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06-04-2012, 11:31 AM   #1
sid
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Vitamin B12 injections

After reading thread on this forum, I was confirmed that my foot cramps were due to some vitamins deficiencies. after giving it a thought , I observed that I was really not getting enough B12. Since I am mainly a vegetarian, I had a lot of milk and dairy product earlier, thus my B12 intake was adequate but , now I am totally deprived of B12 completely as I cant take dairy products and I dont eat Meat. (only fishes,may be twice a week). I went to my GP and told him about this. He prescribed me Nurokind injections to be taken 1 every alternate days. I was a little suprised he didnt prescribe me any B12 supplement in a form of tablet/capsule or syrup (which are readily available) but injections. Upon asking him why he didnt give me any other form than an injections, he says its because B12 diet supplements would not be absorbed properly through my guts and it would be a waste. Similarly he wants me to take sunbath instead of any Vit D supplement...and he gives the same reason. I am a little confused guys..please suggest what should I do ??

I mean should I do what he says or shall I try taking other form of B12 supplements (syrups and tablets in same quanity) since I dont really like the idea of injections.
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In remission since Diagnosis

Crohn's since Jan 2011.

No meds.
Diet as per ayurveda.
Vitamin D and B12 shots.
Currently experimenting with Probiotics, starting 2016.
And a large joint mad family, thus stress cant touch me.

Last edited by sid; 06-05-2012 at 12:57 AM.
06-04-2012, 11:40 AM   #2
Kelly2
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Do you perhaps have pernicious anemia - and he didnt share that with you? If you do have it, then it doesnt matter how much B12 you take orally, it would not be absorbed. You could do the injections for a while, just to get your levels up, and then change to supplements, and monitor it with lab work to make sure you are sustained in the normal range. B12 is very important - and can cause a lot of unpleasant side effects if you are deficient.
06-04-2012, 11:52 AM   #3
CLynn
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The ileum is the only spot in the body that process and absorbs the B-12, so if you have Crohn's disease in that area, you will never absorb it well, or in my case at all since the re-section I had in that area. So oral B-12 will not suffice. I would assume that malabsorption would be his concern on the D orally as well, although I take that orally, I use a gel tab instead of a pill on that, take it with a meal and a fish oil tablet as well.
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Cheryl
Diagnosed:1988
Previous meds: Sulfadiazine, Flagyl, Prednisone, Imuran, Pentasa, Asacol
Surgeries: re-section 2004
Currently taking: B-12 injections every 2 weeks, multi vitamin/mineral, fish oil (1000 mg), D3 (5000 mg)

Also lucky enough to have psoriasis as well.
06-05-2012, 01:03 AM   #4
sid
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The ileum is the only spot in the body that process and absorbs the B-12, so if you have Crohn's disease in that area, you will never absorb it well, or in my case at all since the re-section I had in that area. So oral B-12 will not suffice. I would assume that malabsorption would be his concern on the D orally as well, although I take that orally, I use a gel tab instead of a pill on that, take it with a meal and a fish oil tablet as well.
Unfortunately, Yes. I have crohn's at my ileum. But it is reall mild.

So does that mean , I can never take B12 supplement orally ?? wow !

and what bout Vit D ?? is it also processed and absorbed in Ileum ?
06-05-2012, 09:42 AM   #5
David
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The process by which vitamin B12 is absorbed is very intricate. It begins in the mouth with secretion of R factor which protects the B12 in the stomach when pepsin and hydrochloric acid release it from protein. Also in the stomach, intrinsic factor is release which binds to the B12 in the duodenum once the rfactor/B12 bond is broken by pancreatic enzymes. That IA/B12 bond is what is absorbed in the terminal ileum by cubam receptors and nowhere else.

Crohn's Disease patients can have issues at any step of that process which is why B12 deficiency is so common. If you can't properly absorb dietary or oral B12, then only 1-2% of it will be passively absorbed which is usually not enough to get to ideal levels. Thus the need for alternative methods of supplementation.

Vitamin D from sunlight is better especially since there are other photochemicals and processes in the skin associated with sunlight that we don't yet understand. However, most people with Crohn's Disease are able to absorb supplemental vitamin D. Taking it with a little fat such as olive oil can aid that absorption. Usually high dosages are needed to get vitamin D levels into the ideal range, MUCH more than your typical multivitamin would provide.

