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I need some help regarding B12 self injections

Discussion in 'Detox: Methylation; B12; Glutathione; Chelation' started by PDPJ, Jul 16, 2010.

  1. taniaaust1

    taniaaust1 Senior Member

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    D3 deficiency.. i've had a severe D3 (my D2 is good) deficiency. (D2 is from the sun.. mine just doesnt convert well to D3, so getting more sun dont help in my case).

    I was on 2000mcg cholecalciferol per day (standard supplementation dose in Australia for those with D deficiency) but after several months or so.. my D3 levels were even worst.

    While at the hospital for something else, they gave me a dose of 50,000mcg to take in one go. Ive no idea how that went as i havent had my levels tested again (and my doctor threw my case in the too hard basic when the normal supplementation amounts failed, this was a couple of years back), so i then went back to just taking 2000mcg again as I know i would of gone quickly deficient again.

    i recently had a specialist do a heap of blood tests and asked for my D3 levels to be done too, so i'll find out soon just how bad they are (thou i've kept up continous supplementation).
    ......................

    I also have to take Calicum too or otherwise my mood swings are worst. Vitamin D and Calicum work together in some way (i cant think how right now).
  2. PDPJ

    PDPJ

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    I've yet to read the B12 thread. It's quite lengthy and I want to be able to concentrate on it while reading it all at one time. This is best done in the wee hours of the morning for me.

    More good information taniaaust1.

    I'm wondering now if I should be in contact with a nutritionist?... would this be the correct type person to help with understanding and applying vitamin/mineral supplements?... I don't want info on how to obtain from foods, I want to know what supplements I need to be taking per lab tests. If not a nutritionist, then who?

    Does anyone have experience with ordering B12 and/or Vitamin D from Canada?
  3. richvank

    richvank Senior Member

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    Adding 5-methyl tetrahydrofolate to B12

    Hi, tania.

    Since B12 has been helpful to you, you might want to consider taking some 5-methyl tetrahydrofolate along with it. Together, these two will lift the partial block in the methylation cycle, which appears to be present in most people who have CFS. More info is available at www.cfsresearch.org

    My position it that a person needs to be under the care of a physician while treating to lift the methylation cycle block, just in case some rare adverse effects appear, which need to be dealt with promptly and properly.

    I understand that there is a company in New Zealand that sells Thorne Research 5 MTHF, and that they distribute to Australia as well:

    http://www.fxmed.co.nz/ThorneProductInfo/5_MHTF.htm

    Best regards,

    Rich
  4. taniaaust1

    taniaaust1 Senior Member

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    Hi Rich

    I just tried to look up 5-methyl tetrahydrofolate on wikipedia to try to work out what it is.. its all confusing, so can you tell me if that is a type of folate or something else?

    Cause of my polymophism, my CFS specialist (who's right into biochemistry) has got me on folate (ordinary kind) as well as other special things to donate methy groups (eg a special form of B6 which i have to get specially.. as it cant be brought from the pharmacist)
  5. zoe.a.m.

    zoe.a.m. Senior Member

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    taniaaust1,
    How were you able to find out you had this polymorphism? Sounds like a very good thing to know, I just haven't heard much of people being tested for them or what type of doc would think to do such testing.

    Rich, or anyone else in the know: Would the 5-methyl tetrahydrofolate replace the Folapro on Yasko's protocol?
  6. richvank

    richvank Senior Member

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    Hi, tania and zoe.

    5-methyl tetrahydrofolate is indeed a type of folate. It is one of the active forms of folate used by the body. It is normally the most abundant folate present in the blood of normal, healthy people. It is found in many natural foods. It is the only form of folate that is imported into the brain. Merck in Switzerland/Germany has a patent on a process to make it commercially, and it is sold under the names Metafolin and FolaPro. It is also sold in larger dosages as a "medical food" called Deplin, which is prescribed for treating depression. All of these contain the Merck product.

