B-12 Supplements...tablets vs injections

[billethkid]

My sister has been getting B-12 for the last few years for low B-12.
A lot is written about injections vs tablets much of which concludes no difference in results.
The next issue is dosage....500/1000 mcg per day???
How best to determine what to take.
She is not ready to ask the doctor to switch....I volunteered to do some research and would appreciates opinions/suggestions from TOTV members who have been confronted with this issue.

Based on what I have read I would not hesitate to take the tablets instead of monthly injections!

_______________________________________

:censored:

[villagetinker]

IMHO, I would absolutely ask the doctor, the dosage for pills maybe very different from the dosage forinfusion, and the frequency of the pills needs to be considered. I would not rely on medical opinions.

[retiredguy123]

I have always understood that injections were more reliable than pills because of the inconsistent reliability of the digestive system. I used to give a friend of mine regular injections of B12 drawn from a vial. If you can do it yourself, it seems to me the best way to go, but I am not a medical expert.

[blueash]

There is a rare condition, pernicious anemia, where the patient is unable to absorb oral B12 because a factor produced by cells that line the stomach don't make that factor or the lining of the stomach is absent from surgery or other rare conditions.

If you cannot absorb oral B12 then injection is the only option other than massive oral supplementation to try to get sufficient amounts into the bloodstream. There are very rare cases other than absent intrinsic factor that can impair B12 transport.

There are two reasonable approaches depending on whether you are treating a symptomatic person... they need B12 now so give the shot to correct the deficiency while you do the evaluation. But if the patient has no symptoms it is perfectly reasonable to try oral supplementation and follow up with a blood test to see if the B12 deficiency is corrected.

Those doctors who give you a B12 shot to boost your energy are quacks or crooks, IMO. YMMV

[golfing eagles]

There is a rare condition, pernicious anemia, where the patient is unable to absorb oral B12 because a factor produced by cells that line the stomach don't make that factor or the lining of the stomach is absent from surgery or other rare conditions.

If you cannot absorb oral B12 then injection is the only option other than massive oral supplementation to try to get sufficient amounts into the bloodstream. There are very rare cases other than absent intrinsic factor that can impair B12 transport.

There are two reasonable approaches depending on whether you are treating a symptomatic person... they need B12 now so give the shot to correct the deficiency while you do the evaluation. But if the patient has no symptoms it is perfectly reasonable to try oral supplementation and follow up with a blood test to see if the B12 deficiency is corrected.

Those doctors who give you a B12 shot to boost your energy are quacks or crooks, IMO. YMMV

Agree, with 2 modifications:

1) pernicious anemia is not all that rare, the most common cause being anti-intrinsic factor antibodies and more rarely a transcobalamin deficiency. The prevalence in the general population is 0.1% but is 1.9% in those over 60.

2) If oral supplementation is ineffective, a trial of sublingual B12 supplementation might have better results.

[Two Bills]

Two years ago I started to get tired and breathless. I put it down to getting older (I'm 83)
Eventually went to doctor, had blood tests, and found my B12 levels were very low.
Had a course of 6 injection over two weeks, and now have a single top up every 3 months,. Felt better ever since.
Cannot take tablets as I cannot absorb the stuff orally.
I also take iron to raise my red cell count as well, as that was also lowish.
Definitely do not change unless doctor authorizes as your sister maybe another case where absorption orally is a problem.
As a footnote.
If tablet form is recommended, always take B12 tablets and iron on an empty stomach for best results.

[Lisanp@aol.com]

B12 is better absorbed in an oral drop then a tablet form but I believe injection is best.

[Nell57]

30 years ago I was diagnosed with neuropathy. My B-12 level was low normal.My doctor said she likes her neuropathy patients in the high-normal range and she prescribed monthly B-12 injections.
I first had them done in her office but for convenience sake I learned to give them to myself.
At times I tried oral sublingual, but it was too time consuming . I skipped days. Tablets were not as effective for me. I always went back to injections.
As a side note, I do notice lower energy and too many naps, when it’s the end of the month. I do have more energy when my B-12 level is in the correct range. I’ve stuck with them for 30 years because they are effective and do make a difference.
I’ve had nurse-friends or my husband administer the shots. Now I do it. It doesn’t have to be done in the doctors office.
You said that your sister is not ready to ask the doctor to switch. I would leave it at that. She is happy with her current situation. Maybe IM ( intermuscluar) injections are the treatment of choice for her medical condition. This is a decision best made between your sister and her doctor.

