Vitamin B12 injections

[Guest guest]

In a message dated 07/02/2001 10:13:01 PM Eastern Daylight Time,

faussettdp@... writes:

<< I am looking for a source of preferably methylcobalamin for injection, but

if I can't get that, I would take cyanocobalamin. >>

Hi Patty:

In case Dr does not reply to your post you might want to contact him

yourself. Here is his website.

http://www.cancer-alternatives.com/

What is the difference between cayano and methylcobalamin.?

Christel

[Guest guest]

In a message dated 07/02/2001 10:13:01 PM Eastern Daylight Time,

faussettdp@... writes:

<< I am looking for a source of preferably methylcobalamin for injection, but

if I can't get that, I would take cyanocobalamin. >>

Hi Patty:

In case Dr does not reply to your post you might want to contact him

yourself. Here is his website.

http://www.cancer-alternatives.com/

What is the difference between cayano and methylcobalamin.?

Christel

[Guest guest]

Injectable methylcobalamin (vitamin B12) is available from

this compounding pharmacy - BY DOCTOR'S PRESCRIPTION :

The McGuff Company

3524 West Lake Center Drive

Santa Ana, CA 92704

Phone 1-800 854-7220 (7:30 am - 5:00 pm)

When ordering, ask for Glenn (or the compounding pharmacy

department). First, ask for their fax number, so your

doctor's office can fax the prescription.

30 cc vials: 1 mg/cc = $24.00 - plus shipping

5 mg/cc = $27.00 "

10 mg/cc = $28.65 "

The best Methyl-B12 is " mix your own, " which contains no

preservatives. I don't know if they sell this type, or if

there is some type of preservative already added to the mix,

or what the active life is, after you receive the shipment.

You should ask them about this.

Bill

..

[Guest guest]

Injectable methylcobalamin (vitamin B12) is available from

this compounding pharmacy - BY DOCTOR'S PRESCRIPTION :

The McGuff Company

3524 West Lake Center Drive

Santa Ana, CA 92704

Phone 1-800 854-7220 (7:30 am - 5:00 pm)

When ordering, ask for Glenn (or the compounding pharmacy

department). First, ask for their fax number, so your

doctor's office can fax the prescription.

30 cc vials: 1 mg/cc = $24.00 - plus shipping

5 mg/cc = $27.00 "

10 mg/cc = $28.65 "

The best Methyl-B12 is " mix your own, " which contains no

preservatives. I don't know if they sell this type, or if

there is some type of preservative already added to the mix,

or what the active life is, after you receive the shipment.

You should ask them about this.

Bill

..

[Guest guest]

Patty I can not find a source for it, I have tried Merit, Darby and all of

the rest of the manufactures.

Sorry

Vitamin B12 injections

> I am looking for a source of preferably methylcobalamin for injection, but

if I can't get that, I would take cyanocobalamin. Does anyone know where I

can get this over the internet without prescription? I am on my last vial

of cyanocobalamin, which I got in Mexico a couple years ago. I just can't

get back there very soon.

> This is simply Vitamin B12, but I need more than a sublingual can provide.

> Any help is appreciated!

> Patty

>

>

>

[Guest guest]

Patty I can not find a source for it, I have tried Merit, Darby and all of

the rest of the manufactures.

Sorry

Vitamin B12 injections

> I am looking for a source of preferably methylcobalamin for injection, but

if I can't get that, I would take cyanocobalamin. Does anyone know where I

can get this over the internet without prescription? I am on my last vial

of cyanocobalamin, which I got in Mexico a couple years ago. I just can't

get back there very soon.

> This is simply Vitamin B12, but I need more than a sublingual can provide.

> Any help is appreciated!

> Patty

>

>

>

[Guest guest]

I can only buy the cyanocobalamin. However the other is better, as for Folic

acid, I buy it from either drug company along with all the others we use for

the IVs

Re: Vitamin B12 injections

Patty I can not find a source for it, I have tried Merit, Darby and all of

the rest of the manufactures.

Sorry

Vitamin B12 injections

> I am looking for a source of preferably methylcobalamin for injection, but

if I can't get that, I would take cyanocobalamin. Does anyone know where I

can get this over the internet without prescription? I am on my last vial

of cyanocobalamin, which I got in Mexico a couple years ago. I just can't

get back there very soon.

> This is simply Vitamin B12, but I need more than a sublingual can provide.

> Any help is appreciated!

> Patty

>

>

>

[Guest guest]

I can only buy the cyanocobalamin. However the other is better, as for Folic

acid, I buy it from either drug company along with all the others we use for

the IVs

Re: Vitamin B12 injections

Patty I can not find a source for it, I have tried Merit, Darby and all of

the rest of the manufactures.