    Ordinary folate supplements contain folic acid. Folic acid is a synthetic, oxidized form of folate, which is not found to a significant extent in natural foods. It is favored commercially because it has a long shelf life. In some countries (including the U.S.) it is added to bread and other grain products in order to lower the incidence of neural tube defects such as spina bifida in babies, and it has been successful in doing that.

    In order for a person's body to use folic acid, it must be converted (mainly in the liver) to dihydrofolate, and then to tetrahydrofolate. This is accomplished by the enzyme DHFR (dihydrofolate reductase). However, some people have inherited a very slow form of this enzyme. Its activity varies by 500% between different people. As a result, some poeple are not able to utilize folic acid very well, and it rises to relatively high levels in their blood, but is not very helpful functionally. There is some published research that suggests that folic acid can cause a higher risk of cancer, but this is not firmly established at this point.

    The Simplified Treatment Approach, which I have proposed for treating CFS, was extracted from the full Yasko treatment program and includes FolaPro and Actifolate. The latter contains three forms of folate: folic acid, folinic acid and 5-methyl tetrahydrofolate.

    Best regards,

    Rich
  7. PDPJ

    PDPJ

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    This thread has taken a bit of a swerve away from the B12 topic as often happens on message boards. In my 9th post I posted this and still would like a response if possible:


    "I'm wondering now if I should be in contact with a nutritionist?... would this be the correct type person to help with understanding and applying vitamin/mineral supplements?... I don't want info on how to obtain from foods, I want to know what supplements I need to be taking per lab tests. If not a nutritionist, then who?

    Does anyone have experience with ordering B12 and/or Vitamin D from Canada?"
  8. zoe.a.m.

    zoe.a.m. Senior Member

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    Yes, sorry about my adding to the swerve PDPJ!

    Unless you can get your hands on a world-class nutritionist, and one who really knows supplements, I would have to say that a naturopath would be the person with the training on this. A seriously good doctor who is on the cutting edge would probably know supplements as well, but most do not. Especially since you're not looking to get food advice, a nutritionist would probably not be of much help. I don't know what the alt medicine situation is like in Canada, but, imo, it sounds like you need a very good naturopath!
  9. PDPJ

    PDPJ

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    Hi Zoe
    One of the nice things about swerves is there is always something new to learn.

    so.... a naturopath huh.... a new term for me. Time to engage Mr. Google ..... for the kabillionth time.

    I need more B12 just to keep researching B12 ! All I want is to get my levels up beyond brain damage by taking the right stuff, in the correct dose at least 3 times a week.... ok.... going to look to see if there is a naturopath near me.

    ETA: This looks like a good place to start :
    American Association of Naturopathic Physicians
    Promotes professional awareness, while providing consumer information and a searchable database of members.
    Find a doctor - 2010 Convention - What is a Naturopathic Doctor
    www.naturopathic.org/ - Cached - Similar
  10. taniaaust1

    taniaaust1 Senior Member

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    These are tests which an ordinary doctor will not think about doing... but CFS specialist gets done in his patients.

    CFS specialist after i had blood test, picked up up by my homocysteine being at 8.9umol/L which indicated some issue at this level thou that is within normal range (doctors will miss that unless they know this level or higher indicates polymorphism!). Most with this issue fall within normal range, people who's metabolism is functioning right thou is below this level.. its an issue about about 5-12% of world population has but is even a lot higher in some countries. If at that level or higher.. it can be then vertified with a Thrombophilia genotypes test or one could go straight to having a Thrombophilia genotypes test which can pick up several different blood disorders involing hypercoagulation of blood. MANY with CFS have some form for hypercoagulation issue going on (Ive heard from a specialised blood lab that this may be as high as 95% of those with CFS!).

    Most blood labs do the two tests i just mentioned. Just ask your normal doctor that you want these tests done...
  11. Sushi

    Sushi Moderator and Senior Member Albuquerque

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    For those in the US, Quest will test MTHRF and thus many insurance companies will pay for it.

