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B12 dropping with sublingual supplements? vitamin C interference?

Messages
16
Against my better judgement, I decided to follow the advice of my GP. After finding my B12 to be 205 (mma 0.38, I think), she recommended 2 weeks of 100mcg b12 (no specifications of type/method) and then simply the RDA. We suspected the low levels were due to a nearly vegan diet for 20 years.

I started with liquid cyano, then after researching, switched to sublingual methyl, which I couldn't tolerate. So, I tried a sublingual dibencozide b complex and tolerated it ok. After getting several weeks of at least 100mcg/day (+ a daily whole foods vitamin with A, C, and E), I went to drop down to the RDA and wasn't sure how to get the correct amount using a B complex, so I switched to sublingual hydroxyb12 and broke off a little chunk (more than the RDA, maybe 25 mcg if I had to guess) and have been taking that daily for awhile. It's now 3 months later and my level came back lower, at 157. Obviously I need higher dosage, and am frustrated that my GP wouldn't retest me sooner.

So, I have two questions:
1. With a sublingual dosage of any sort/dosage, is it odd that my level dropped this much in 3 months? Though I'm not surprised it didn't raise it, I thought having a daily sublingual intake of some sort would at least keep the level stable.
2. Can vitamin C interfere with absorption? I read this somewhere and (since fruit is one of a handful of things that my stomach will tolerate) I often followed my B12 shortly after with orange juice or a smoothie.

If anyone can shed light on either of these, it would be very appreciated!
 
Messages
17
Location
Canada
Hi patteecreek
Serum B12 tests have a fairly high degree of error. I think that they can easily be out plus or minus 50 points. Once you are deficient in B12, it isn't easy to get your levels up and keep them there. There is a book called "Could it Be B12?" by Sally Pacholok, that you might find interesting. She recommends getting your serum B12 up to 1000 and keeping it there. You won't be able to do that on RDA amounts. I was taking 1000 mcg of cynoB12 for a year and my level did not get above 320, and I kept getting sicker. It wasn't untill I started on Freddd's Active B12 protocol that I started to get better.
If you are taking the sublingual supplements for a period under the tongue, the vitamin C shoundn't affect absorption.
Hope this helps,
mogy
 

nanonug

Senior Member
Messages
1,709
Location
Virginia, USA
If anyone can shed light on either of these, it would be very appreciated!

Two quick things:


  1. Forget the RDA, those dosages are way too low! The body is only able to absorb about 1% of any large dosage of vitamin B12. If you orally supplement with 1000mcg, your body is only going to absorb around 10mcg (plus a couple more micrograms via the intrinsic factor mechanism, assuming there are no issues with your gastrointestinal system). I am not yet convinced that the sublingual route works.
  2. Your need to take a good multivitamin with all the B vitamins. I personally like and take Thorne Basic Nutrients III.

So, what is the solution?

If I were in your place, I would request weekly 1000-5000mcg shots of either hydroxo or methylcobalamin (cyanocobalamin is garbage - depletes glutathione) until your levels stabilize. At the same time, and in addition to the multivitamin, I would orally supplement with at least 5000mcg of hydroxo/methyl/adenosylcobalamin (whatever form one tolerates except cyano).

Finally, I would read Fredd's Active B12 Protocol Basics thread.

Good luck!
 
Messages
15,786
I am not yet convinced that the sublingual route works..

It's difficult to find anything definitively saying that B12 can or cannot be absorbed sublingually. But smaller molecules are easier to absorb that way, and B12 isn't a small molecule, so it might or might not work. And absorbing through the gums is even more difficult, from what I understand, so even less likely to be effective.
 
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16
Thanks all for taking the time to respond.... will definitely be upping my dosage right away (starting with a combo of hydroxo and dibencozide), and crossing my fingers that I don't have the negative response to it as I did with the larger dose of methylb12.
 

nanonug

Senior Member
Messages
1,709
Location
Virginia, USA
Thanks all for taking the time to respond.... will definitely be upping my dosage right away (starting with a combo of hydroxo and dibencozide), and crossing my fingers that I don't have the negative response to it as I did with the larger dose of methylb12.