Sorry

Vitamin B12 injections

> I am looking for a source of preferably methylcobalamin for injection, but

if I can't get that, I would take cyanocobalamin. Does anyone know where I

can get this over the internet without prescription? I am on my last vial

of cyanocobalamin, which I got in Mexico a couple years ago. I just can't

get back there very soon.

> This is simply Vitamin B12, but I need more than a sublingual can provide.

> Any help is appreciated!

> Patty

>

>

>

[Guest guest]

I live in Calexico border to Mexicali B.C. if you send me a check or m.o.

for the medicine I'll gladly will send it to you.

M.D.

Vitamin B12 injections

I am looking for a source of preferably methylcobalamin for injection, but

if I can't get that, I would take cyanocobalamin. Does anyone know where I

can get this over the internet without prescription? I am on my last vial

of cyanocobalamin, which I got in Mexico a couple years ago. I just can't

get back there very soon.

This is simply Vitamin B12, but I need more than a sublingual can provide.

Any help is appreciated!

Patty

[Guest guest]

I live in Calexico border to Mexicali B.C. if you send me a check or m.o.

for the medicine I'll gladly will send it to you.

M.D.

Vitamin B12 injections

I am looking for a source of preferably methylcobalamin for injection, but

if I can't get that, I would take cyanocobalamin. Does anyone know where I

can get this over the internet without prescription? I am on my last vial

of cyanocobalamin, which I got in Mexico a couple years ago. I just can't

get back there very soon.

This is simply Vitamin B12, but I need more than a sublingual can provide.

Any help is appreciated!

Patty

[Guest guest]

Here is the B12 injection... it contains the syringes, needles and it is

contained in an ampoule multi dosis.

----------------------- Pasted from the PDRS named in Mexico

PLM---------------------------------------------------

TIAMINAL*

B12 50,000

Solucion inyectable

Vitaminico

Cianocobalamina, tiamina y lidocaina)

FORMA FARMACEUTICA Y FORMULACION:

Cada ml de SOLUCION INYECTABLE contiene:

Vitamina B12 (cianocobalamina) 5,000 mcg

Vitamina B1 (clorhidrato

de tiamina 33,300 U.I.) 100 mg

Clorhidrato de lidocaina 1 mg

Vehiculo, c.b.p. 1 ml.

INDICACIONES TERAPEUTICAS: TIAMINAL* B12 50,000 esta indicado en la

prevencion y/o tratamiento de la deficiencia por aumento de los

requerimientos diarios o por aumento del gasto metabolico de las vitaminas

contenidas en su formula. Auxiliar en el manejo de radiculitis, polineuritis

de etiologia alcoholica y diabetica, neuritis del embarazo, polineuritis por

isoniacida, neuralgias perifericas, faciales del trigemino y herpeticas,

coadyuvante en el manejo del sindrome de Korsakoff.

FARMACOCINETICA Y FARMACODINAMIA EN HUMANOS: Las vitaminas B1 y B12

intervienen en el metabolismo de todas las celulas del organismo,

destacandose su actividad principalmente sobre las celulas del sistema

nervioso, de ahi que se les denominen comunmente vitaminas neurotropas.

La deficiencia de una de ellas son causa de alteraciones neurologicas y

hematologicas; estas deficiencias en la actualidad se presentan en forma

multiple, predominando una de ellas en la expresion clinica, por ello se

hace necesario la combinacion vitaminica; en la combinacion de ellas no se

busca ni se tiene potencializacion farmacologica, se justifica por la

deficiencia vitaminica multiple.

Vitamina B12: Hoy se sabe que la vitamina B12 corresponde a una serie de

sustancias denominadas cobalaminas que poseen cobalto en su molecula. A su

vez, las cobalaminas derivan de una sustancia fundamental, la cobamida que

contiene cobalto trivalente.

La vitamina B12 propiamente dicha es la cianocobalamina y posee un grupo

cianuro unido al cobalto, mientras que la hidroxocobalamina posee un grupo

hidroxilo unido al cobalto; tanto la cianocobalamina como la

hidroxocobalamina poseen la misma actividad terapeutica.

En la naturaleza, la unica fuente original se encuentra en ciertos

microorganismos que crecen en el suelo, el agua o el lumen intestinal.

El hombre depende de fuentes exogenas de vitamina B12 ya que lo que el

sintetiza en el colon no esta disponible para ser absorbida, por lo tanto la

obtiene al ingerir subproductos animales en su dieta diaria.

Aunque es mucho lo que ya se sabe de las vias metabolicas intracelulares en

las que participa esta vitamina, no se ha determinado el papel metabolico

exacto de la vitamina B12,, pero se sabe que es esencial para el crecimiento

y replicacion celular en el metabolismo de lipidos, la formacion de ADN y la

maduracion normal de los eritrocitos.