[Eg_cruz]

We use liquid, my daughter does a higher dosage because she is a vegan. My grandson is lower because of his weight (5”10 125lbs) point is knowing why you need it and then work out the dosage.
The liquid is a better form over the pills.

[Black Beauty]

The VA has prescribed 1000mg once a day. I go there this morning and 'll ask about my B12 levels..thanks

[amdubuc]

Consider EB-N6. EBM Medical.
While dealing with a host of health issues and testing for specialists 3 years ago the Endocrinologist suggested this product might be better for my conditions. I had been getting B injections from my Hematologist Oncologist. He agreed I no longer needed the injection. EB-N6 is working great for me. Add to your research.
support@ebmmedical.com
636-614-3152
Dispense by Physician Only

[Windguy]

If oral supplementation is ineffective, a trial of sublingual B12 supplementation might have better results.
I inherited pernicious anemia from my father, who almost died from it. He did injections.

A routine blood test showed I was anemic, so my doctor sent me to a blood specialist. I was told I also had pernicious anemia. I was prescribed sublingual B12 tablets to treat it. I take 1000 mcg every morning and have been free of symptoms for years now.

[Whitley]

Is it possible for any of the vaccines components (ie. mRNA) to be transmitted from a blood transfusion ?
I read that it remains in the body longer than planned. Thanks for any answers.

[Bellavita]

I think you should ask your doctor ...there are lots of quacks on this website. :


My sister has been getting B-12 for the last few years for low B-12.
A lot is written about injections vs tablets much of which concludes no difference in results.
The next issue is dosage....500/1000 mcg per day???
How best to determine what to take.
She is not ready to ask the doctor to switch....I volunteered to do some research and would appreciates opinions/suggestions from TOTV members who have been confronted with this issue.

Based on what I have read I would not hesitate to take the tablets instead of monthly injections!

_______________________________________

:censored:

[golfing eagles]

Consider EB-N6. EBM Medical.
While dealing with a host of health issues and testing for specialists 3 years ago the Endocrinologist suggested this product might be better for my conditions. I had been getting B injections from my Hematologist Oncologist. He agreed I no longer needed the injection. EB-N6 is working great for me. Add to your research.
support@ebmmedical.com
636-614-3152
Dispense by Physician Only

Consider it considered and dismissed. Just another proprietary vitamin/supplement blend that claims superiority. Save your money. BTW, did that endocrinologist own stock in that company????

Also, for those that are convinced that liquid B12 is "superior" to tablet form, consider this: The tablet will dissolve in your stomach in 30-45 seconds. B12 is absorbed in the terminal ileum (about 25-30 feet downstream) with an average transit time of 8-16 hours. Do the math for yourselves. Again, save your money.

[DonnaNi4os]

I am a cancer survivor and my oncologist has me on monthly B12 injections administered intramuscularly. While B12 deficiency can be addressed using oral administration, it can be ineffective in patients that have absorption issues that take place in the gut. B12 deficiency can cause many problems besides fatigue. It also affects neurologic functions including neuropathy. I’ll continue with the injections. They are painless and take just a small part of my month to administer.

[DonnaNi4os]

30 years ago I was diagnosed with neuropathy. My B-12 level was low normal.My doctor said she likes her neuropathy patients in the high-normal range and she prescribed monthly B-12 injections.
I first had them done in her office but for convenience sake I learned to give them to myself.
At times I tried oral sublingual, but it was too time consuming . I skipped days. Tablets were not as effective for me. I always went back to injections.
As a side note, I do notice lower energy and too many naps, when it’s the end of the month. I do have more energy when my B-12 level is in the correct range. I’ve stuck with them for 30 years because they are effective and do make a difference.
I’ve had nurse-friends or my husband administer the shots. Now I do it. It doesn’t have to be done in the doctors office.
You said that your sister is not ready to ask the doctor to switch. I would leave it at that. She is happy with her current situation. Maybe IM ( intermuscluar) injections are the treatment of choice for her medical condition. This is a decision best made between your sister and her doctor.

Monthly B12 injections were prescribed by my oncologist because of my deficiency, likely due to my treatments. As a bonus I found that the neuropathy in my legs and feet was not nearly as bad. As the time approaches for me to go for another, the nerve zaps begin to return. For that reason alone I will continue to get the injections.

[Two Bills]

Is it possible for any of the vaccines components (ie. mRNA) to be transmitted from a blood transfusion ?
I read that it remains in the body longer than planned. Thanks for any answers.