    Sushi
  12. taniaaust1

    taniaaust1 Senior Member

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    It depends on the Nutritionist themselves if they can help you or not. I know my Naturopathic collage does 4 yr full time, government acceditated Nutrition courses they are trained Nutritionists at the end of it. Their Nutritionists would probably be quite capable of helping you.

    I studied Nutrition as just a single subject for 2 years as part of a Naturopathy course there and we did learn about not just foods but also vitamin supplementation (we went as far as learning minerals and amino acids). Nutrition as a subject over here is a necessarily area of study for Naturopathy.

    (ive been told that doctors only have about 2 or 3 lectures in Nutrition and that is it. A Naturopath has it as a weekly lesson for 2 yrs.. and that gives the basics.. so medical doctors have virtually nil training in this area in comparision!).

    So anyway.. my point is that there are two different kinds of Nutritionists (in Australia anyway)... those who gain properly recognised accredication throu the Naturopathic colleges and those who gain it (also properly recognised) elsewhere. The Naturopathic collages trained Nutritionists will often recommended more higher doses for things as it is thought the "recommended daily amount" (RDA) isnt always suitable to all as everyones bodies are different and some may get symptoms of things on taking the RDA's (which for some nutrients are set quite low). The more so natural therapies .. Nutritionists base the dosages of things tailored to suit a person based on all kinds of factors in a persons life. eg the other kind may not recognise a need for B12 injections in CFS as blood tests dont show deficiencies often in us (when in fact B12 often still helps us). The other kind of Nutritionists, tend to stick more in sticking to the RDAs (they dont tend to recognise subclinical deficiencies etc like the other kind do).
    .........

    Naturopathic doctors are those which have proper recognised government accrediated training... also called NDs. (well at least in my country). These people go throu many of the same course criteria as doctors do.. At Naturopathic collage we had subjects such as "Anatomy/ Physiology, biochemisty, communication and counselling, Notifiable and transmittable diseases, Pharmacology etc etc .. some of our lecturers were actually MDs or taught at the states universitary where doctors, nurses etc are trained). So by end of training (4 years full time, 5 years if they take the study further) they come out being Naturopathic doctors...

    Good to see that you are looking them up throu a recognised association. This helps back up that they are properly trained.
  13. PDPJ

    PDPJ

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    I searched and there are a few within 100 miles of me... but only for wealthy people.... really wealthy people. These guys sure ain' cheap... but they do exist. Most of them rely on foods/diets etc which will NOT be helpful once I have the DS surgery.

    Re the B12: I found this which seems helpful ~

    Oral vs. Parenteral Therapy
    Because most clinicians are generally
    unaware that oral vitamin B12 therapy is effective,
    17 the traditional treatment for B12 deficiency
    has been intramuscular injections.

    However, since as early as 1968, oral vitamin
    B12 has been shown to have an efficacy equal
    to that of injections in the treatment of pernicious
    anemia and other B12 deficiency states.9,17-19 Although the majority of dietary
    vitamin B12 is absorbed in the terminal ileum
    through a complex with intrinsic factor, evidence
    for the previously mentioned alternate
    transport system is mounting.

    In one study,18 38 patients with vitamin B12
    deficiency were randomized to receive oral or
    parenteral therapy. Patients in the parenteral
    therapy group received 1,000 mcg of vitamin
    B12 intramuscularly on days 1, 3, 7, 10, 14, 21,
    30, 60, and 90, while those in the oral treatment
    group received 2,000 mcg daily for 120
    days. At the end of 120 days, patients who
    received oral therapy had significantly higher
    serum vitamin B12 levels and lower methylmalonic
    acid levels than those in the parenteral
    therapy group.

    The actual transport
    mechanism used in this pathway remains
    unproved, but vitamin B12 is thought to be
    absorbed “en masse” in high doses. Surprisingly,
    one study20 showed that even in patients
    who had undergone gastrectomy, vitamin B12
    deficiency could be easily reversed with oral
    supplementation.

