B12 deficiency - Frequently Asked Questions - page 2

Continuing Frequently Asked Questions:

• Can I overdose on B12?
• Are injections better than oral lozenges?
• Can I stop treatment/ Should I stop once my blood B12 is up to a certain level?
• Will I recover completely?  Will all of my damaged cells regenerate?
• If I am B12 deficient, will other people in my family also be B12 deficient?

Can I overdose on B12?

you asked if it is possible to get too much B12?  B12 is one of very few substances which is completely safe at all levels (European Union report on Drugs and Nutritional Supplements, August 2004).  If you receive a very big dose by injection and the body does not need it, then it will pass the excess out quite easily.  For example, one of the treatments for cyanide poisoning is a large dose (5g) of methyl-B12 by infusion.  Your typical injection is 1000mcg, which is 1/5,000 of this (1000mcg is 1mg, whereas 5g is 5000mg).  Cyanide poisoning is much more common than you might suppose - burning furniture releases a lot of cyanide in the smoke, and I'm told that 5g infusion of B12 is regularly used on firemen in the Paris Fire Brigade if they are suspected of inhaling smoke - every week?

Are injections better than oral lozenges?

After 3 months, we will be able to notice the improvement in the symptoms, which means a) the patient is absorbing, and b) that it is being successfully utilised right through the body wherever the deficiency caused damage.  Your blood level will be much higher than at the start after 3 months, but you need to keep it high once you have had a deficiency because the tissues have shown they need high blood B12 levels.  Unfortunately we believe that many patients do not show the desired improvement when given large doses of oral B12 tablets or sublingual lozenges; this is due to genetic problems in the stomach gastric cells (lack of Intrinsic Factor protein) or due to transport protein deficiency or even a problem within the cell due to lack of co-enzymes.  We believe the best treatment of choice is intramuscular/subcutaneous injection or in severe cases, initially intravenous administration of methyl-B12.  Having said this I do not wish to alarm you.  Patients will absorb a certain amount of oral B12 directly or indirectly through perfusion.

Can I stop treatment/ Should I stop once my blood B12 is up to a certain level?

You asked if you should stop treatment after 3 months.  Our experience is that on two occasions we were asked to stop treatment for nearly 1000 patients who were on injections or oral medication.  The average level at the beginning of treatment was 180ng/L.  After 6 months of treatment the level reached over 1000ng/L and their signs and symptoms were reversed - they were well people.  On stopping the treatment, the B12 level dropped back to their original lower level in 6-12 months, and they were much worse than when we originally commenced the treatment.  We would recommend that you continue to take the therapy after 3 months.

Will I recover completely?  Will all of my damaged cells regenerate?

Regeneration of damaged cells.  This depends on how soon or how late the clinician has managed to make the correct diagnosis and instituted the treatment without undue delay.  The longer the period before the diagnosis was made, the higher the possibility that the damage has become permanent - this is why we recommend commencing treatment as quickly as possible, especially as there are no dangers - see "Can I overdose".  Each generation left untreated passes on a much damaged mitochondrial DNA to the subsequent generation.  This results in many end-stage presentations that you see these days, for example, Multiple Sclerosis-like presentation, ME, Chronic Fatigue, psychosis, depression.  In answer to your question, in most cases, B12 therapy will heal the damaged cells though it may not happen straight away.  We also believe that it is possible for the DNA to recover with timely B12 therapy, so that a future generation may not have the damage.

If I am B12 deficient, will other people in my family also be B12 deficient?

Regarding your family members, may I advise that before you take any supplements, please have the baseline blood test carried out as you have done for your children, so that we know truly what is the problem and what needs to be done.  Once you have had the blood taken, you don't need to wait for the results if you have already detected symptoms which indicate B12 deficiency.  The adult dosage should be between 1000mcg and 5000mcg per day, and you can get tablets that administer this whole amount, relatively cheaply rather than taking the children's tablets (for young children, 500mcg is sufficient though there is no danger with much higher intake.