Tambien se sabe que se requiere vitamina B12 para la sintesis de mielina y

mantener la integridad del tejido neuronal.

La cianocobalamina y la hidroxocobalamina se absorben facilmente cuando se

administran por via intramuscular y subcutanea; cuando es por via bucal su

absorcion en individuos normales es de 70%; para que ocurra la absorcion en

el ileon, es necesario la presencia del " factor intrinseco gastrico de

Castle " , que al combinarse con la vitamina B12 permite su absorcion en forma

de un complejo: factor intrinseco-B12.

Una vez absorbida la vitamina B12 pasa al plasma sanguineo y su nivel

normalmente es de 15 a 100 ng/dl, es decir, 150 a 1,000 pg/ml en 4 a 5 horas

y declina en el transcurso de 72 horas. En el plasma se encuentra entre 80 a

85% combinada con las globulinas: transcobalamina I y II, esta ultima es la

que sirve especialmente como transporte de la vitamina B12 a los tejidos.

Tanto la cianocobalamina como la hidroxocobalamina se transforman en las

coenzimas metilcobalamina y

5'-desoxiadenosilcobalamina que son esenciales para el crecimiento, la

replicacion celular y el mantenimiento de la vaina de mielina de todo el

sistema nervioso.

La metilcobalamina se requiere para la formacion de metionina y su derivado

la S-adenosil-metionina a partir

de la hemocisteina. Este proceso tiene por fin regenerar continuamente el

tetrahidrofolato que es indispensable para

la sintesis de las purinas y pirimidinas, partes esenciales en la sintesis

del acido desoxirribonucleico (ADN)

indispensable para una eritropoyesis y trofismo normales de las celulas

epiteliales.

En presencia de una deficiencia de vitamina B12, la sintesis reducida de

metionina y de S-adenosil-metionina interfiere con la biosintesis proteica,

con numerosas reacciones de metilacion y con la sintesis de poliaminas;

ademas, la actividad de la metilenotetrahidrofolato-reductasa aumenta, lo

que determina que los folatos intracelulares se dirijan a los depositos de

metiltetrahidrofolato, el cual es atrapado a falta de sustrato; estos

fenomenos generan una base para el desarrollo de anemia megaloblastica por

deficiencia de vitamina B12.

La prevision insuficiente de vitamina B12, la replicacion de ADN, se hace

muy anormal; el defecto de replicacion cromosomica produce incapacidad por

parte de las celulas de maduracion y completar las divisiones nucleares en

tanto que la maduracion citoplasmatica continua en forma relativamente

normal. Esto lleva a la produccion de celulas morfologicamente anormales o a

la muerte de las celulas durante la fase de maduracion, fenomeno llamado

" hematopoyesis ineficiente " . Clinicamente esta anomalia se denomina anemia

megaloblastica macrocitica como la anemia perniciosa.

La 5'-desoxiadenosilcobalamina es importante en la transformacion

(isomerizacion) de la metilmalonil-coenzima A en succinilcoenzima A

producida por la enzima metilmalonilcoenzima A-mutasa con intervencion de la

5'-desoxiadenosilcobalamina, aunado a una deficiencia de metionina sintetasa

y al bloqueo de la conversion de metionina a

S-adenosil-metionina.

Normalmente la metilmalonilcoenzima A procede de la propionilcoenzima A que

es el metabolito principal de degradacion de los acidos grasos con numero

impar de carbonos; la formacion de la succinilcoenzima A con intervencion de

la 5'-desoxiadenosilcobalamina hace posible la metabolizacion de los citados

acidos grasos a traves del ciclo tricarboxilico, ya sea a su oxidacion final

o bien en la sintesis de acidos grasos de la mielina, lipoproteina

indispensable para conservar la integridad del sistema nervioso.

Una deficiencia de la vitamina B12 produce danos, incluso de caracter

irreversible al sistema nervioso, se presenta progresiva hinchazon de las

neuronas mielinicas, desmielinizacion y muerte celular en medula espinal y

corteza cerebral. Esto causa gran variedad de signos y sintomas

neurologicos, incluyendo parestesias de manos y pies, disminucion de la

sensacion de vibracion y posicion con la consiguiente perdida del

equilibrio, disminucion de reflejos tendinosos profundos, y en etapas

posteriores perdida de la memoria, confusion, depresion, delirio,

alucinaciones, sicosis franca y hasta perdida de la vision central.

La vitamina B12 se elimina principalmente por el rinon en forma libre,

ocurriendo la maxima eliminacion dentro de las primeras 8 horas

postadministracion. La fraccion excretada esta en relacion con la dosis

administrada, siendo de alrededor del 10% con 50 mcg de cianocobalamina por

via intramuscular y de 85% con 100 mcg de hidroxocobalamina en 48 a 72

horas; la excrecion urinaria en 72 horas es de alrededor del 60%. La vida

media de la vitamina B12 es de 5 dias.

