Info on Methyl-B12/Neubrander/long

[Guest guest]

Dear Jaquelyn,

As you know, very rarely do I respond to “stuff out there” or posts on the

Internet. However, I am troubled by information some patients are telling me

“is making the rounds”.

The most troubling is the use of methyl-B12 shots being prescribed in

preservative-free multidose vials to save some money over the cost of prefilled

syringes. Please note that every quality compounding pharmacy I have

communicated with states emphatically that this is an extremely unwise position

for the prescribing clinician and participating parent to undertake together.

It should be noted that compounding pharmacies load the syringes in “clean rooms

with sterile conditions” resulting in an extremely small chance that

contamination may occur [though still possible]. Without a clean room and

sterile conditions when a parent draws up the solution, with or without alcohol

wipes, etc., the best that can be hoped for is “less possibility of

contamination”. The FDA, though not always our friend, would be appalled at

such a practice. The possibility for contamination in a bottle that is

repeatedly punctured is not an insignificant risk, even if all the syringes are

filled at the initial sitting rather than just before the shots were to be

given. It causes me great alarm to think that the slight cost benefit one may

receive weighed against the not insignificant possibility of injuring a child is

even considered, especially when methyl-B12 shots are not that expensive when

compared to everything else that a child is doing and taking. It is even more

surprising to think that this cost [small though not insignificant], when graded

against the obvious benefit it produces, and a benefit that is cumulative over

time, comes into question.

Another “thing” that is making the rounds in certain circles is that the shots

into the buttocks, even with the small needles I recommend [3/10 cc BD insulin

syringes, item #328438 ONLY, 31 gauge needle, 8 mm length] can potentially hit

the sciatic nerve. Without defending this too much, let me just state that the

anatomy teachers at medical schools and neurosurgeons laugh at such a ridiculous

thought – even with the smallest premie!

One more “thing” should make the rounds and be better understood so that more

parents can see the results possible if their child receives long-term

treatment. Dose is only 1/3 of the equation; location of the injection site is

1/3 of the equation; and high viscosity of the base methyl-B12 parent solution

is the last 1/3 of the equation. Let me explain by first illustrating a few

obvious facts.

The first fact is that if one would take an extremely fine mesh sieve and put a

drop of molasses on it, the molasses would take a very long time to go through

the mesh sieve. If one took an equal sized drop of water and diluted the

molasses, now one has sugar water and the sugar water would immediately run

through the sieve even though the sugar content [analogous to methyl-B12

dose/content] was exactly the same.

The second fact, maybe not well known to many parents or clinicians, is that

different types of fat have different rates of accumulation and diffusion. What

is even less well understood, but which is a fact no less as stated by

toxicologists in this area, is that adjacent areas of the same region of the

body [e.g. the buttocks] will accumulate and/or allow diffusion of the contents

at significantly different rates. Therefore, “butt fat” is definitely different

than fat from the arms or abdomen, etc. and the diffusion rate characteristics

will differ markedly.

The third fact that needs to be reviewed is that the diffusion rate

characteristics of fat is related to viscosity of the solution administered to

the adipose tissue and that the diffusion rate is not a linear function but more

closely akin to a logarithmic function. For example, if one injects a “watery”

12.5 mg/ml solution of methyl-B12 in one buttock and a 25 mg/ml “syrupy”

solution of methyl-B12 in the other buttock, the 25 mg/ml solution will be found

much more than twice as long in the tissue.

Many of us believe that the phenomenon we are witnessing with methyl-B12 is not

strictly “a deficiency”. Instead, we believe it is “a dependency” and that

feeding this dependency “24/7” is a better treatment option than the peaks and

valleys that occur with most of the other forms of administration. Note that

methyl-B12 administered by injections into a fatty substance, no matter what the

concentration of the base solution, e.g. 1 mg/ml, 12.5 mg/ml, or 25 mg/ml, will

supply the tissues with a more steady-state of methyl-B12 than will

intramuscular injections, sublingual preparations, oral, etc. In addition, the

more “syrupy” the substance that is injected into the tissue is, the longer the

effective treatment lasts, and the longer the interval between shots can be [to

obtain the same symptom improvement]. One of the problems that exists is that

unless one has followed thousands of doses “with no other confounding factors

being added or subtracted” at the same time, one will not be able to see that

these differences exist, especially when any dose of methyl-B12 given by any

form of administration will produce results, a statement I have made many times.

