My B-12 levels were so low I had to be on injections for weeks to get back up to normal levels.  When they were back up I could either switch to capsules or continue the injections.  Injections can be done without a prescription at the local med spa in my gyno's office so I do that. They're cheap too, $50 for a package of 5 or $12 each.  It's easier to get a shot twice a month or more than mess with daily supplements for me.

Some athletes get the shots for the burst of energy for competitions.

You can also get a prescription to do your own shots.

I go see nurse Heidi for my 2 minute appointment at the med spa on the way home from Homeschool PE every other Thursday.

[fdrinca]

Any time I do  B supplementation, two things happen:

 

1. I break out like crazy. Big, bad pimples.

2. I feel like I excrete all of it through my urine, which turns bright orange despite drinking lots of water.

 

B vitamins have such a horrible taste to them. Am I the only one? I gag whenever I take them - and I've taken a variety, hoping to get one that I can tolerate. 

[Alicia64]

No, those weren't tested. She didn't quite roll her eyes when I asked to have the B12 tested, but gave that same kind of vibe. My hematocrit and red blood cell counts, etc. were good but she didn't order iron or folate. 

 

I do have "subclinical" neurological problems, which make me wonder even more about the B12. I've read older people can have neuro symptoms but not the anemia issues. 

 

The whole problem is finding a doctor who takes it seriously. 

 

Anything in the neighborhood of your doctor rolling her eyes is just flat wrong. I would look for a new doctor and I don't say that lightly, but not being on board w/ your concerns can lead to serious health problems.

 

Alley

[gardenmom5]

Any time I do  B supplementation, two things happen:

 

1. I break out like crazy. Big, bad pimples.

2. I feel like I excrete all of it through my urine, which turns bright orange despite drinking lots of water.

 

B vitamins have such a horrible taste to them. Am I the only one? I gag whenever I take them - and I've taken a variety, hoping to get one that I can tolerate. 

it sounds like it gets your body doing  a toxin dump, that could make you break out.  you might wan to look at a lower dose.   the urine dumping is indicative you aren't absorbing much.  maybe also trying the injections - they are absorbed more slowly.

[ktgrok]

I recently switched to the methylated forms of B12 and Folate due to having a single mutation of the MTHFR gene. I was fine for a while, but lately was having anxiety, rapid heart rate, intolerance to caffeine, etc. Some people do have that reaction. At first, I just felt energized, but after a few weeks it was like I was on speed. 

 

The last two days I've gone back to the regular kind to give myself a break and my pulse rate is back down and I feel a lot better. I could actually sleep and everything. I may play around with dosage in a bit but I needed to get this book written and can't do that while having panic attacks!

[gardenmom5]

I recently switched to the methylated forms of B12 and Folate due to having a single mutation of the MTHFR gene. I was fine for a while, but lately was having anxiety, rapid heart rate, intolerance to caffeine, etc. Some people do have that reaction. At first, I just felt energized, but after a few weeks it was like I was on speed. 

 

The last two days I've gone back to the regular kind to give myself a break and my pulse rate is back down and I feel a lot better. I could actually sleep and everything. I may play around with dosage in a bit but I needed to get this book written and can't do that while having panic attacks!

 

what it sounds like is it is getting your methylation cycle working the way it is supposed to work (but hasn't been) - but that also means the toxins that have built up overtime, are dumping.  use a much lower dose.

my allopath knew enough to test me, but not remotely enough to treat me.  she automatically told  me to take 15mgs.  I knew better, I knew better, but I was  too tired . . . then,  when I told her I was having side-effects, she told me to stop cold turkey and just not take it.  uh - no. (I hope to not have tia's like my mother and grandmother and aunts - one of the things linked to mthf.)  I did know enough to know ramping is necessary.  so, I ramped down slowly over a couple weeks.  loved that burst of energy.  I think I was down to 1 or 2mgs for six months.  I didn't feel much - but I wasn't  having side effects either.  I wanted it to start my methylation cycle - without making me ill.  I'd only add a mg every few months.  If I have issues - I go back down.

 

I'm now at 8.5mgs and I'll see how I am in another couple weeks and I'll consider adding another mg.

I do feel so much more functional on it - I can just do stuff,  instead of having to force myself.

[ktgrok]

I was only getting 600mcg in my multi, plus another 1mg taken separately. Today I am taking just the old multi, with regular folic acid, and finishing my work. Tomorrow I'll take the regular and add in the 1mg methylfolate I think. Or take the multi but not the extra 1mg. 

[hornblower]

Any time I do  B supplementation, two things happen:

 

1. I break out like crazy. Big, bad pimples.

2. I feel like I excrete all of it through my urine, which turns bright orange despite drinking lots of water.

 

B vitamins have such a horrible taste to them. Am I the only one? I gag whenever I take them - and I've taken a variety, hoping to get one that I can tolerate. 

 

I have this problem with b-complex but not with plain b12. B complex makes me queasy.  Plain b12 is fine. 

 

I take cyano & use the chart under #1. Vitamin B12 Recommendations here: http://www.veganhealth.org/articles/vitaminb12