    Intramuscular injections, although safe and
    inexpensive, have several drawbacks. Injections
    are painful, medical personnel giving the
    injections are placed at risk of needlestick
    injuries, and administration of intramuscular
    injections often adds to the cost of therapy.

    Treatment schedules for intramuscular
    administration vary widely but usually consist
    of initial loading doses followed by monthly
    maintenance injections. One regimen consists
    of daily injections of 1,000 mcg for one to two
    weeks, then a maintenance dose of 1,000 mcg
    every one to three months.

    Although the daily requirement of vitamin
    B12 is approximately 2 mcg, the initial oral replacement
    dosage consists of a single daily dose
    of 1,000 to 2,000 mcg (Table 4). This high dose
    is required because of the variable absorption
    Vitamin B12

    MARCH 1, 2003 / VOLUME 67, NUMBER 5 www.aafp.org/afp AMERICAN FAMILY PHYSICIAN 985
    TABLE 4
    Schedule for Vitamin B12 Therapy
    Route of
    administration Initial dosage Maintenance dosage
    Oral 1,000 to 2,000 mcg per day 1,000 mcg per day for life
    for one to two weeks
    Intramuscular 100 to 1,000 mcg every day 100 to 1,000 mcg every one
    or every other day for one to three months
    to two weeks

    Vitamin B12 of oral vitamin B12 in doses of 500 mcg or less.19
    This regimen has been shown to be safe, costeffective,
    and well tolerated by patients.19

    Follow-Up
    After the diagnosis of vitamin B12 deficiency
    has been made and a treatment plan has been
    initiated, follow-up is important to determine
    the patient’s response to therapy. If vitamin B12
    deficiency is associated with severe anemia,
    correction of the deficiency state should lead to
    a marked reticulocytosis in one to two weeks.
    In mild vitamin B12 deficiency,we recommend
    repeat measurements of serum vitamin B12,
    homocysteine, and methylmalonic acid levels
    two to three months after initiating treatment.
  14. zoe.a.m.

    zoe.a.m. Senior Member

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    Thanks for the info taniaaust. Holy genetics Batman! It certainly sounds like one of those tests where the doc has to be better than the test though. I will look into it and mention it to the CFS doc I see and see if my regular PCP might be able to order it (if she orders, it's covered by insurance). I have heard the same thing about hypercoagulation, to the point where one naturopath said that the hypercoagulation was CFS, but I think he was off the mark there.

    Also, PDPJ, the sublingual B12 I mentioned is supposed to be almost as effective as the shots. I do think it's a decent avenue to try since it can cost a lot to see a naturopath (though usually that's a one-time big expense and then a little here and there as followup) and if you know you're B deficient. I'm not sure of all sublinguals, though the good ones are mentioned in Freddd's thread, but the Perque is physician-quality and is part of the Yasko protocol that Rich is connected to (I think you are Rich! Apologies if I've gotten any of that wrong). The only thing I don't know for certain is if the lab values change as much with the Perque as with the injections. I doubt I will be tested again for awhile, so I'm just trying it. I would think it would be a good thing to try as long as a doctor knows (and approves) your taking it and is willing to do your levels again in a little while to look for progress.
  15. PDPJ

    PDPJ

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    the sublingual B12 I mentioned is supposed to be almost as effective as the shots.

    Yes, I am for sure, big time, deficient in B12. Sublingual has not worked for me. I've had 2 shots and am ready for more, however, I've not ordered any due to not knowing which type I wanted to take. I'll have to read up on Perque (physician-quality) as this is a new *name* for me. Now that I've found somewhat of a schedule to follow is a problem solved. Injecting myself is not a problem as I've been a diabetic for 3 years and inject myself many times a day.

    I have been exhausted 24/7 for the past 4 days and have slept and slept, (yes, still tired) that I've yet to read the B12 thread. My concentration is really low and the headaches are reaching migraine levels. The most I've been able to stay up between sleeps is about 2 hours, then I go back to bed and sleep for 4-6 hours. Walking has been very difficult. I feel like I'm wading hip deep in heavy wet concrete... so slow and sluggish.