Una escasa cantidad se excreta con la leche materna. Alrededor de 1 a 3 mcg

se elimina por via biliar, un poco mas del 50% se reabsorbe por el circuito

enterohepatico.

Vitamina B1:

Tiamina: Las reservas de tiamina en los tejidos son escasas y no hay pruebas

de que la tiamina sintetizada por bacterias intestinales represente una

fuente aprovechable de esta, la ingestion diaria insuficiente es la causa

principal de la deficiencia de tiamina.

La tiamina en el organismo se transforma en una coenzima, el pirofosfato de

tiamina, que es la forma activa, tambien conocida como cocarboxilasa.

Se sabe que el pirofosfato de tiamina interviene en 24 diferentes reacciones

bioquimicas, destacandose su papel fundamental en el metabolismo de los

carbohidratos, cuya transformacion quimica se produce por accion enzimatica.

Asimismo la tiamina desempena un importante papel en los mecanismos

relacionados con la conduccion nerviosa (interviene en la formacion de

mielina) de los nervios perifericos y en la transmision neuromuscular, ya

que interviene en la sintesis de la acetilcolina (mediador quimico

neuronal).

En el metabolismo de los hidratos de carbono, las transformaciones quimicas

se producen por accion enzimatica; entre ellas la carboxilasa que esta

constituida por la apocarboxilasa y el pirofosfato de tiamina. Dicho sistema

enzimatico provoca la descarboxilacion de los alfacetoacidos que intervienen

en el metabolismo de los carbohidratos que entran en el ciclo de Krebs, en

primer lugar el acido piruvico y el acido alfa-cetoglutarico.

La descarboxilacion del acido piruvico pasa por las etapas de piruvato

activo y acetaldehido activo y finalmente mediante la intervencion del acido

tioctico o acido lipoico se llega a la acetilacion de la coenzima A para

producir la acetilcoenzima A, sustancia de gran importancia biologica en el

metabolismo oxidativo de los carbohidratos, especialmente en el ciclo de

Krebs; en la misma forma el acido alfa-cetoglutarico (metabolito importante

en el citado ciclo de Krebs) es transformado en succinato activo y luego en

acido succinico, pivote fundamental en dicho ciclo.

La tiamina se absorbe facil y completamente cuando se administra por via

subcutanea e intramuscular, no asi por via bucal, perdiendose entre el 20 y

75% en las heces.

Absorbida la tiamina pasa a la sangre alrededor de 0.06 a 6.0 mcg/dl.

Se almacena principalmente en higado, cerebro, rinon y corazon en forma de

pirofosfato de tiamina. El pirofosfato de tiamina se destruye parcialmente

en el organismo y el resto se excreta.

Del 20 al 40% de la dosis dada se excreta con la orina principalmente, asi

como en pequenas cantidades con el sudor y la leche.

Esta eliminacion depende de la dosis y del estado de deficiencia del

organismo, si tal es el caso, el organismo retiene cantidades importantes de

tiamina.

Se comprende pues que una deficiencia de tiamina ocasionara deficiencia en

la oxidacion de los carbohidratos, que conlleve a trastornos funcionales de

diversos tejidos, especialmente en el corazon y sobre todo en el sistema

nervioso, cuyo metabolismo depende casi exclusivamente del consumo de

glucosa; ademas a nivel de los nervios mielinicos, se presentan alteraciones

tanto en la conduccion como en la velocidad de conduccion, debido a una

desmielinizacion que ocasiona las neuritis y polineuritis del diabetico, del

alcoholico y del embarazo.

CONTRAINDICACIONES: Personas hipersensibles a los componentes de la formula,

asi como hipersensibilidad al cobalto o cianuro y en la policitemia vera.

PRECAUCIONES O RESTRICCIONES DE USO DURANTE EL EMBARAZO Y LA LACTANCIA:

Estudios en animales y mujeres embarazadas no han demostrado efecto nocivo

para la madre ni el feto.

Las 2 vitaminas se han encontrado en muy pequenas cantidades en la leche

materna.

Por lo tanto su uso en mujeres embarazadas y en periodo de lactancia queda a

criterio del medico tratante.

REACCIONES SECUNDARIAS Y ADVERSAS: En personas hipersensibles a la tiamina

y/o cianocobalamina, puede provocar reacciones de hipersensibilidad o

alergia y, en algunas, shock anafilactico. Por su contenido de tiamina, se

puede presentar enrojecimiento en cara, nausea, vomito, rash y diarrea que

son transitorios y no obligan a suspender el medicamento.

Puede presentarse dolor en el sitio de la inyeccion.

