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I don't want to get shot - a shot that is - B12 deficiency  RSS feed

 
r ranson
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This thread isn't just about me.  I'm just an example to get the conversation started.  Let's make it into a great big resource for B12 deficiency solutions. 


I got a phone call from the doctor to pick up some B12 medication on the way to see her next week.  I'm getting a shot (I hate shots, but that's another story).  It looks like there's no way to avoid this shot, but I don't want it to happen again.  So what can I do to increase my B12?

Why is the B12 low?
   identify the cause of the deficiency.  Is it diet, genetic, environment, stress, or symptom of a greater problem? 

In my case, it's probably a mixture.  I suspect it's that way for a lot of people.  On one side of the family, everyone who died in the 20th century died of pernicious anaemia (except for two that didn't come back from the first world war).  They also had other symptoms which make me think the B12 deficiency was caused by other ailments that weren't known at the time - like Crohn's (I'm awaiting tests to determine if I have this).  Both of these prevent the absorption of vitamins and minerals in the body.   They can take as many pills as they like, but if the body doesn't have the ability to absorb them, then it does no good. 

I've also almost stopped eating meat.  Not for any specific reason, I just don't like it much these days.  I do however, really like liver, so I'll be chowing down on that at least once a week.  But if my gut can't absorb it, is it worth me eating it?

Is it a B12 deficiency? There are lots of things that have similar symptoms getting an accurate diagnosis is an important step. 

Diet seems the logical place to start.  People often think this is considered a vegetarian disease, but there is a lot more to it than that.  Meat and animal products contain B12, so if that's your dietary path, then it's a good place to start.  Fermented foods like Miso and stout are also said to contain B12, and are supposedly easier to absorb than animal B12.  No matter your dietary path, it's a good starting place to increase B12.

Vitamines, not something I enjoy taking.   I always feel like I'm putting chemical fertiliser into my body when I should be able to get all this from my diet.  Only I am not getting what I need from my diet, either because my diet is faulty or my body is faulty.  If it's the latter, I don't think swollowing pills is going to do any good so I plan to get some sublingual B12 with Folic Acid.  This way, it goes directly into my bloodstream and bypasses my gut. 

What other solutions are there to B12 deficiency?  Should I be worried about it? 
 
Tyler Ludens
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Can you eat clams?  Clams are one of the best sources of B12.  We have been trying to eat canned clams once a week but sometimes mess up the meal plan and miss them.  Just a tiny portion of clams contain a lot of B12.

https://www.dietitians.ca/Your-Health/Nutrition-A-Z/Vitamins/Food-Sources-of-Vitamin-B12.aspx

Personally I don't think the evidence that fermented foods contain B12 is robust.

B12 deficiency may take a long time to develop, is apparently more prevalent in older people, and can cause serious neurological symptoms.

 
Anne Miller
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R Ranson wrote:This thread isn't just about me.  I'm just an example to get the conversation started.  Let's make it into a great big resource for B12 deficiency solutions. 


I got a phone call from the doctor to pick up some B12 medication on the way to see her next week.  I'm getting a shot (I hate shots, but that's another story).  It looks like there's no way to avoid this shot, but I don't want it to happen again.  So what can I do to increase my B12?

Why is the B12 low?   identify the cause of the deficiency.  Is it diet, genetic, environment, stress, or symptom of a greater problem?   


Thank you for an excellent topic!  My DH is B12 deficient.  My question is "Why pick up some B12 on the way to her office?"  Does she want you to have it in your system so she can see if the shot helped?

For the conversation: commonly mentioned sources of B12 includes mushrooms, nutritional yeast, tempeh, eggs, soy milks, breakfast cereals, chicken, fish, liver, foods rich in iron and cherry extract.

I have also heard that B12 in foods is destroyed in the stomach, any thoughts?
 
Susan Pruitt
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Great topic.  I've been exploring these issues for several years myself.   I'm 63 and when tested by an integrative health nurse practitioner, came up deficient in virtually all hormones, B vitamins...on and on.     So she did a genetic test for the MTHFR gene and I was double positive which means I'm not metabolizing nutrients properly.   (you can google that - it's another big topic :)    So along with a bunch of supplements she told me to get methylated B12    I've been buying Solgar brand "Methylcobalamine".    I also give plasma twice weekly and am struggling to keep my serum protein level up because I don't buy a lot of meat.    But as you say, it's useless to put a bandaid on one symptom or test - I believe our chronic health issues and cancer are such a complex matrix that we will never fully understand.   That's why I embarked on growing my own food and trying to eliminate anything in my house made in a factory.    On top of what we eat, we're completely surrounded by toxins in air, water, household products, personal care products that are compromising our health in sneaky ways.    I know that part of my problem was consuming way too much refined sugar in the form of Ben & Jerry's ice cream (the FDA really should investigate their ingredients - I believe there's opium in there - haha!)   Sugar DESTROYS our metabolism and arteries as we all know but maybe haven't eliminated 100% things.     Rather than babble on for hours here when I should be out planting on this beautiful day,    I'd like to recommend Dr. John Bergman's videos.  He's a brilliant chiropractor who really knows science and anatomy and has a plethora of videos on a variety of topics based on scientific studies.   Here's one with a good overview,     
 
