Vitamin B12: Look Ma, no needles!

If I could hand out trophies to anthropomorphic representations of vitamins, D3 would be getting gold (with K2 holding onto its back) and B12 would be taking a strong silver.

B12 is a supplement I’ve been taking for a couple of years now to correct a deficiency (2yrs ago: 140 pg/mL, ‘normal’ = 200-900), although there was a disputation by another doctor who didn’t believe my original level was low enough to require treatment.
I had been offered seasonal intramuscular injections – like my mother, whom I likely inherited this problem from – but being a Google fiend I wanted to learn a bit more and came to understand that, while I was deficient (the second doctor who viewed my original result thought my common value meant I didn’t have a problem), it wasn’t necessary to have a sore arm four times a year at the GP.

High strength B12 tablets are absolutely adequate to correct a deficiency. Not because standard dose tablets are inadequate in themselves, but because if you lack the cells which absorb B12 at normal amounts (a likely case in my scenario given that a lot of food I eat has ample amounts) you need at least a thousand units daily since 1% of a given dose is absorbed by an alternative pathway [the reference for this is not open access but referred to on many articles]. The smaller the dose, the less units get fed to that pathway.

Since declining the injections and taking 1250 IU per day my level reached an optimal level (589 pg/mL). But I did not experience any visible benefits since I hadn’t been suffering from the obvious effects of B12 deficiency. A B12 deficiency, like a D3 one, is often insidious, so this is more of an investment from problems like Alzheimer’s disease. I was, however, perniciously anaemic on account of fairly large, immature red blood cells and these normalised when my B12 level did. I was hoping B12 would also reverse some minor premature greying, but it hasn’t.

My B12 deficiency came to light only 3 years ago, my mother was diagnosed as deficient about a decade prior. She had been given tablets to start with – the ordinary low dose – and upon their obvious failure had to succumb to the jab; a very unfortunate event as my mum hates needles more than most people, even though she is qualified in being able to give others intramuscular injections. The injections did their job but, perhaps due to sensitivity issues at such a large dose in one go, she would feel pretty dizzy for a few days after. Being underweight also meant that needle entry at any point was quite painful.

Knowing that my mother would prefer tablets I asked her to tell her hospital doctor on her second-last yearly appointment that she would like to give the tablets another final go. Amused, the doctor thankfully let her and gave her a prescription of ordinary – low dose – tablets again. High dose isn’t available on the NHS and I don’t think she would’ve got her way if she said she was going to get her own.
But get her own she did, and six weeks ago she had her last appointment. She didn’t get her B12 result because they said they would only write if there was a problem, so while I don’t know her exact level, she wasn’t forced to see her local nurse; the tablets sustained (or exceeded) the level of the 1000 mcg jabs. As far as they know, she’s taking what they prescribed, which I’m sure would have seen the return of the needle. My mother had a very evident problem with anaemia and they do not drop the ball in her treatment.

I have seen recently in the press that Simon Cowell likes to have B12 IVd into him, but this is just ridiculous. High dose tablets and sprays means treating B12 deficiency is convenient nowadays. I do, however, believe that a lot of people are probably vitamin B12 deficient (not to extent of the vitamin D deficiency pandemic though), so it’s worth getting a test, and in this case, being disobedient to the ancient UK treatment guidelines. Our Atlantic friends already treat B12 deficiency often through high dose tablets. It’ll either give you more energy or save you from a host of other problems.

B12 is easy to find in high doses in most local online outlets. I and my mother take 5000 IU in recommended methylcobalamin form every four days. The tablets are often cherry flavoured and easily dissolve under the tongue.

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