Por su contenido de vitaminas B6, se ha reportado neuropatia periferica con

la administracion prolongada; a dosis altas disturbios gastrointestinales,

deficiencia de acido folico, sedacion, hipotension y reacciones dermicas.

INTERACCIONES MEDICAMENTOSAS Y DE OTRO GENERO: El cloramfenicol disminuye la

respuesta hematopoyetica de la vitamina B12.

La vitamina C puede inactivar a la vitamina B12.

Los bloqueadores H2, el omeprazol, la colchicina, la neomicina,

preparaciones de potasio de liberacion prolongada y acido aminosalicilico y

sus sales, pueden disminuir la absorcion de vitamina B12.

El alcohol disminuye la absorcion de la vitamina B12.

Se ha reportado que la tiamina puede aumentar el efecto de los agentes

bloqueadores neuromusculares, su importancia clinica es desconocida.

ALTERACIONES DE PRUEBAS DE LABORATORIO: No se han reportado a la fecha.

PRECAUCIONES Y RELACION CON EFECTOS DE CARCINOGENESIS, MUTAGENESIS,

TERATOGENESIS Y SOBRE LA FERTILIDAD: No se han reportado anomalias en estos

rubros por la administracion de este grupo de farmacos.

DOSIS Y VIA DE ADMINISTRACION: Por via intramuscular profunda se administran

1-2 ml diarios o cada 2 a 3 dias, segun la intensidad y evolucion del cuadro

clinico.

SOBREDOSIFICACION O INGESTA ACCIDENTAL: MANIFESTACIONES Y MANEJO

(ANTIDOTOS): Respecto a la tiamina y a la cianocobalamina o

hidroxocobalamina no hay peligro por una sobredosificacion.

PRESENTACION:

Caja con 1 frasco ampula de 10 ml, 5 jeringas de 3 ml y 5 agujas esteriles

desechables.

RECOMENDACIONES PARA EL ALMACENAMIENTO: Mantengase en lugar fresco y seco.

Protejanse las ampolletas de la luz.

LEYENDAS DE PROTECCION:

Literatura exclusiva para medicos.

No se deje al alcance de los ninos.

Su venta requiere receta medica.

LABORATORIOS SILANES, S. A. de C. V.

Amores Num. 1304 - 03100 Mexico, D. F.

* Marca registrada

Reg. Num. 42443, S. S. A.

GEAR-17052/95

Vitamin B12 injections

I am looking for a source of preferably methylcobalamin for injection, but

if I can't get that, I would take cyanocobalamin. Does anyone know where I

can get this over the internet without prescription? I am on my last vial

of cyanocobalamin, which I got in Mexico a couple years ago.

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[Guest guest]

Hydroxycobalamin is the best and longest lasting.

You need a prescription for any injectable.

Physiologics brand of B12 sub-lingual spray (Vitamin B12 Liposome) is as good as

the shot, says Dr. in his newsletter.

jp

Vitamin B12 injections

I am looking for a source of preferably methylcobalamin for injection, but if

I can't get that, I would take cyanocobalamin. Does anyone know where I can get

this over the internet without prescription? I am on my last vial of

cyanocobalamin, which I got in Mexico a couple years ago. I just can't get back

there very soon.

This is simply Vitamin B12, but I need more than a sublingual can provide.

Any help is appreciated!

Patty

[Guest guest]

Hydroxycobalamin is the best and longest lasting.

You need a prescription for any injectable.

Physiologics brand of B12 sub-lingual spray (Vitamin B12 Liposome) is as good as

the shot, says Dr. in his newsletter.

jp

Vitamin B12 injections

I am looking for a source of preferably methylcobalamin for injection, but if

I can't get that, I would take cyanocobalamin. Does anyone know where I can get

this over the internet without prescription? I am on my last vial of

cyanocobalamin, which I got in Mexico a couple years ago. I just can't get back

there very soon.

This is simply Vitamin B12, but I need more than a sublingual can provide.

Any help is appreciated!

Patty

[Guest guest]

Dr :

I am interested in purchasing the B12 for injections. How much and to which

address!

Thanks,

Sara

------------------------------------

** It's ALL good ! **

------------------------------------

Vitamin B12 injections

I am looking for a source of preferably methylcobalamin for injection, but

if I can't get that, I would take cyanocobalamin. Does anyone know where I

can get this over the internet without prescription? I am on my last vial

of cyanocobalamin, which I got in Mexico a couple years ago. I just can't

get back there very soon.

This is simply Vitamin B12, but I need more than a sublingual can provide.

Any help is appreciated!

Patty

[Guest guest]

Dr :

I am interested in purchasing the B12 for injections. How much and to which

address!