Rebecca Norman
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My husband had pernicious anemia due to not absorbing vitamin B12, and I had to give him monthly shots for a few years. I researched it pretty thoroughly, and what I remember is this:

-- Pernicious anemia could be caused by a strict vegan diet, but much more commonly it is caused by malabsorption of B12, in which case you can't get your B12 levels up even by eating liver. The rumors of B12 being available in vegan foods such as those mentioned above seem not to be true, but they keep popping up. I believe that it is only found in animal foods.

-- In fact, eating liver at the beginning made him worse, because it has so much folic acid (and other B vitamins) and your body uses them together, so eating liver actually increases your body's demand for B12. When he was first diagnosed with megaloblasts (oversized red-blood cells, the sign of pernicious anemia), we couldn't get any B12 locally, so first he bought some liver and ate big portion of it, but it made everything worse and he took to his bed for a day or two.

-- Your system can absorb B12 only with the help of a substance called "intrinsic factor" which is produced by the stomach. I don't know why there isn't oral intrinsic factor and instead B12 malabsorption is always treated only with shots.

-- People whose stomachs are removed cannot produce intrinsic factor so they can't absorb B12 and have to give themselves shots regularly for life. Our friend whose stomach had been removed after cancer gave us some cyanocobalamin doses until we could get them from a good pharmacy in a big city (because most cyanocobalamin requires controlled temperature storage).

-- At the time, I combed through resources like online medical journals and the CDC website. Most sources said that once you stop producing intrinsic factor it stays that way for life, but several very small studies had found patients with pernicious anemia who had giardia infections, and when the giardia was eliminated, the intrinsic factor resumed production and the person no longer had B12 malabsorption.

-- Since he had had a couple of years of persistent stomach problems a few years earlier, we thought that a giardia infection was possible, and the meds for it are available over the counter here, so we just dosed him up. We kept up the monthly B12 shots for another couple of years, but when he moved for work to another country for several months, we dropped it for a year and the symptoms never resumed. It has been 10 years now so I think he was cured and produces his own intrinsic factor again.
 
r ranson
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Thank you for an excellent topic!  My DH is B12 deficient.  My question is "Why pick up some B12 on the way to her office?"  Does she want you to have it in your system so she can see if the shot helped?


The doctors here don't keep medication in their office.  That comes from the pharmacy and has to be picked up by the patient (except in certain circumstances like a hospital, elder care, accessibility issues, stuff like that).  So she sends a prescription for the B12 shot to the pharmacy and I pick it up, take it to her, she sticks me with the needle.  According to my dad who had to have B12 shots many times, it gives one an instant pick-me-up but it's strong stuff and since I've never had it before, it needs to be administered by a doctor in case of a reaction. 

I have also heard that B12 in foods is destroyed in the stomach, any thoughts?


I haven't done any google time with this yet, but from what my family tells me and what the doctor says, the B12 is absorbed in the small intestines and my own malabsorption could be because I have problems at my ileum.  It may be I am eating enough B12 for a normal person, but if I'm not absorbing enough of it.

I'm very careful to keep a balanced diet and this is the first vitamin deficiency I've had in over 10 years.  I keep as natural a diet as I can and because I don't take vitamin pills like a 'normal' person, my doctor likes to do bloodwork every year or two to see how I'm doing. 
 
Andrew Brock
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I don't eat animal products. I use b12 spray and eat fermented foods. My last test was in the 700s ( range is 200-900 ish).
 
r ranson
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It seems to me that diet is only a small part of B12 absorption.  Some people seem to have no problems getting it from fermented foods and vegan sources, others seem to absorb it best from animal products. I wonder why this is.  Does gut bacteria play a part in absorbing B12?  Maybe B12 found in animal products comes with something else that makes it easier for some people to absorb? 
 
Anne Miller
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R Ransom, Thanks for the explanation.

My DH is a meat, beans and potatoes kind of guy so why is he deficient? Maybe some folks have a system that just doesn't absorb it?