The key (for both vitamins) is to get your levels retested on occasion to ensure you are absorbing enough and to adjust your dose as need be. Both should be treated as medications and only be taken when necessary and an optimal dose should be found over time to avoid taking too little or too much.
06-05-2012, 09:59 AM   #6
sid
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^^Thanks David. So does that mean I can still take my Vit D supplement orally, although i have crohns located at the ileum ??

BTW just got my first shot of B12 injection
06-05-2012, 10:11 AM   #7
David
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Yes, you should be ok with the vitamin D but as mentioned, get your levels tested again to make sure it's working. How many IU is your vitamin D?
06-05-2012, 11:21 PM   #8
sid
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^^havent yet got the vit D levels tested. wil do it asap.
06-09-2012, 02:38 AM   #9
sid
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Yes, you should be ok with the vitamin D but as mentioned, get your levels tested again to make sure it's working. How many IU is your vitamin D?


Hi david, Just got my test reports.

vitamin D -------- 11.13 ng / ml

vitamin B12 ------ 2,000.00 pg/ml

..I can see that my vit b12 level is higher than normal, but the test was done after two shots of vitamin B12 within last four days..so is it becauseof tjhose two injections ?? if thats so then it means , i need to bring down the doses..may be one injection a week ?? and the vitamin D seems to be not really bad, although it is still not enough..the nromal range is I guess somewhere between 21 - 100..so i guess I have to work on that.

Last edited by sid; 06-09-2012 at 04:46 AM.
06-09-2012, 05:04 AM   #10
David
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Yeah, 2000 is pretty high I don't think you need two shots a week.

And yes, you need some high dose vitamin D.
06-09-2012, 04:50 PM   #11
elizamt
 
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Sid, I was taking the sublingual B12 for awhile and it just wasn't cutting it, even though my levels weren't that bad. I noticed that when I went to my doctor's office to get the B12 shots, I'd immediately feel better and it'd last awhile. Last month, I asked them if they'd let me do the injections myself to save me from having to drive an hour roundtrip every time I needed a shot. I wasn't sure I could give myself a shot because I HATE needles, but it wasn't so bad. Feeling better is worth it a million times over!
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Dx: May 2011
Surgery: Ileocecal resection May 2011 (~13 in)
Meds: 500mg Pentasa 4x/day
B12 Injections 1x/month
Iron 45 mg for Anemia
Vitamin D 1000 mcg
Thinking about starting Remicade or Humira
09-03-2013, 05:11 PM   #12
mreyn
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Question.... My sons liquid multi has b12 in it , but not alot. I found a b12 spray from dr mercola... its 1,000 mcg... 16, 666% daily value.

IS that too much?



Dr Mercola also has some sleep support spray and vit d spray... considering those as well so any info /advice would be appreciated. My son is 13 so can take adult doses.


His multi also has this fish oil, but I'm wondering if that's enough. I'm considering adding nordic naturals ultimate omega with 1280 mg total.


DHA AND EPA (FROM FISH OIL)
150 Mg
N/A*

TOTAL OMEGA 3 (FROM FISH OIL)
180 Mg
09-03-2013, 07:04 PM   #13
David
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The 1000mcg will not be too much if he is deficient in B12 due to Crohn's. In fact, it may not be enough. If you choose to go that route, get his B12 checked before and then 3-4 weeks after you begin so you can begin to optimize the dosage.

As for vitamin D sprays, I don't know much about them, sorry.
09-03-2013, 07:09 PM   #14
mreyn
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Thank you David! What about the fish oil? If you can point me to info on dosages for that, or share if you know... I would appreciate it.
09-03-2013, 07:13 PM   #15
David
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A multi with fish oil? Interesting. I've never heard of that.

What kind of fish oil is the nordic naturals? I'm a fan of krill oil as it has pretty much zero heavy metals in it. As for dosage, I always went with what the bottle said on those but others may have better advice.
09-03-2013, 08:28 PM   #16
mreyn
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Yes, he's taking Kids Calm. It has fish oils and omegas in it. The nordic naturals I'm looking at is anchovy and sardines... although they do have others
09-03-2013, 08:29 PM   #17
David
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Anchovy and sardine oil is actually pretty darn good compared to most fish oils as they're near the bottom of the food chain.
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