I think you are trying to start another anti-vaccine argument.

[Whitley]

I think you are trying to start another anti-vaccine argument.

OR... I am a stage 3 cancr survivor who gets infusions &/o transfusions every other month and would like to know.

[golfing eagles]

OR... I am a stage 3 cancr survivor who gets infusions &/o transfusions every other month and would like to know.

Actually, you posed a very interesting question. I don't know definitively, but my guesstimate would be as follows:

The original mRNA in the vaccine disappears after a few hours, so it is no longer present. The antibodies against the virus should be present, otherwise there's no point in the vaccine. However, those antibodies are present in the blood plasma component---transfusions are packed red cells that do not contain any significant amount of plasma/serum, so my answer is no.

Now a question in return----what does it matter if you received any mRNA or anti-COVID antibodies in a transfusion?????

[Whitley]

Actually, you posed a very interesting question. I don't know definitively, but my guesstimate would be as follows:

The original mRNA in the vaccine disappears after a few hours, so it is no longer present. The antibodies against the virus should be present, otherwise there's no point in the vaccine. However, those antibodies are present in the blood plasma component---transfusions are packed red cells that do not contain any significant amount of plasma/serum, so my answer is no.

Now a question in return----what does it matter if you received any mRNA or anti-COVID antibodies in a transfusion?????

Thank you for the response. The reason I ask; After discussions with my oncologist and hematologist I decided not to get the vaccine. We had plans and orders set should I have gotten covid. For whatever reason (i have no way to know why) I never got covid. I do not want to get political, so all I will say is that for now I want to remain unvaccinated with the mrna. I have an appointment (seems every week I have appointments) with the blood doctor from FCS Tuesday, and want to discuss the other type of vaccine (not MRNA). At the same time I will be discussing the blood transfusions (ie my original question). IF I get to see the actual hematologist, and not a PA or aide, I would like to come to the appointment with as much knowledge as possible. Googleing it does not come up with much info.. I would love to have the luxury of having a detailed discussion with my doctor, but that is rare. Thank you again for the response.

[golfing eagles]

Thank you for the response. The reason I ask; After discussions with my oncologist and hematologist I decided not to get the vaccine. We had plans and orders set should I have gotten covid. For whatever reason (i have no way to know why) I never got covid. I do not want to get political, so all I will say is that for now I want to remain unvaccinated with the mrna. I have an appointment (seems every week I have appointments) with the blood doctor from FCS Tuesday, and want to discuss the other type of vaccine (not MRNA). At the same time I will be discussing the blood transfusions (ie my original question). IF I get to see the actual hematologist, and not a PA or aide, I would like to come to the appointment with as much knowledge as possible. Googleing it does not come up with much info.. I would love to have the luxury of having a detailed discussion with my doctor, but that is rare. Thank you again for the response.

Very hard to speculate on a social media site, but I'd guess if your oncologist was reluctant to let you have the mRNA vaccine (which is not an unreasonable decision), then he should be ten times as reluctant to give you a traditional vaccine, especially anything that is a live attenuated strain, since you are immunocompromised by definition.

[Whitley]

Very hard to speculate on a social media site, but I'd guess if your oncologist was reluctant to let you have the mRNA vaccine (which is not an unreasonable decision), then he should be ten times as reluctant to give you a traditional vaccine, especially anything that is a live attenuated strain, since you are immunocompromised by definition.

Thank You. I get different suggestions from my doctors. My cardiologist suggests I get the vaccine. The doctor that removed a lobe, Pulmonologist, will not discuss it. He hands out a paper from the NIH, and then will not discuss it. As I mentioned earlier my blood doctor and oncologist advise me not to. (I am immunocompromised as you mentioned, and have bleeding issues as well). I am OK and will be OK. Thank you for the info.

[golfing eagles]

Thank You. I get different suggestions from my doctors. My cardiologist suggests I get the vaccine. The doctor that removed a lobe, Pulmonologist, will not discuss it. He hands out a paper from the NIH, and then will not discuss it. As I mentioned earlier my blood doctor and oncologist advise me not to. (I am immunocompromised as you mentioned, and have bleeding issues as well). I am OK and will be OK. Thank you for the info.

Best wishes for continued improvement

[SusanStCatherine]

If you have been diagnosed with pernicious anemia, work with your doctor.