I had anemia as a child, it was cured by eating two or three raw eggs a day. I suspect that my mother being a very frugal person gave me very little to eat and mostly canned soup and pasta.  After the anemia bout she probably added more meat to our diet.
 
R Scott
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If you are deficient, supplements or diet changes almost never move the needle, indicating it is an absorption problem.  I have had one vitamin that actually did move the levels, it's secret ingredient was aloe.  Try adding aloe as part of a b12 rich meal every day and see if it helps.

 
Regan Dixon
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Last year, a blood test revealed that my B12 levels were jaw-droppingly low.  The doctor prescribed methylcobalamine, the idea of which I resisted, but after reading up on B12 deficiency and not wanting permanent neurological damage, I caved and bought a bottle of methylcobalamine pills.  Took one, and noticed positive results within 24 hours.  Looking back over the years, I've come to believe that from my 20's forward, my permanent hunger, lack of weight gain for the amount of calories I put away on my meat-eating diet, and weak-and-stupid attacks if I didn't get food in a timely fashion, all are explained by a near lifelong inability to absorb B12--no matter how good my diet nor how much animal protein, nor how non-toxic my environment, etc.  I don't take these daily, but one every couple of months as I feel myself slipping into the old hunger.  I haven't gotten a second blood test to run the numbers, but no longer thinking about food nonstop allows me to think about other things, and no longer having weak-and-stupid spells is great, and justification enough for continuing to take them as I feel the need.  They may not be "natural", but where natural fails, they make a world of difference--as do reading lenses.

So, if you want my opinion, go ahead and pick up a bottle of methylcobalamine pills--they're cheap enough--give them a try, and see if you notice a positive difference.
 
r ranson
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I had my shot and it is apparently the first of many.  Every two weeks for an unknown length of time.  It didn't hurt nearly as much as some other shots I've had, so that's good at least. 

Everyone said I would feel instantly better.  I don't.  I'm just as tired and as sore as before.  But my levels are very low.

I also have excessively low Vit D and phosphorous - which are also thought to be caused by a problem in my ilium where these things are absorbed the most.  Again, following in my family pattern. 

The pharmacist gave me a lecture on the 'dangers of eating vegan' - until I showed him the contents of my grocery basket.  "Oh, so you aren't vegan?  What do you need B12 for then?"
I'm getting pretty fed up with the general approach to B12.  It's oversimplified.  I know people who have been on a purely vegan diet for 20 years and they have great B12 levels (with no supplements) and others who eat a full omnivore diet who have shitty B12.  It is so much more complex than diet alone.


For my own journey, we have identified the main (probable) cause as being crohn's which is a nasty disease with inflammation, ulcers, pain, well.. you don't need the intimate details of my bowels.  Basically, the solution is to heal my gut with diet and exercise.  I already know what many of the trigger foods are, so I can cut them out of my diet.  I'll go on a zero to low fibre diet for a few months (sob, no chickpeas, sniffle), up my vegi intake (within reason - avoiding too much fibre of course), try to eat fish at least five times a week (budget allowing) as well as more bacon (mmm, bacon).  This should help reduce inflammation and with luck, give my gut a chance to start absorbing the nutrition it needs.

I'm also thinking of drying some stinging nettles for tea as my iron was borderline low.  I don't know if this will help, but maybe.
 
Hans Quistorff
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As I understand it B-12 contains cobalt as its key structure.  Proper bacteria in ruminants produce B-12 and can also produce it in the human colon.  Dr. Mercola has a culture available that produces B-12 in fermented foods but the cobalt has to be there. My mother studied up on this back in the 1950's and purchased a bottle of cobalt chloride crystals. We would dissolve these in water and add a dash to the warm molasses water we fed to our dairy goats.  This produced healthy goats  but through their droppings and milk spread to the whole farm over time. 
The rain here in the PNW tends to wash the cobalt out of the soil, it is available in the plants and animals in the salt water around us. It returns to the land through the fish returning to spawn and by farmers adding seaweed to their land.
So on your island can you gather seaweed after a storm at low tide which breaks it loose and deposits it at the high tide along the beach?  I exit my peninsula on a sandspit causeway so I watch for it and pick up a bag full when I can, If the sheep are deficient they may like it and you can put it on your dirt that is suffering from contamination. Asparagus and other marsh vegetables do especially well when mulched with it.
 
Xisca Nicolas
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Raven ranson, I do not want to go out of the title of the topic, so if you have opened or if there is something else about healing guts and about getting vitamine D.... I would post.