    I'll have no problem having labs done as often as I want them. I have so many issues going on that require lab studies.

    While doing some reading, I came across this and would like to know what it's saying ~

    350 μg/day

    also, the letter in red... is it a "y' or a "q" ?

    (Vitamin B12
    Recommended dietary allowance (RDA): 2.4 μg/day
    Postbariatric surgery patients should take a multivitamin that contains at least the RDA for B12
    Patients who are mildly deficient should be started on 350 μg/day and monitored
    Patients who do not respond to oral replacement need monthly subcutaneous injections)
  16. taniaaust1

    taniaaust1 Senior Member

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    that symbol you are wondering about is how they often do ug and is the same as mcg .. it means microgram
    .........

    I tried taking my B12 injections sublingual (a doctor suggested that to me) but I found thou that they then didnt work.
  17. richvank

    richvank Senior Member

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    B12: Oral vs. Sublingual vs. Subcutaneous vs. Intramuscular

    Hi, all.

    As you've been discussing, there are several ways in which people supplement various forms of vitamin B12. In a normal, healthy person, an oral dosage of a few micrograms per day is sufficient, because they are able to absorb it using intrinsic factor secreted in their stomach, and the RDA level for a normal person is only a few micrograms per day.

    If a person has pernicious anemia, they can still take their B12 orally, but the dosage must be at least about 100 times higher, because only about 1% of the oral dosage is absorbed by diffusion in the gut, without the help of intrinsic factor.

    If a person has CFS or autism, larger dosages are needed, because the B12 is not adequately protected by glutathione and is being hijacked by reactions with toxins in their cells. In order to overcome this and supply enough B12 for its normal uses, it is necessary to use larger dosages, and the ordinary oral route is not adequate for this.

    Most PWCs can absorb enough B12 into their blood sublingually, using either hydroxocobalamin (such as the Perque brand that is part of the protocol I have extracted from the full Yasko protocol), or a methylcobalamin product. Methylcobalamin is not as stable chemically as hydroxocobalamin, and it is important to use a good brand, according to freddd. Perhaps the reason some people have not experienced benefit from sublingual methylcobalamin is that the brand used was not potent. I think he recommends Country Life and Enzymatic Therapy brands. I don't know what their availability is outside the U.S.

    In the DAN! project for treating autism, subcutaneous injection of methylcobalmin is done, using short needles. This puts the B12 in the subcutaneous fat layer, and it is then released slowly into the blood.

    Conventional physicians treat pernicious anemia with intramuscular injections of B12. This is effective, but in this case, high oral dosages will also work, which can be done without visiting a physician.

    CFS and autism are special cases in which large dosages (in the milligrams or thousands of micrograms per day) are needed, because of the hijacking of the B12 by toxins. So either sublingual or injected B12 is needed in CFS. In autism, sublingual may not work if the child is very young or will not cooperate with sublingual administration, which can take a long time. In those cases, subcutaneous injection is the preferred method.

    Best regards,

    Rich
  18. Freddd

    Freddd Senior Member

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    I will try to answer all the questions in this summary.

    I have tested 10 brands of sublingual mb12 with a panel of 5 hypersensitive. All the results are the result of 100% agreement of all 5. The least effective brand had no apparent activity for any panel member. The two most effective brands tested were Jarrow mb12 in 1mg and 5mg, and Enzymatic therapy in 1mg. The nominal dose size made no difference in this test. The 1mg dose of the two 5 star brands were superior to doses of all doses of any other brands by a large margin. There was at least a 100x difference between top to bottom.

    The only brand of adb12 tested was Country Life and it was also a 5 star.

    All 5 star products were tested for absorbtion in comparison to mb12 or adb12 injections based on quickly recognizable effects and urine colorimetry at doses that made the effects and colorimetry possible. Absorbtion was definitely time related tp time in contact with tissues for all brands. 45-120 minutes under tongue and/or lip or cheek resulted in 15-25% ABSORPTION.