However, it has been my privilege [job?? – calling??] to evaluate between 35,000

to 40,000 shots from hundreds of my patients and from patients that have done

many other things. I keep coming back to the same conclusion – for the greatest

results for the majority of children [exceptions exist] with the fewest

“intolerable” side effects [in contrast to nuisance or at times even severe

nuisance side effects, e.g. if at school the child is able to learn and be

redirected and focused, even with difficulty], injections made from 25 mg/ml

administered (VISCOSITY – 1/3 of the equation) into the buttocks (INJECTION

SITE – 1/3 of the equation) once every 3 days at a total dose not too excessive

or too minimal (DOSE – 1/3 of the equation) [i use as my standard initiation

dose 150 mcg/kg/week typically given once every 3 days which translates 64.5

mcg/kg every 3 days, 43 mcg/kg every 2 days, or 21.5 mcg/kg given daily.]

Please note also that FREQUENCY of injections is a mixed function of viscosity,

injection site, and of each child’s unique adipose clearing rate [diffusion rate

– most likely a genetic component is involved here], and that frequency of

injections is not a function of “total dose” unless one still believes in the

deficiency vs. dependency theory. I do not.

Thank you, Jaquelyn, for posting this for me,

Jim Neubrander, M.D.

[Guest guest]

Dr. JM,

We are about to start the TD DMPS from Dr. Usman. her PA told

me to give the injection every 4th day opposite from the TD DMPS

because the shot contained the mineral cobalt.

What about zinc and magnesium? I was told not to give on TD days but

many people on the boards are giving these minerals on DMPS days.

What is your opinion about this?

Thanks

Sym

Mom to 5

[Guest guest]

I am checking with Neubrander on whether cobalt could possibly complex with

DMPS, and will let you know. I have not altered my injection schedule; some

are on q 3 days, some every other day, some twice a week, a few daily. My

scheduling is to give the DMPS in the evening, then give one whole day's

minerals when the child gets home from school the next day (about 20 hours

from the chelator) and then give another full daily dose of minerals the

next morning, about 10-12 hours before the next dose of DMPS. I just could

not get two days of minerals down most of the kids all in one day; that much

zinc all at once makes some kids very sick. Dr. JM

RE:Info on Methyl-B12/Neubrander/long

>

> Dr. JM,

> We are about to start the TD DMPS from Dr. Usman. her PA told

> me to give the injection every 4th day opposite from the TD DMPS

> because the shot contained the mineral cobalt.

> What about zinc and magnesium? I was told not to give on TD days but

> many people on the boards are giving these minerals on DMPS days.

> What is your opinion about this?

>

> Thanks

> Sym

> Mom to 5

>

>

>

>

> Many frequently asked questions and answers can be found at

<http://forums.autism-rxguidebook.com/default.aspx>

>

>

[Guest guest]

DR M -please post here-we are giving the MB12 shots daily.

i gave my son the td-dmps tonight at 7, and then gave him the Mb12

at 10pm. this makes me very nervous.

also my doc told me to give minerals 12 hours later(1/2 daily dose)

ie 7am. 1/2 dose 24 hr later. 1/2 dose 36hrs later

i will try to do it your way. arghhh but tomorrow it will be 24 hrs

later since he has piano lesson after i pick him up.

thanks

roz

> I am checking with Neubrander on whether cobalt could possibly

complex with

> DMPS, and will let you know. I have not altered my injection

schedule; some

> are on q 3 days, some every other day, some twice a week, a few

daily. My

> scheduling is to give the DMPS in the evening, then give one whole

day's

> minerals when the child gets home from school the next day (about

20 hours

> from the chelator) and then give another full daily dose of

minerals the

> next morning, about 10-12 hours before the next dose of DMPS. I

just could

> not get two days of minerals down most of the kids all in one day;

that much

> zinc all at once makes some kids very sick. Dr. JM

> RE:Info on Methyl-B12/Neubrander/long

>

>

> >

> > Dr. JM,

> > We are about to start the TD DMPS from Dr. Usman. her PA

told

> > me to give the injection every 4th day opposite from the TD DMPS

> > because the shot contained the mineral cobalt.

> > What about zinc and magnesium? I was told not to give on TD

days but

> > many people on the boards are giving these minerals on DMPS days.

> > What is your opinion about this?

> >

> > Thanks

> > Sym

> > Mom to 5

> >

> >

> >

> >

> > Many frequently asked questions and answers can be found at

> <http://forums.autism-rxguidebook.com/default.aspx>

> >

> >