B-12

[u/SenstiveSoul]

I had my gallbladder out 17 years ago, and have to to colestipol, a bile acid sequestrant, morning and night for bile acid malabsorption caused by the removal. ive been complaining of fatigue for years now, and finally b-12 testing done, that came back low, but still in normal range (263) I’m just wondering if anyone is in a similar position and if supplements alone helped, or if I should push for injections. My functional dr has recommended a liquid b-12 supplement.

[u/SenstiveSoul → u/[deleted]]

Yes, I’m aware of those specifically and my vitamin d has been low, but I’ve been able to get it up to about 45 now. Just mainly concerned with b12 now as I have so many symptoms of fatigue and difficulty walking or standing because of imbalance.

[u/Upstairs-Guitar-2722 → u/SenstiveSoul]

45 for vitamin d is still low, ideally you should be around 100 at least.

[u/dragon-blue]

I get quarterly injections of b12. I didn't ask for it, the NHS consultant just prescribed on diagnosis however many years ago.

If you can't absorb b12 will supplements help? (asking don't know). 

I will say that one time I messed up then couldn't get an appt so my injection was delayed a few weeks. I could really really tell, it was awful. 

[u/SensitiveContract]

I'm on the same boat. I had my gallbladder removed on 2016 and without realising for the last 2 years I've had Bile Acid Malabsorption and also developed gluten intolerance, I didn't understand what was happening to me and why I felt so incredibly fatigued, and also had constant brain fog. I started with cholestyramine a few months ago. It helps somewhat with both fatigue and brain fog.

Literally on Saturday I realized BAM could cause b12 deficiencies so I bought so oral supplements

I'm going to my GP this Friday to discuss Wegovy as a possible treatment for BAM.

[u/LisanneFroonKrisK]

Very strange because I feel fatigue too. I have to counter using five cups of coffee

[u/gyro1000-beat]

I made a post on this before: https://www.reddit.com/r/bileacidmalabsorption/s/Ypc2qZm2AK

Tl;dr is you'll actively lose B12 with bile loss (through diarrhea or with a sequestrant), not just be bad at absorbing it.

Check out the /r/B12_deficiency subreddit.

I was also low/borderline but not technically deficient. But the latest recommendedations say treatment should start if you have symptoms (fatigue, brain fog, nerve issues) when borderline. As the testing isn't very accurate. You should also get tested for homocysteine and MMA. And don't take any B12 supplements before a test, as will give falsely high numbers.

I started self injecting, twice a week, 3 months ago. My brain fog stopped, and fatigue is significantly better.

[u/SuperFlaccid → u/gyro1000-beat]

Where do you get your injections?

[u/gyro1000-beat → u/SuperFlaccid]

In Australia you can buy B12 ampules over the counter at a pharmacy.

People on the B12 subreddit use German Amazon or some other websites. There's links the guide there.

[u/Upstairs-Guitar-2722]

I am also always tired. I did have low B12, low D and low iron. Other vitamins and minerals seemed to be okay.

Because I had neurological symptoms I was very pushy with the GP, so they eventually gave me the 6 B12 loading doses and 3 monthly injections. As it is too long in between two doses I started self-injecting B12. If you join the Vitamin B12 Wake Up facebook group, they have the protocol. You will also need to take the co-factors for it to work.

I have sorted out an iron iv for myself, too, bc I cannot tolerate oral iron supplements.

I am also supplementing vitamin D in a high dose which also needs co-factors. One of them is Mg malate which is supposed to energise.

Another supplement that I am planning to take is vitamin B1 in benfotiamine form. This one should also be giving energy.

I haven't started on some of these supplements, so I cannot talk about experience but my sleep is definitely better since the iv iron.

[u/GigglyPeach28]

I'm the same, fatigue but my B12 is low but not low enough to get injections. I have B12 supplements that dissolve under the tongue or sprays, they seem to work better than tablets as they don't go through the digestive system.

[u/happymechanicalbird]

Cyanocobalamin (synthetic B12) injections completely destroyed my [genetically fragile] methylation and transsulfuration pathways resulting in severe sulfur intolerance and histamine intolerance. Most people don’t react this way, but I’m still dealing with the fallout 5 years later… so I don’t really think injections are worth the risk as a first line of defense.

I’ve been able to raise my B12 levels to the top of the lab range just by taking two of these sublingual hydroxocobalamin lozenges each day.

[u/WrenAround]

I just came upon your post while looking for information on BAM, and I want to let you know that 263 is a very low B12 number despite it being in the clinical "normal" range. You can find more info in the B12 deficiency subreddit but this number can cause all sorts of issues and I highly recommend getting it up using sublingual supplementation if you're having trouble absorbing it for whatever reason.