    CNS/CSF penetration was demonstrated with 50mg of sublingual product or 7.5+mg SC of injectable.

    Injectable mb12 supplied by many pharmacies was exposed to too much light during preparation and worked poorly. When it is exposed to too much light it looses the neurological healing qualities of mb12 and causes acne type lesions just as Hycbl does. 10 minutes exposure to room light in a 10ml vial may be too much. 1 minute of exposure in a 1/2 ml syringe is approximately equal to 10 minutes in a 10 ml vial.

    For unknown reasons, there are differences even between batches of mb12 crystals in activity, especially neurological activity. This may account for some of the brand differences. It definitely makes a difference for injectable mb12. I did a side by side test of 5 batches from 3 wholesale sources after the pharmacy became aware of the light problem and there was a whole range of effectiveness despite test results showing the same concentration and purity.

    Vials should be wrapped in foil. Syringes should be wrapped in foil up to the fill level.

    I use a 0.5ml insulin syring with a 5/16" 31 gauge needle. 25 gauge is a huge spike by comparison. Subcutaneous is supperior to IM as the absorbtion time is 4-8 hours typically instead of 30 minutes. With a 30 minute serum halflife immdiately post absorption that means the serum peak is maintained 8-16 times as long aiding diffusion into tissues and especially the CSF/CNS when a large enough dose is used. I use various places on my abdomin for injection as it is easy to reach and see what I am doing.


    All in all, I find that sublingual with the 5 star brands as long as a person doesn't need the higher CNS/CSF penetrating dose for those with poor penetration, is superior in stabilty, reliability and effectiveness.

    For those taking mb12 sublinguals daily at 45 minutes minimum absorption time, don't expect the serum level to be below 3000pg/ml 24 hours following a dose. That is something remarked upon in research, how much higher mb12 maintains the serum level. 3000pg/ml is getting to the approximate level needed at which, when maintained over time might hypothetically lead to an asymptomatic condition. Studies have shown mb12 dose proportionate responsive neurological symptoms exist at initial untreated levels over 1500pg/ml.

    An advantage of sublinguals over oral tablets that are swallowed is that intestional absorbtion have nothing to do with it as that is completely bypassed. That only results in 1% or so anyway whereas sublingual can go as high as 15-25%.


    Hycbl works on about 1/3 of symptoms for 2/3 of people and on 0% of symptoms for 1/3 of people. Mb12 and adb12 are about 100 to 10,000 times as effective as cycbl or hycbl in many various ways of measuring it from actually recovering and going back to work to cost effectiveness to percentage effects for percentage of symptoms. In one year most people will have substantial improvment on all applicable symptoms with needed cofactors in place. Most people get through startup responses in about 3 months or so with those things that repsond the most immediately being most rapid to recover. Mb12/adb12, with appropriate cofactors works for approximately 100% of people with suitable symptoms. Mb12/adb12 will cause startup responses even in people who have been on Hycbl or Cycbl for years as these never completely fill the need for virtually anybody. During treatment with Hycbl/cycbl most people will have continuing worsening of unaffected b12 deficiency symptoms and virtually nobody actually gets well with them.
  19. taniaaust1

    taniaaust1 Senior Member

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    One thing which may be different about those who have CFS to other illnesses which are B12 deficiency are that we can show good blood levels but still be deficient in our tissues and brain. Due to that blood tests dont tell us if we are deficient or not. Many doctors do not realise this. There was at least one study done on how one can have good B12 blood levels but still be very deficient in the body tissues.

    Hence why i think it is a good idea for those with CFS to trial B12 and just go by whether it helps you or not.
  20. curry

    curry Senior Member

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    I would like to start with mb12 injections, but not sure where to purchase for good quality.

    Any hints, advices would be much appreciated. :Retro smile:

    Cheers,

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