Thanks,

Sara

------------------------------------

** It's ALL good ! **

------------------------------------

Vitamin B12 injections

I am looking for a source of preferably methylcobalamin for injection, but

if I can't get that, I would take cyanocobalamin. Does anyone know where I

can get this over the internet without prescription? I am on my last vial

of cyanocobalamin, which I got in Mexico a couple years ago. I just can't

get back there very soon.

This is simply Vitamin B12, but I need more than a sublingual can provide.

Any help is appreciated!

Patty

[Guest guest]

Dr :

I am interested in purchasing the B12 for injections. How much and to which

address!

Thanks,

Sara

------------------------------------

** It's ALL good ! **

------------------------------------

Vitamin B12 injections

I am looking for a source of preferably methylcobalamin for injection, but

if I can't get that, I would take cyanocobalamin. Does anyone know where I

can get this over the internet without prescription? I am on my last vial

of cyanocobalamin, which I got in Mexico a couple years ago. I just can't

get back there very soon.

This is simply Vitamin B12, but I need more than a sublingual can provide.

Any help is appreciated!

Patty

[Guest guest]

>

>I am interested in purchasing the B12 for injections. How much and to

>which address!

>Thanks,

I have used tons of vitamins and minerals over my lifetime, but never

worried about iron and B12.

What am I missing? Why do people need these injections?

Wayne

[Guest guest]

>

>I am interested in purchasing the B12 for injections. How much and to

>which address!

>Thanks,

I have used tons of vitamins and minerals over my lifetime, but never

worried about iron and B12.

What am I missing? Why do people need these injections?

Wayne

[Guest guest]

>

>I am interested in purchasing the B12 for injections. How much and to

>which address!

>Thanks,

I have used tons of vitamins and minerals over my lifetime, but never

worried about iron and B12.

What am I missing? Why do people need these injections?

Wayne

[Guest guest]

Wayne wrote:

>

>I have used tons of vitamins and minerals over my lifetime,

>but never worried about iron and B12.

>

>What am I missing? Why do people need these injections?

Low iron (anemia) may be caused by a vitamin B12 deficiency,

but that's the tip of the iceberg.

Do a MedLine search on the vitamin B12 " keyword list "

shown below to get a real education.

You will find hundreds of distinct reasons why vitamin B12

(the largest of all vitamin molecules) is frequently difficult

to assimilate and /or utilize -- everything from several genetic

" inborn errors of metabolism, " to intestinal disorders,

to dysbiosis, to mineral and toxin interference, to vitamin B12

analog interference, to metabolic disorders or required

binding-protein deficiency or blockage, including autoimmune.

There are many, probably hundreds of large and very technical

biomedical books written on the subject.

In other words you're missing very, very much.

First, an outline of the symptoms and causes of B12 deficiency:

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

from:

NEUROMUSCULAR DISEASE CENTER

Washington University School of Medicine, St. Louis, MO

---------------------------------------------------------

http://www.neuro.wustl.edu/neuromuscular/index.html

http://www.neuro.wustl.edu/neuromuscular/nother/vitamin.htm#b12

Vitamin-related syndromes

excerpt:

6. Vitamin B12 (cobalamin) deficiency

Clinical features

Polyneuropathy

Sensory

Early paresthesias

Loss especially of large fiber modalities

Distal

Motor: Later in course; Distal

Reflexes

Tendon: Reduced or absent at ankles

Plantar: Upgoing

Autonomic: Postural hypotension

CNS

Spinal cord

Major cause of sensory & motor disability

Posterior column fiber loss

Spasticity in legs

Cortical function

Cognitive impairment in adults:

Leukoencephalopathy on MRI

Mental retardation or encephalopathy in

childhood syndromes

Anemia: Megaloblastic; Due to reduced DNA synthesis

Gastrointestinal: Glossitis; Diarrhea

Causes of B12 deficiency: Normal body stores last 3 to 4 years

Gastrointestinal malabsorption

Deficient intrinsic factor production

Post-gastrectomy

Antibody vs parietal cells

No digestion of cobalamin-R-binder complex

Pancreatic insufficiency

Consumption of cobalamin in GI tract

Intestinal bacterial overgrowth

Poor absorption by distal ileum

Sprue-related disorders

Autosomal recessive disorders

Anemia; Proteinuria; Juvenile onset

Dietary inadequacy in vegetarians

Sources: Meat & dairy products

Congenital disorders of B12 binding proteins

Vitamin B12 R-binding protein deficiency

Neurological B12 deficiency syndromes in adults

Gastric intrinsic factor deficiency

Congenital anemia & jaundice

Transcobolamin II deficiency

Megaloblastic anemia; Diarrhea; Immunodeficiency;

Mental retardation

Abnormalities of synthesis of active forms of B12

Methylcobalamin deficiency, types E and G

Neurological (CNS) & hematological B12 deficiency

syndromes in children

Adenosylcobalamin deficiency

Episodic ketoacidosis; Encephalopathy;

