Vitamin B12 Deficiency - Tablets...

[Sarahlouiseis33]

Hi,

Has anyone had an experience of a vitamin b12 deficiency? I had low b12 and folate on a blood test at my doctors and have been given 5mg folic acid tablets and 50mcg cyanocobalamin tablets. Any advice would be great x

the only thing I know about B12 deficiency is that you get an injection every 8-12 weeks depending on how deficient you are. Its pernicious anaemia. Although maybe you have something different, Im not a HP so you might want to ask your pharmacist, they will be able to advise you.

You start on high dose tablets, try Holland and Barrett...then have a blood test after about 2-3 months, I no improvement get injections.

Hi OP

Do you eat a dirt containing plenty of B12? It's found in meat, fish, dairy, eggs, Marmite and some fortified breakfast cereals, energy drinks etc.? You need around 2 to 3 portions of food containing B12 each day to meet the RDA.

If you are already eating well, and your B12 is low, it's likely that you are unable to properly absorb B12 through your gut. This means that B12 in tablet form will also struggle to get to your cells, where it is needed.

According to Nice guidelines, if low B12 is not caused by poor diet then treatment should be regular injections for life. The trouble with tablets is that they will probably raise your serum B12 (the B12 floating around in your blood) but it still may not be getting to your cells.

@BlackInk - My diet isn’t great to be honest. I have very little dairy, no eggs and the only milk I have is in tea. I don’t eat a great amount of meat. I had the test for the intrinsic factor and it came back negative so I am trying the tablets first to see if they are helpful. I don’t have any symptoms of low b12 other than hair loss and oily skin which I don’t think is a symptom??

I'm on the tablets instead of injections and end up coming off them every few years then deficiency develops then am put back on them! My symptoms were all neurological.

@Longfacenow - What tablets have you been put on?

If you're on tablets it's probably because you have a dietary folic acid (vitamin B9) and/or cobalamin (vitamin B12) deficiency. Patients with pernicious anaemia have to have a form of vitamin B12 (hydroxocobalamin) injected because they can't absorb it from their small intestine owing to a lack of intrinsic factor.

Have you been told to change your diet so that the supplements can be stopped at some point? B vitamins come from meat/fish/dairy products but mostly from microorganisms, so anything dirty (e.g. root vegetables that haven't been washed too thoroughly) will contain some. If you can bear to eat tuna sandwiches or Marmite you should be able to get your levels up without supplements, otherwise breakfast cereals are fortified with B vitamins. Fruit with yeast on the skins (grapes, plums, etc.) should be good, too.

If you're getting neurological symptoms it's fairly severe. If you're not sure about your diet it is important that you keep taking the tablets and get your B12 levels checked regularly to make sure they're working. Do you know which autoantibodies you were tested for? There are three types that can occur in pernicious anaemia.

@BlackInk - The trouble with tablets is that they will probably raise your serum B12 (the B12 floating around in your blood) but it still may not be getting to your cells.

No. The lack of intrinsic factor (IF) means you can't absorb B12 from your intestine into your blood. B12 has to complex with IF to be taken up into the cells linining the last section of the small intestine (terminal ileum). Once the complex is inside those cells it dissociates and the B12 binds to a different carrier called transcobalamin II, which is what carries it into the blood.

If someone with pernicious anaemia (deficiency of IF resulting from autoimmune gastritis) takes B12 tablets the B12 stays in the intestine: it doesn't reach the blood. Once it's in the blood it will get to the cells that need it.

I take sublingual (under the tongue) tablets as my IF antibodies test also came back negative so they stopped my injections, but regular tablets didn’t seem to help. I’ve since read that the IF test isn’t very reliable so you may well have trouble absorbing through normal tablets.

There are also different kinds of supplements - the cyano one is considered to be worse than methyl due to the body having to convert it before it can be used. So try to find the methyl version. Jarrow do some good ones you can buy on Amazon etc for not a lot of money. Taking them sublingually has raised my B12 from 250 up to 900+ within a couple of months.

some info about different types of supplement