Hi minniemom,
I haven't always followed his advice in the past, so I don't mind ignoring it this time; however, part of the reason he suggested that is because the last time I took the MB12 I was knocked out flat! I had extreme fatigue for several days after. Why would this have happened?
A lot of people have a very strong response to the mb12. It can be for any number of reasons such as lack of other cofactors, things that go deficient as soon as the 600 stalled processes all try to start up at once and things like that. That is why the active b12 protocol is not simple, it includes all those other things. Further, you may need the adb12 for energy before you take the mb12.
My other concern is that all of the recommended MB and AD12 lozenges seem to have some type of sugar in them - xylitol, mannitol, sorbitol, etc, etc. I am on a very restricted diet and am not supposed to have any sugar
While the sublingual b12s all have very small amounts of sweet alcohols in them, they are not sugar per se. And the amount is so tiny as to be inconsequential for almost everybody. These are what are used in sugar free gums etc and at a fraction of the amount that are in a stick of gum. As with many poisons, dose is everything.
If you are diabetic I am sure you can find precise info about the impact of sweet alcohols in mg quantities, if there is any concern at all about that. If it is a "sensitivity", be aware that the lack of mb12/methylfolate causes hyper-reactivity to all sorts of things.
http://www.ynhh.org/about-us/sugar_alcohol.aspx
Sugar alcohols, also know as polyols, are ingredients used as sweeteners and bulking agents. They occur naturally in foods and come from plant products such as fruits and berries. As a sugar substitute, they provide fewer calories (about a half to one-third less calories) than regular sugar. This is because they are converted to glucose more slowly, require little or no insulin to be metabolized and don't cause sudden increases in blood sugar. This makes them popular among individuals with diabetes; however, their use is becoming more common by just about everyone. You may be consuming them and not even know it.
Unfortunately, there are some negatives associated with sugar alcohols. The most common side effect is the possibility of bloating and diarrhea when sugar alcohols are eaten in excessive amounts. There is also some evidence that sugar alcohols, much like fructose (natural fruit sugar) in fruit and fruit juice can cause a "laxative effect." Weight gain has been seen when these products are overeaten. The American Diabetes Association claims that sugar alcohols are acceptable in a moderate amount but should not be eaten in excess. Some people with diabetes, especially Type I diabetics, have found that their blood sugars rise if sugar alcohols are eaten in uncontrolled amounts.
but my nutritionist has been adamant that I only take the hydroxy form of B12.
My opinion is not in concert with that which is probably based on 60 years of research on inactive b12s. However, other people may express differing opinions. And opinions and hypothesis are subject to change which is happening right now with folic and folinic acid. As you can try one and then the other you can test the idea for yourself. But in all cases I suggest all the basics and methylfolate.