Please, make sure you have plenty of potassium at hand. Especially when supplementing with methylcobalamin, potassium depletion is a strong possibility. Bananas are good but a tablespoon of blackstrap molasses is even better, supplying an instant 600mg of potassium.
 
Messages
16
Please, make sure you have plenty of potassium at hand. Especially when supplementing with methylcobalamin, potassium depletion is a strong possibility. Bananas are good but a tablespoon of blackstrap molasses is even better, supplying an instant 600mg of potassium.

I purchased some potassium, but really like the idea of molasses, thanks for suggesting it.



I am also wondering if any of you can tell me whether a negative response to methyl B12 automatically indicates a problem with methylation? (Sorry if this is a silly question - much of the info I've been reading here is a bit over my head.)
 

nanonug

Senior Member
Messages
1,709
Location
Virginia, USA
I am also wondering if any of you can tell me whether a negative response to methyl B12 automatically indicates a problem with methylation?

Would you be more specific about the "negative" response you describe?

Depletion of potassium is a common occurrence and, if severe, might require hospitalization. There is also the possibility of temporary depletion of glutathione which tends to make people feel bad. Both cases, however, actually illustrate the need for methylcobalamin.
 
Messages
16
Would you be more specific about the "negative" response you describe?

Depletion of potassium is a common occurrence and, if severe, might require hospitalization. There is also the possibility of temporary depletion of glutathione which tends to make people feel bad. Both cases, however, actually illustrate the need for methylcobalamin.

Hi nanonug,
Thanks for replying again. Within minutes of taking methyl b12, I became so sedated that I could barely keep my eyes open, and was forced to lay down until I slowly became more alert over a couple hours. Following this, I noticed a severe decrease in mood, felt like crying (this is unusual for me), became quite shaky with some muscle pains/twinges, and felt generally 'spaced out' and weak for 24-48 hours. After feeling relatively 'normal' again, I halved the dose, and the same thing happened.

When I took the methylb12, I started off high (or what I consider to be high) at 1000mcg. After Freddd suggested that I try adb12, I decided to gradually build up on a hydroxy/dibencozide combo (am currently at about 200mcg with minimal issues) - so, I have not yet taken an equivalent amount of another b12 type for comparison to my negative methylb12 response.
 

nanonug

Senior Member
Messages
1,709
Location
Virginia, USA
Within minutes of taking methyl b12, I became so sedated that I could barely keep my eyes open, and was forced to lay down until I slowly became more alert over a couple hours.

One possible explanation is that methylcobalamin may have sped up the methylation cycle. Methylation is necessary to convert serotonin into melatonin.

Following this, I noticed a severe decrease in mood, felt like crying

Maybe withdrawal? Methylcobalamin helps in the production of methylfolate. Higher levels of methylfolate may lead to higher levels of tetrahydrobiopterin, which in turn results in increased production of neurotransmitters. Once methylcobalamin was all used up, neurotransmitter production reverted to your "normal".

became quite shaky with some muscle pains/twinges

Low potassium? Methylcobalamin is known to cause lower potassium levels due to increased production of "backed up" new cells. That's why it is always a good idea to supplment with extra potassium. One tablespoon of blackstrap molasses contains roughly 600mg of potassium.

When I took the methylb12, I started off high (or what I consider to be high) at 1000mcg.

For reference purposes, I currently take 15mg of methylcobalamin/day. :)

Please, note that the "explanations" above are nothing but "educated speculation" based on expected biochemical effects of methylcobalamin. For obvious reasons, I really don't know what happened!

I don't remember if you told already, but are you taking a multivitamin with all the B's?
 
Messages
16
Low potassium? Methylcobalamin is known to cause lower potassium levels due to increased production of "backed up" new cells. That's why it is always a good idea to supplment with extra potassium. One tablespoon of blackstrap molasses contains roughly 600mg of potassium.