About vitamine B12, there is absolutely none in vegetarian food, as it is produced by bacterias in gut. I am not sure, but in veg food, there might be some in insects shit in wormy fruits... Remember ape's diet, organic but with the worms, which in a step beyond OUR organic views!!! And they eat termites etc. Grains that are stocked used to have a lot of frass as well.... B12 deficiency is growing in India because of a change in the "quality" of their food.

Not all animal product can give B12 because all is too clean I think.
But main concern is low stomach acid, which gives low meat taste, you do not want meat any more.
Just take betaine HCl, there is a lor of informations about it on the web.
I do not know how this is related to the intrisic factor and to stomach infection...

I also was better overnight with methylcobalamine, in sublingual form.
I do not favor cyano-cobalamine...
Methyl form and with folate, yes.

I advise you to add some magnesium, in the ionic form or in the glycinate form (glycine is heal for the gut too), this last being soft on irritated gut.
Or/and bath, like epsom, or the chloride they call magnesium oil, to put on the skin. Just impossible when air is wet because you stay sticky, there is no oil but the sensation yes!
And always take it with the organic B6, which is p5p.
When I added this to the B12, I got better from fatigue.
The biotin is also a + and even more, for metabolism.

As I raise cuys, I can eat intestine, and of course I do not clean as the white stuff from beef they sell....
 
Xisca Nicolas
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So along with a bunch of supplements she told me to get methylated B12    I've been buying Solgar brand "Methylcobalamine".  
we're completely surrounded by toxins in air, water, household products, personal care products
I know that part of my problem was consuming way too much refined sugar in the form of Ben & Jerry's ice cream (the FDA really should investigate their ingredients - I believe there's opium in there - haha!)   Sugar DESTROYS our metabolism and arteries as we all know


Sorry, I cannot let this un-replied, as I have discovered that sugar is a red herring I think you say in English....
I used to have a bad view upon sugar, and then decided to change my mind about it.
Sugar is just what it is, and sure you need more things, but it gives you the same as all other carbs.
Rice will give you glucose only, and sugar gives you glucose and fructose, as fruits.
Of course without the fiber, so just guess what to do to balance it!

Rice will up your insuline much more if you do not eat it with something else!
Even more than sugar that has some fructose in it.
And protein up insuline too...

Then, avoid sugar but also fruits if you have an issue with fructose absorbtion of course.
Personnaly my gut does better with honey than sugar, but that's me.

Also you can have problem with sugar if you already have the metabolic problem, but this is not the other way round. We need C, the carbon, that's all.
Get organic sugar, be careful with the brown panella if you can have alergies, there are impurities that are alergising, it is almost burned like caramel.
So I buy the organic whole but light colored.

Then, ice cream is worse for other stuff than milk and sugar... I would not eat the caragheenan for example, nor any thickener that can be bad for my guts.

TOXINS, yes this I agree, as B12 and others are part of the METHYLATION PATHWAY.
This is how we detox.
Toxin from outside but also endotoxins.
So, we have probably a liver that is overwhelmed...
Might need some gluthatione as a supplement...

And remove all toxins.
I learned a lot because a friend of mine has MCS, multi chemical sensitivities.
She receives B12 and gluthatione for example.

Then, all about matabolism and guts are related to the autonomic nervous system, especially the vagus nerve.
So any trauma like surgery in the chilhood or even later, can be a big trigger, as birth trauma, or between a few months and 2 years after an accident. Anyone can search to correlate in her life. Just know you have to guess, because the relationship is totally invisible to yourself.
 
Xisca Nicolas
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It took me ages to find it again!
https://dogwoodbotanical.com/ayurveda-vitamin-b12/

nearly all you  want to know about B12!
It least it was my 1st interest and gave me interest in looking for more. I did not think I could be concerned as I was eating animal products, but I was...

and

https://dogwoodbotanical.com/vegetarianism-and-ayurveda/
 
Tj Jefferson
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B12 stuff at the bottom, but this morphed and I am going to roll with it. Bottom line is we used to eat a lot of rich dirt and now we don't.

Hans is very accurate on the mineral issue. There is widespread micromineral deficiency in many (most? all?) central valley production vegetables, since the soils have been depleted for years and they just replace the macrominerals. Worse, mineral imbalances in soils can present as deficiencies. A good example is Iron/Copper/Zinc, the oversupply of any can present as deficiency as they often have the same transport mechanisms. Basically if you look at a periodic table and find the elements in yellow, many of which are only absorbed/active in the 2+ state. Some proteins require specific ions but many will use what they can get with the correct charge, and this can make the enzymes ineffective or counterproductive. It is very hard to test for, since by definition it is in your body not a test tube.

Reasonable strategies in my opinion are to either supplement with high-quality multivitamin/multimineral supplements or eat plants that do it for you.

