Vitamin B-12; New Understanding and Approach to an Old Problem

University of Wisconsin Madison Department of Family Medicine physician, Irene Hamrick, MD, discusses Vitamin B-12 deficiency with some tips on diagnosis and treatment.

[@Number69]

Excellent and very clear outline, hopefully we are moving (finally) to a model of b12 folate and omega 3 for elderly before signs of cognitive impairment

[@kabirmd.ghulam8984]

Most likely essential vitamin for elderly people .but absorption is difficult particularly those who are having gastric and intestinal problems. Thanks.

[@andreamacarthur3467]

All was going well until the part about injections not being necessary anymore. Clearly, no one spoke to the patients themselves! Before posting advice on how to treat PA, perhaps you would be better to consult with real patients to see what effect injections and oral supplements have on their symptoms. You might find you actually learn something new yourself and be better able to help your patients receive effective treatment for their PA, rather than just regurgitating the same misconception that normal serum B12 levels mean all is well with the patient. B12 doesn't just have to be absorbed in the stomach, it has to make it all the way to the cells and it is extremely common to find patients with high serum levels but who still require up to daily injections to remain stable.

[@simongilmore1581]

i had very low b12 and i was taing methylocolobalamin 1000mg everyday for a month and i am now 300 before i was 101 i now take it once a week as i had some rashes i dident get any injections

[@elvirastevenson8402]

The drs Do not give any more B12 injections. So, take B 12 sublingual + Iron and do respiration exercises.

[@andreamacarthur3467]

If it was that simple everyone would prefer to take sublingual B12 rather than have to have injections.. For most people with actual malabsorption, injections are vital and the only way they can access the B12. I've experienced it myself, and also communicate with many thousands of people who all have found the same so it's time the medical profession listened to them and updated its understanding of B12 Deficiency.

[@plucky2901]

3 injections every week for me for the last 3 years. I’ve tried to drop down to 2 but symptoms start to return. My quality of life has never been this good. Even 20 years ago when I was in my 20’s. No one could figure out my stomach issue. Always told it was IBS (over 30 years). Now even that’s gone. I’m starting to think patients should be the ones teaching the class on that one Wednesday in med school that is spent on vitamins!

[@ssiddi2]

@@plucky2901 can you tell me what dosage you get for your shots? I have a feeling my "IBS" is the result of my deficiency. also, how long did it take until you started feeling better after the injections?

[@natashawiebe8351]

Information on how small intestine bacterial overgrowth impacts vitamin B12 absorption would be helpful. I am guessing the IM route is better than PO

[@ahmadsabban]

Thx for this informative concise presentation , Vitamin D deficiency is a hot topic nowadays , u have any material on it ?

[@wizardatmath]

I can imagine toxcity depends on the type of cobalamine. Cyanocobalamin could easily be toxic at high doses, relative to hydroxocobalamine, which is used to detox from cyanide poisoning...

[@plucky2901]

There is no toxicity as it is water soluble. The amount of cyanide in cyanocobalamin is no where near what one would require to become “poisoned”. I self inject 3 times every week for the last 5 years.

[@wizardatmath]

@@plucky2901 poisoned is a binary state. Toxcity is a continuum. You wouldn't necessarily notice a mild toxcity, even though it might take a few years off at the end. Smoking.... For example.

[@plucky2901]

@@wizardatmath I would definitely not compare cyano to smoking. Smoking would take more than a few years off. I know 80 year olds that have been injecting cyano for over 30 years and are doing well. I will say hydroxocobalamin is ideal but not necessary for supplementation.

[@wizardatmath]

@@plucky2901 it would be neat to know how many milligram cyanocobalamin would translate into the ld50 of cyanide.... 🤔

[@Igaluit]

One can have serious deficiency without macrocytic anemia. Moreover, the elderly have lower stomach acid. But, a very informative video overall.

[@margaretsmith9637]

And what about the MTHFR gene variation making them slow methylators. Wouldn’t that affect oral absorption of B12?

[@angelhoot1310]

I was wondering With a patient with beta thalesemmia minor, can one become b-12 deficient?With Hasimoto's , Lyme, and mercury amalgam toxicity, it's hard to know Low MCV count too. . Great presentation, thanks!

[@margaretsmith9637]

If stomach acid is low wouldn’t intramuscular injections be better than oral dosing?

[@johnlawrence2757]

It’s developing obsessional level : this unstoppable effort to convince us that vegetarian and vegan diet ( by implication) are bad for you.
It’s odd how everything that involves attempts to improve quality of life becomes subject to these obsessional efforts to convince us they are bad for us!

[@colinthomson5358]

Vegetarians should be able to get enough B12 in, depending on them having a "healthy diet" meaning they get all their nutrients.
Veganism is where the concern is, and someone could become seriously ill if they went vegan and didn't know about B12.

[@plucky2901]

@@colinthomson5358 b12 only comes from animals. Vegetarians could and most likely do find themselves deficient.

[@RajinderSingh-fv8et]

Cholesterol ,lipid trigecide bdne se numbness and tingling ki problems hoti ha....90% people suspect b12 problems

[@MrOldeastdallas]

I got three 3 shots of vitamin B, I skipped 2 days in between each shot, and on the 3rd shot I noticed stomach pain, diarrhea and my face and back break out. I stopped taking vitamin B. Does anyone know when will my skin get better?

[@momoary5740]

Sometimes when I eat meat it feels like I am not digesting it properly. I am suffering slot from either B12 or B6. I feeling very bad. Tired, bloated, dry skin, esp scalp, esp. I feel like there is something above my navel. I feel thirsty, I lost glow on my face and much more..

[@margaretsmith9637]

Try taking HCl Pills and digestive enzymes with your food.

[@jammatoonarmy]

SOME bad advice in this video - seriously!! methy injections are a necessity if your extremely defiant and/or lacking intrinsic factor!

[@plucky2901]

Injections are absolutely necessary to those with absorption problems. Why in the world would anyone think that someone with P.A. would benefit from oral supplementation?! Completely inaccurate. I suggest you spend some time on a forum, talking with patients living with this deficiency nightmare and then make a video that makes a little more sense. A “normal” level on a blood test does not mean that a patient is getting enough at the cellular level. Educate yourself instead of spewing what physicians around the world do. There is a serious need for more time spent on this deficiency in med schools. Outrageous that us patients have to self treat because it’s easier to treat everything with a pill. More time needs to be spent on why we have the issue and treat that problem. The sheer number of people unaware that they are deficient is scary.

[@planetbspace]

Exactly. Thank you. You nailed it. More spew
I self inject daily

[@plucky2901]

@@planetbspace as do I but I’m still ok with 3x per week. Hope you are doing well.

[@planetbspace]

@@plucky2901 I’m pretty damaged. Misdiagnosis for over a decade. Hoping big doses more frequently will heal some neuropathy. Keep Shining

[@michellemedina3763]

Expensive urine lol

[@elisafongtang2228]

JAw

[@ngisian]

.

[@ahmedel-sherif5095]

Learn how to do videos then come do it

[@ahmedel-sherif5095]

Dont ever try to do videos in your life