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I would be most grateful if someone could answer the following questions:-

I have diagnosed Hypothyroidism, and although not diagnosed, I think I actually have Hashimoto's Hypothyroidism. I also have Vitamin B12 injections because of lack of the intrinsic factor in my stomach. The type of injection I have is Hydroxocobalamin, 1mg/ml, 1ml ampoule once every eight weeks. I was originally having that same injection once every twelve weeks, and I had a terrible 'battle' to get it more often. I have been having these injections since 1997, and have been having them once every eight weeks for more than one year now. I usually start to go downhill about four weeks before I am due my next injection, with the two weeks before being more pronounced symptoms wise. After I have had my injection it seems to take about two to three weeks before it takes affect. This time round it does not seem to have had any affect. I, therefore, do not know whether this is a Hypothyroid problem and/or a vitamin B12 problem.

Is there any way of distinguishing between the two?

What specific symptoms do you have in relation to Vitamin B12 deficiency?

Is a pressure (without pain) at the back of the head one of them? I have had this pressure (without pain) at the back of my head off and on for many years now. My head feels heavy at such times, when I also feel like I want to go to sleep, but in the past lying down has either alleviated the problem, but when I sit up again it returns, and/or I have immediately fallen asleep. This time round I fall asleep with it. Again I do not know whether this is because of hypothyroidism, vitamin B12 deficiency, hypoglycaemia, or low blood pressure.

Are there any tests to determine how often one should have Vitamin B12 injections? As if one has these injections more than is needed that in turn can cause significant side effects.

Any advice would be more than welcome.

Hi Tab,

Many thanks for your reply to my last post.

I am getting really behind with everything at the moment with being in poor health, together with the fact that my sleeping patterns have changed, and also I am finding that I am sleeping for longer than I normally do; again resulting in less time available when I am awake, so I will not be able to answer your latest reply in detail at this moment in time, but will as soon as I can...

I was pleased to hear that most of your symptoms are clearing nicely.

Regarding:- "Too much in the way of B12 shots is bad for you". I cannot remember where I read that particular article, and also I read it a long time ago. Like you , I was totally surprised when I read it, which is why it 'stuck' in my mind, but when I am in better health I will try to find it again.

I live in a smallish town, so not many local shops, which was why, as an emergency 'quick stop gap measure', I bought that particular cyano-b12, so that I could be taking at least 150 mcg extra per day until I found something better on the internet. I usually do buy most of my medications over the internet, as you correctly said it often proves to be a lot cheaper in terms of cost. Thanks for telling me about "i herb". I have visited that particular site in the past, but again as you rightly said I found it cheaper to buy in this country because of the shipping/postage costs etc. However, if there was something that I could not find in England, then I would not hesitate to buy it from another country.

Cost of medicines, (apart from those prescribed by my doctor), is another problem, as I already spend a small fortune on them at the moment!! Therefore, nearly reaching my financial limit on that score.

Thanks for telling my about the cyanide component in cyano-b12.
Wish I had your excellent retentive memory; being able to bring facts and figures to hand at a moment's notice!! Earlier this year I was given two filing cabinets, so I have been gradually filing away a 'mountain' of paper work in relation to my past and on-going medical research. If I had not gone downhill again healthwise this time round I would have finally managed to have got all that particular filing finished, which is slightly annoying as I could do with having some of it to hand at the moment. Therefore, in a nutshell, the medical information in those files act as my memory, as well as being a good source of reference.

Regarding when to take medications during the day. I am gradually finding out that certain medications that I am taking should be taken at certain times of the day, or with food, or in between meals, and/or should not be taken at the same time as other medications etc. This is fine when you are sleeping in a normal healthy daily pattern, but 'fun and games' when not!!

Yes, I did some research on liver health about just over two years ago. Another long story relating to another past medical problem, where medications being taken had been affecting my liver. If I remember correctly the cells in the liver can regenerate (regrow) themselves providing there has not been too much liver damage, but having said that, as you say, it is far better to take care of if in the first place; especially since B12 is stored in the liver. Also thanks for reminding me that I might not be storing B12 well in my liver, which in turn may account for my "down" period between B12 shots.

Reference : "Too bad my doctor wasn't up-to-date with B12 knowledge" in your penultimate paragraph. I too had a similar problem, where my doctor should have prescribed B12 injections, but had not done so, fortunately when I saw a different doctor in that same practice, he spotted that mistake and prescribed me B12 etc...

Regarding your thyroid, I would suggest that you have a thyroid function test
at least four times a year as a safety precaution, especially if it is a common within your family, as said tests can come back normal even if you do have a thyroid problem. It would take too long to cover all the main points of note regarding that particular issue, so I will leave that one until I am feeling a bit better. Regarding the "Wilson's Syndrome", it has been critized by some medical professsionals, as they feel that it does not cover all the bases that should be covered in relation to the thyroid, even though it may be a good starting point in relation to some aspects (such as monitoring body temperature etc.).

Many thanks again for all your advice.

Take care

Vitamin B12

Who is likely to be deficient?