Sorry for the delayed response, but thanks again nanonug for replying. I'm not sure whether potassium is causing my shaking/muscle twinges at this point- I have been eating very high potassium foods (including blackstrap molasses) and notice no difference. I have extreme calf/hamstring tightness and some associated pain/cramping, so I am going back to my doctor on Thursday. From what I've read, magnesium could be causing some of this as well (the leg stuff anyway).

I discovered something else last night as I was accessing my lab test results online - perhaps someone may be able to explain this or have some insight: My serum B12 levels dropped from 205 to 157 in 3 months time while on a low supplement of B12 (25-100mcg). During this time, my serum MMA went from 0.38 to 0.30. I can't understand why my serum B12 would drop, when the MMA level improved?? Does this make any sense, or does it seem like a testing error somewhere? Mogy explained that serum B12 testing has some degree of error, but this still strikes me as odd.
 

nanonug

Senior Member
Messages
1,709
Location
Virginia, USA
I'm not sure whether potassium is causing my shaking/muscle twinges at this point- I have been eating very high potassium foods (including blackstrap molasses) and notice no difference. I have extreme calf/hamstring tightness and some associated pain/cramping, so I am going back to my doctor on Thursday. From what I've read, magnesium could be causing some of this as well (the leg stuff anyway).

Magnesium deficiency is known to cause hypokalemia. Basically, with magnesium deficiency, you end up peeing all the potassium away. To test for magnesium deficiency, ask for either RBC magnesium or Exatest. Serum magnesium is close to useless.

My serum B12 levels dropped from 205 to 157 in 3 months time while on a low supplement of B12 (25-100mcg). During this time, my serum MMA went from 0.38 to 0.30. I can't understand why my serum B12 would drop, when the MMA level improved?? Does this make any sense, or does it seem like a testing error somewhere?

Either way, error or not, those levels are very low. I guess you already know that the very low amount of B12 you are currently taking is borderline useless, right? :) And the difference between those two MMA levels is essentially insignificant. I would focus on trying much higher amounts of hydroxo- or methylcobalamin, in the miligram range. I currently take more than 15mg (15000 mcg) of methylcobalamin a day, for comparison purposes, and I don't even have a deficiency!
 
Messages
16
Either way, error or not, those levels are very low. I guess you already know that the very low amount of B12 you are currently taking is borderline useless, right? :) And the difference between those two MMA levels is essentially insignificant. I would focus on trying much higher amounts of hydroxo- or methylcobalamin, in the miligram range. I currently take more than 15mg (15000 mcg) of methylcobalamin a day, for comparison purposes, and I don't even have a deficiency!

I have worked my way up to 500mcg/day over the last week and surprisingly my serum levels are now 270, up from 157 only two weeks ago. I realize that's still very low, but am glad to see an increase of any sort at this point. Doctor also ran an h. pylori test, which turned out positive. Not sure if that's relevant to my situation, but it's nice to feel like some progress is being made.
 

nanonug

Senior Member
Messages
1,709
Location
Virginia, USA
I have worked my way up to 500mcg/day over the last week and surprisingly my serum levels are now 270, up from 157 only two weeks ago.

Awesome!

Doctor also ran an h. pylori test, which turned out positive. Not sure if that's relevant to my situation

It is totally and completely relevant!

Helicobacter pylori wreaks havoc with people's body's. It is even associated with Parkinson's Disease!

Once I got rid of H. pylori (took me a year and four rounds of antibiotics) and bacterial overgrowth in the small intestine, both my IBS and CFS disappeared in a matter of weeks. How's that for a cure?
 
Messages
16
It is totally and completely relevant!

Helicobacter pylori wreaks havoc with people's body's. It is even associated with Parkinson's Disease!

Once I got rid of H. pylori (took me a year and four rounds of antibiotics) and bacterial overgrowth in the small intestine, both my IBS and CFS disappeared in a matter of weeks. How's that for a cure?

Thanks, this is good to hear! Did you use a probiotic that ended up particularly helping during/after the antibiotic treatments?