Everyone is different. What I have found is the injections and sublingual B12 does not get absorbed well for me. What works for me is Mary Ruth's Methyl B12 Liquid spray and NanoNutriTopicals Daily Energy B12 patch. Just something to consider.

[blueash]

Jumping in on the cancer and wisdom of mRNA Covid vaccines. As you likely recall when the vaccine was first available you had to be in a high risk category to get it. Cancer qualified you. Doctors while trained in science are not immune to political forces. You have at least two doctors who tell you to get the vaccine, one who is so tired I would speculate of arguing with patients about Covid that they have resorted to just giving the NIH handout (?CDC handout).

I found not a single reliable online recommendation to not receive the vaccine. Everything I read said that those actively being treated as well as those on long term treatment and those in remission all should be vaccinated. Some situations such as high dose steroids made it likely the vaccine would be less protective than in a non-cancer patient.

No one said don't get it. You have survived as the more lethal forms of Covid seem to have left circulation and those continuing to be here are less likely to hospitalize or kill. Like most people who drive drunk, don't wear seat belts, and run stop signs, survival is not evidence of having made good choices.

Mayo Clinic Here (https://www.mayoclinic.org/patient-visitor-guide/covid-19-faqs/cancer#:~:text=Is%20it%20safe%20for%20cancer,with% 20their%20health%20care%20provider.)
Cleveland Clinic Here (https://health.clevelandclinic.org/can-i-get-the-covid-19-vaccine-if-i-have-cancer/)
MD Anderson Here (https://www.mdanderson.org/patients-family/becoming-our-patient/planning-for-care/coronavirus-protections/covid-19-vaccine-information.html)

Now ask that oncologist who said no, what is the reason, supported by the literature and expert opinion that lead that oncologist to tell you no and to continue to tell you no. Your originally posted question about whether you were at risk if mRNA was in a transfusion suggests to me that you have been getting really bad information about mRNA vaccines.

[golfing eagles]

If you have been diagnosed with pernicious anemia, work with your doctor.

Everyone is different. What I have found is the injections and sublingual B12 does not get absorbed well for me. What works for me is Mary Ruth's Methyl B12 Liquid spray and NanoNutriTopicals Daily Energy B12 patch. Just something to consider.

Another considered and rejected. Injections do not get absorbed for you??? Hmmmm.....
Also , everyone is different? To a point, yes, but medical physiology is medical physiology.

[golfing eagles]

Jumping in on the cancer and wisdom of mRNA Covid vaccines. As you likely recall when the vaccine was first available you had to be in a high risk category to get it. Cancer qualified you. Doctors while trained in science are not immune to political forces. You have at least two doctors who tell you to get the vaccine, one who is so tired I would speculate of arguing with patients about Covid that they have resorted to just giving the NIH handout (?CDC handout).

I found not a single reliable online recommendation to not receive the vaccine. Everything I read said that those actively being treated as well as those on long term treatment and those in remission all should be vaccinated. Some situations such as high dose steroids made it likely the vaccine would be less protective than in a non-cancer patient.

No one said don't get it. You have survived as the more lethal forms of Covid seem to have left circulation and those continuing to be here are less likely to hospitalize or kill. Like most people who drive drunk, don't wear seat belts, and run stop signs, survival is not evidence of having made good choices.

Mayo Clinic Here (https://www.mayoclinic.org/patient-visitor-guide/covid-19-faqs/cancer#:~:text=Is%20it%20safe%20for%20cancer,with% 20their%20health%20care%20provider.)
Cleveland Clinic Here (https://health.clevelandclinic.org/can-i-get-the-covid-19-vaccine-if-i-have-cancer/)
MD Anderson Here (https://www.mdanderson.org/patients-family/becoming-our-patient/planning-for-care/coronavirus-protections/covid-19-vaccine-information.html)

Now ask that oncologist who said no, what is the reason, supported by the literature and expert opinion that lead that oncologist to tell you no and to continue to tell you no. Your originally posted question about whether you were at risk if mRNA was in a transfusion suggests to me that you have been getting really bad information about mRNA vaccines.

Agree again. Which is why I was wondering what the problem would be if some mRNA was received with a transfusion (Clearly a highly unlikely event)

[Two Bills]

OR... I am a stage 3 cancr survivor who gets infusions &/o transfusions every other month and would like to know.

I was not to know that, but given the propensity for posters (myself included) to divert threads, I assumed , wrongly, that was the reason for your post.
Good luck with your remission, and I wish you well.