Vegans (vegetarians who also avoid dairy and eggs) frequently become deficient, though the process often takes many years. People with malabsorption conditions, including those with tapeworm infestation and those with bacterial overgrowth in the intestines, often suffer from vitamin B12 deficiency. Malabsorption of vitamin B12 can also result from pancreatic disease, the effects of gastrointestinal surgery, or various prescription drugs.

Pernicious anemia is a special form of vitamin B12 malabsorption due to impaired ability of certain cells in the stomach to make intrinsic factor—a substance needed for normal absorption of vitamin B12. By definition, all people with pernicious anemia are vitamin B12-deficient. They require either vitamin B12 injections or oral supplementation with very high levels (1000 mcg per day) of vitamin B12.

Older people with urinary incontinence6 and hearing loss7 have been reported to be at increased risk of B12 deficiency.

Infection with Helicobacter pylori, a common cause of gastritis and ulcers, has been shown to cause or contribute to adult vitamin B12 deficiency. H. pylori has this effect by damaging cells in the stomach that make intrinsic factor—a substance needed for normal absorption of vitamin B12. In one trial, H. pylori was detected in 56% of people with anemia due to vitamin B12 deficiency. Successful eradication of H. pylori led to improved blood levels of B12 in 40% of those infected.8 Other studies have also suggested a link between H. pylori infection and vitamin B12 deficiency.9 10 Elimination of H. pylori infection does not always improve vitamin B12 status. People with H. pylori infections should have vitamin B12 status monitored.

In a preliminary report, 47% of people with tinnitus and related disorders were found to have vitamin B12 deficiencies that may be helped by supplementation.

HIV-infected patients often have low blood levels of vitamin B12.

A disproportionate amount of people with psychiatric disorders are deficient in B12.13 Significant vitamin B12 deficiency is associated with a doubled risk of severe depression, according to a study of physically disabled older women.14

A preliminary study found that postmenopausal women who were in the lowest one-fifth of vitamin B12 consumption had an increased risk of developing breast cancer.

Although blood levels of vitamin B12 may be higher in alcoholics, actual body stores of vitamin B12 in the tissues (e.g., the liver) of alcoholics is frequently deficient.

Low blood levels of vitamin B12 are sometimes seen in pregnant women; however, this does not always indicate a vitamin B12 deficiency. The help of a healthcare professional is needed to determine when a true vitamin B12 deficiency exists in pregnant women with low blood levels of the vitamin.

Hydroxocobalamin (a form of vitamin B12) has been recognized for more than 40 years as an effective antidote to cyanide poisoning. It is currently being used in France for that purpose. Because of its safety, hydroxocobalamin is considered by some researchers to be an ideal treatment for cyanide poisoning.

How much is usually taken?
Most people do not require vitamin B12 supplements. However, vegans should supplement with at least 2 to 3 mcg per day.

People with pernicious anemia are often treated with injections of vitamin B12. However, oral administration of 1,000 mcg per day can be used reliably as an alternative to vitamin B12 injections.

Absorption of vitamin B12 is reduced with increasing age. Some research suggests that elderly people may benefit from 10 to 25 mcg per day of vitamin B12.

When vitamin B12 is used for therapeutic purposes other than correcting a deficiency, injections are usually necessary to achieve results.

Sublingual forms of vitamin B12 are available, but there is no proof (nor is there any reason to expect) that they offer any advantage to oral supplements (i.e. a sublingual preparation is eventually swallowed).

Are there any side effects or interactions?
Oral vitamin B12 supplements are not generally associated with any side effects.

Although quite rare, serious allergic reactions to injections of vitamin B12 (sometimes even life-threatening) have been reported. Whether these reactions are to the vitamin itself, or to preservatives or other substances in the injectable vitamin B12 solution, remains somewhat unclear. Most, but not all, injectable vitamin B12 contains preservatives.

If a person is deficient in vitamin B12 and takes 1,000 mcg or more of folic acid per day, the folic acid supplementation can improve the anemia caused by vitamin B12 deficiency. The effect of folic acid on vitamin B12 deficiency-induced anemia is not a folic acid toxicity. Rather, the folic acid supplementation is acting to correct one of the problems caused by B12 deficiency. The other problems caused by a lack of vitamin B12 (mostly neurological) do not improve with folic acid supplements, and can become irreversible if vitamin B12 is not provided to someone who is vitamin B12 deficient.

Some doctors are unaware that vitamin B12 deficiencies often occur without anemia—even in people who do not take folic acid supplements. This lack of knowledge can delay diagnosis and treatment of people with vitamin B12 deficiencies. This can lead to permanent injury. When such a delayed diagnosis occurs in someone who inadvertently erased the anemia of vitamin B12 deficiency by taking folic acid supplements, the folic acid supplementation is often blamed for the missed diagnosis. This problem is rare and should not occur in people whose doctors understand that a lack of anemia does not rule out a vitamin B12 deficiency. Anyone supplementing 1,000 mcg or more per day of folic acid should be initially evaluated by a doctor before the folic acid can obscure a proper diagnosis of a possible B12 deficiency.

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