Supplements generally don't work - because they generally don't contain what is on the label. They are not regulated in a meaningful way, made from intermediates imported from all over in a complex process that requires accurate feedstock, and garbage in = garbage out. There are testing agencies (I only trust USP maybe GMP) that ensure that the process has some quality control, but they do not guarantee the validity of the inputs or outputs of the system. There is only one supplement company that I know of that actually meaningfully tests for quality, the rest simply don't do it. It increases the price by ~30% and causes supply disruptions because they may have to destroy a whole supply run. I didn't take any supplements for close to 20 years because I saw how the sausage was made when I worked at a big German nameless enterprise. I have recently started taking a fairly expensive complexed mineral supplement because I don't get enough of my own produce yet to ensure I have adequate supply, and I really want to optimize because I am getting older.

Glacial dust- no good studies that I know of, because there is no one who wins by paying for it.  A small percentage of it probably is absorbed because the gut flora complexes it. Most inorganic minerals are basically not absorbed, including the nasty ones like mercury. Still, make sure if you are going to use it, it has super low levels of cadmium/lead/mercury etc. I am not going to link to one, there are plenty out there. I always want to see an assay from an independent lab. Trust no one selling nutraceuticals.  

Plant-based mineral supplements- seems like a good idea, but I have not found one that is balanced for humans, they contain what the plant needs. If you mixed them you could probably get there, but I don't have the inclination to do it. 

Onward to B12- the old dogma was that it had to be absorbed in the gut requiring intrinsic factor. Due to the use of acid-lowering medications, there are tons of people who cannot complex B12/IF. It is literally commonplace now. I got tested before and after sublingual B12 and there was a marked increase in my B12 levels (I had access to a lab, this was for my own interest). Not perfect because I probably swallowed some, but I do think consensus is that sublingual can be sufficient. Yes, it is a supplement and not Permie/Paleo/awesome, and 100% follows the qualification above about quality control, but I think it is reasonable. This was before the introduction of the methylcobalamin, which is superior because many people are unable to methylate things effectively and it removes that potential issue (at least for one round of the B12 cycle).

Sugar/B12: I agree with Xisca that glucose is glucose to the human body, but the gut flora doesn't live in there, it lives in a fermentation vat. Straight simple sugar is like dumping nitrogen fertilizer on plants, most can probably handle it, but I totally believe there are people that don't have a microbiome that tolerates the rapid rise/tonicity or something. Human physiology resists complete reduction to simple processes. There is so much crossover between the gut microbiome and absorption and immune function (both of which are implicated in IBS) that I am very reticent to blow off anecdotes.
Just take betaine HCl
  The stomach pH is generally <3. Taking anything by mouth that is acidic enough with enough volume to decrease the pH to normal levels would be corrosive to the upper tract or wouldn't work. This is supposed to stimulate the stomach to make HCl but the
studies are basically low-end. Probably worth a try, but I am skeptical that people are really getting the real deal, for the reasons noted above, supplements are generally crap with a nice label. Undiluted household vinegar is pH~2.5, which seems to be a much cheaper path to the same endpoint.

My 0.02...
 
Xisca Nicolas
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Sugar/B12: I agree with Xisca that glucose is glucose to the human body, but the gut flora doesn't live in there, it lives in a fermentation vat. Straight simple sugar is like dumping nitrogen fertilizer on plants, most can probably handle it, but I totally believe there are people that don't have a microbiome that tolerates the rapid rise/tonicity or something. Human physiology resists complete reduction to simple processes. There is so much crossover between the gut microbiome and absorption and immune function (both of which are implicated in IBS) that I am very reticent to blow off anecdotes.


True, but then must be included starches in the sugars, and then do some personal tests. And think about mixes. Something can be good for you, but you do not handle it because of the mix. Or the reverse, you HAVE to mix it.
I cannot handle starches so good, then depends which and how long cooked. And if wholemeal, worse...
I am better with honey than sugar, I guess antixydants and more in honey!
But I could handle sugar when I dropped starch... try try try!
And I can have normal or sweat potatoes if I eat them mixed with butter, as fat will slow the sugar intake. Also most of all, the fat will protect the sugar from fermentation. Tested for me, test for yourself!

->Have a look at personal issues with gut flora state... That's what I mean by personal test.

But mostly, I would not target any specific nutriment, for some it is sugar, for others starches, some other meat, then others accuse polyunsaturated oils... Even some frutarians have suggested a frutarian I know to reduce to apples that have much more fructose than other fruits! So I do not believe in the 3 white devils any more! Find the good guys and there are no more bad guys to be angry at....
 
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