Neutropenia; Osteoporosis

Combined methylcobalamin & adenosylcobalamin deficiency

Types I and II

Mental retardation; anemia; ± myelopathy in

slowly progressive cases

Abnormal release of B12 from lysosomes

Testing

Low serum B12

Clinically significant: < 100 pg/ml

Suspicious: < 200 pg/ml

High serum homocysteine & methymalonic acid

Confirm biological significance of low B12 levels

Treatment: 1 mg i.m. q 3 months

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

MedLine Cobalamin (vitamin B12) keyword list :

Vitamin B12 (B-12) (B 12)

Vit. B12 (VB12) (V.B12)

Cyanocobalamin <-- Biologically inactive, and

(CN-Cbl) (CNCbl) contained in multi-vitamins.

Biologically active Coenzyme B12's - listed below :

AdenosylCobalamin (Ado-Cbl) (AdoCbl)

. Adocobalamin

. Deoxyadenosylcobalamin

. Dibencozide

. Dimethylbenzimide

. Indusil

. JABA B12

. Tridocemine

AquaCobalamin (AqCbl) (vitamin B12b)

AquoCobalamin (AqCbl) (vitamin B12b)

HydroxoCobalamin (OH-Cbl) (vitamin B12a)

HydroxyCobalamin (OH-Cbl) (vitamin B12a)

Methylcobalamin (Me-B12) (MeCbl) (MB12)

. Methyl cobalamin

. Methylobalamin

. Methylcobalamine

. MeCobalamin

. MeCobalamine

. CH3-B12 (CH3B12) (CH3Cbl)

. Methyl B12

. Methyl B-12

. Methyl B 12

. Methyl Vitamin B12

. MethylCoenzyme B12

. Methylepicobalamin

. Co-methyl cobalamin

. Algobaz

. Mecobal

. Methylcobaz

. Methylcobal

NitritCobalamin (vitamin B12c)

NitroCobalamin (vitamin B12c)

Other, less common Coenzyme B12's :

AlkylCobalamin

DeuteroMethylcobalamin

FluorAlkylcobalamin

FluoroMethylcobalamin

OrganoCobalamin

SulphitoCobalamin

SuperoxoCobalamin

Cobalamin 5'-Phosphate

Required Cobalamin Binding Proteins :

. Intrinsic Factor

. Transcobalamin

. Haptocorrin

Cobalamin variants (often block active cobalamin) :

. Analogs

. Analogues

..

[Guest guest]

Wayne wrote:

>

>I have used tons of vitamins and minerals over my lifetime,

>but never worried about iron and B12.

>

>What am I missing? Why do people need these injections?

Low iron (anemia) may be caused by a vitamin B12 deficiency,

but that's the tip of the iceberg.

Do a MedLine search on the vitamin B12 " keyword list "

shown below to get a real education.

You will find hundreds of distinct reasons why vitamin B12

(the largest of all vitamin molecules) is frequently difficult

to assimilate and /or utilize -- everything from several genetic

" inborn errors of metabolism, " to intestinal disorders,

to dysbiosis, to mineral and toxin interference, to vitamin B12

analog interference, to metabolic disorders or required

binding-protein deficiency or blockage, including autoimmune.

There are many, probably hundreds of large and very technical

biomedical books written on the subject.

In other words you're missing very, very much.

First, an outline of the symptoms and causes of B12 deficiency:

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

from:

NEUROMUSCULAR DISEASE CENTER

Washington University School of Medicine, St. Louis, MO

---------------------------------------------------------

http://www.neuro.wustl.edu/neuromuscular/index.html

http://www.neuro.wustl.edu/neuromuscular/nother/vitamin.htm#b12

Vitamin-related syndromes

excerpt:

6. Vitamin B12 (cobalamin) deficiency

Clinical features

Polyneuropathy

Sensory

Early paresthesias

Loss especially of large fiber modalities

Distal

Motor: Later in course; Distal

Reflexes

Tendon: Reduced or absent at ankles

Plantar: Upgoing

Autonomic: Postural hypotension

CNS

Spinal cord

Major cause of sensory & motor disability

Posterior column fiber loss

Spasticity in legs

Cortical function

Cognitive impairment in adults:

