Active B12 Titration Methods These methods can be applied to either active b12; adenosylb12 and methylb12. If a person is having a lot of startup reaction to mb12 then I would suggest starting with adb12. Either should be started on a base of the basic vitamins and minerals; A, D, C, E, B-complex that includes P-5-P and pantethine and without Cyanob12 (Jarrow B-Right, twice a day), methylfolate, magnesium, calcium, zinc (50mg) and Omega3 oils. These are so essential that they often go without saying or being taken. They are absolutely essential for healing and tissue formation. There are many other things that may be beneficial and aid healing tremendously and some critical cofactors that are essential but after the active b12s are started as they don’t work as well or at all when the b12 is short. I will use mb12 as an example but this applies in the same way to adb12 (dibencozide). First there are a few general things to consider. Our nervous systems notice difference Unbound active b12s diffuse into our systems Higher serum levels of unbound active b12s diffuse “deeper” more quickly making more intense change. Maintained serum levels diffuse “wider” but less intense change. After a period at a given dosage level equilibrium is reached and change is maintained but not increased, healing continues at that level but not more. Healing is dose proportionate but not linearly so. An estimated 250mcg of unbound active b12 accounts for almost all of the perceived intensity until very high levels are reached. That is a 5mg tablet is not particularly perceived as more intense than a 1mg but a 1mg is more intense than ¼ of a 1mg. If a particular level is maintained all day equilibrium is reached more quickly that if that level happens once a day for 1 hour. When equilibrium is reached, perceived intensity diminishes quickly. When a sublingual tablet is removed from the mouth via physical removal or chewing and swallowing the increase in intensity stops within minutes. One can actually hold at a certain level of intensity this way. Approximately 15% is absorbed in the first 45 minutes of tissue contact time, about 1% each 3 minutes. After 45 minutes that drops to about an additional 1% each 5 to 10 minutes until gone. Maximum absorbtion appears to be in the area of 25%. This applies only to the 5 star brands. A fine degree of control can be obtained via a timed method as well as cutting the tablets. Slow titration Start on day 1 with 1 quarter tablet of Enzymatic Therapy 1mg or Jarrow 1mg mb12 or Country Life adb12. This can amount to a 30-60mcg absorbtion, 3x that for the adb12. Much of this will go into the tissues within the actual period of absorbtion. Taking additional quarters can be timed so as not to increase intensity. Taking a half will increase the intensity. If one only takes 1 quarter a day it is unlikely to ever reach equilibrium. I would suggest, that as long as the intensity is tolerable to take at least 8 quarters a day. After a few days, as long as comfort is maintained try ½ tablet. It’s not that there won’t be symptoms shifting and intensification, there will be. We are just trying to keep the intensity under control. Rapid titration Do as above with ½ or whole tablets. Over the days increase to ¼ of a 5mg, then ½ of a 5 mg tablet and finally to a 5mg tablet. At 5mg tablet 4 times a day most people will reach a stable equilibrium that is at the maximum short of injections or multiple tablets per dose. However, once one reaches this point, 2 x 5mg tablets at a time or 4x5 may be a just barely noticeable difference from 1 tablet, if there is any additional effect at all. At around the point of 50mg in 2-3 hours with multiple tablets at a time a threshold effect may be noticed. This is the point approximately equivalent to a 7.5mg injection, the point at which the Japanese research and my own experience indicates up regulated neurological healing may occur. Above that dose no additional noticeable effect occurs at up to at least 25mg injection. This may only apply to people with CNS/CSF deficiencies. That is unknown at this time. There are current Japanese studies being done with 50mg IV infusions that may define this zone more clearly. This is the area I’ve labeled as ZONE 3 on some other posts which I’ll repost here. A fast high dose repeated for several days will soon loose it’s startup effects and will rapidly diminish that of smaller doses. Approximately 20mg on day one may cause a lack of startup effect on day two for any dose less than approximately 2-5mg.