Leukoencephalopathy on MRI

Mental retardation or encephalopathy in

childhood syndromes

Anemia: Megaloblastic; Due to reduced DNA synthesis

Gastrointestinal: Glossitis; Diarrhea

Causes of B12 deficiency: Normal body stores last 3 to 4 years

Gastrointestinal malabsorption

Deficient intrinsic factor production

Post-gastrectomy

Antibody vs parietal cells

No digestion of cobalamin-R-binder complex

Pancreatic insufficiency

Consumption of cobalamin in GI tract

Intestinal bacterial overgrowth

Poor absorption by distal ileum

Sprue-related disorders

Autosomal recessive disorders

Anemia; Proteinuria; Juvenile onset

Dietary inadequacy in vegetarians

Sources: Meat & dairy products

Congenital disorders of B12 binding proteins

Vitamin B12 R-binding protein deficiency

Neurological B12 deficiency syndromes in adults

Gastric intrinsic factor deficiency

Congenital anemia & jaundice

Transcobolamin II deficiency

Megaloblastic anemia; Diarrhea; Immunodeficiency;

Mental retardation

Abnormalities of synthesis of active forms of B12

Methylcobalamin deficiency, types E and G

Neurological (CNS) & hematological B12 deficiency

syndromes in children

Adenosylcobalamin deficiency

Episodic ketoacidosis; Encephalopathy;

Neutropenia; Osteoporosis

Combined methylcobalamin & adenosylcobalamin deficiency

Types I and II

Mental retardation; anemia; ± myelopathy in

slowly progressive cases

Abnormal release of B12 from lysosomes

Testing

Low serum B12

Clinically significant: < 100 pg/ml

Suspicious: < 200 pg/ml

High serum homocysteine & methymalonic acid

Confirm biological significance of low B12 levels

Treatment: 1 mg i.m. q 3 months

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

MedLine Cobalamin (vitamin B12) keyword list :

Vitamin B12 (B-12) (B 12)

Vit. B12 (VB12) (V.B12)

Cyanocobalamin <-- Biologically inactive, and

(CN-Cbl) (CNCbl) contained in multi-vitamins.

Biologically active Coenzyme B12's - listed below :

AdenosylCobalamin (Ado-Cbl) (AdoCbl)

. Adocobalamin

. Deoxyadenosylcobalamin

. Dibencozide

. Dimethylbenzimide

. Indusil

. JABA B12

. Tridocemine

AquaCobalamin (AqCbl) (vitamin B12b)

AquoCobalamin (AqCbl) (vitamin B12b)

HydroxoCobalamin (OH-Cbl) (vitamin B12a)

HydroxyCobalamin (OH-Cbl) (vitamin B12a)

Methylcobalamin (Me-B12) (MeCbl) (MB12)

. Methyl cobalamin

. Methylobalamin

. Methylcobalamine

. MeCobalamin

. MeCobalamine

. CH3-B12 (CH3B12) (CH3Cbl)

. Methyl B12

. Methyl B-12

. Methyl B 12

. Methyl Vitamin B12

. MethylCoenzyme B12

. Methylepicobalamin

. Co-methyl cobalamin

. Algobaz

. Mecobal

. Methylcobaz

. Methylcobal

NitritCobalamin (vitamin B12c)

NitroCobalamin (vitamin B12c)

Other, less common Coenzyme B12's :

AlkylCobalamin

DeuteroMethylcobalamin

FluorAlkylcobalamin

FluoroMethylcobalamin

OrganoCobalamin

SulphitoCobalamin

SuperoxoCobalamin

Cobalamin 5'-Phosphate

Required Cobalamin Binding Proteins :

. Intrinsic Factor

. Transcobalamin

. Haptocorrin

Cobalamin variants (often block active cobalamin) :

. Analogs

. Analogues

..

[Guest guest]

I'm new to this field, and have found this group to be very helpful! A

patient's spouse today asked if vitamin B12 injections would be better

than the sublingual B12? Not sure how to answer this one, or what the

literature/research says about this. The program I'm working with

recommends 2000mcg B12 sublingual for gastric bypass patients, and

1000mcg for lap band. Thanks in advance.

Tarra MS, RD

[Guest guest]

It's not that one is " better " than the other. If taking the injections, it only needs to be done once a month. If taken sublingually, it needs to be taken every day, so some people have a preference based on the pros and cons of eachKerry L. Strom, RD, LDN, CNSDDietitian Educatorlin Square Hospital Centerkerry.strom@...443-777-6528This message is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law. If you are not the intended recipient(s), you are notified that the dissemination, distribution or copying of this message is strictly prohibited. If you received this message in error, or are not the named recipient(s), please notify the sender at either the e-mail address or phone number above and delete this e-mail from your computer. Thank you.CONFIDENTIAL: The information contained in this communication, including its attachments may contain confidential information and is intended only for the individual (s) or entity (ies) to whom it is addressed . The information contained in this communication may also be protected by legal privilege , federal law or other applicable law. If you are not the intended recipient of this communication , you are hereby notified that any distribution, dissemination or duplication of this communication is strictly prohibited. If you have received this communication in error please immediately delete and destroy all copies of this message and please immediately notify us of the error by separate communication . Thank you.