hi b, no need for apologies of course! a relapse is a relapse, it takes what it takes no fault of yours.
well, that's good that you're taking vitamin B. becosule...? is it this one?
Each 5ml of Becosules syrup contains:
Vitamin B1 USP 12.5mg
Vitamin B2 USP 6.25mg
Vitamin B6 USP 2.5mg
Vitamin B12 USP 3.75mcg
Niacinamide USP 25mg
D-Panthenol USP 6.25mg
Folic Acid USP 0.25mg
Maltitol 80/55 Ph Eur
those amounts look very small to me. even if you take the recommended 4 tsp / 20 ml per day, you are only going to get 15 mcg of b12.
ms patients using b12 are taking usually 1000 to 2000 mcg per day!!
do you know what your b12 level was when you were diagnosed with ms? did they run that test for you?
anyway overall if you feel this tired, i would recommend a much stronger mega b-complex for energy, that had more like 50mg each of the various b complex vitamins (not every one will be 50, but most. a good one should have choline and inositol for good measure.
even with a b50 or a b100, you'd probably still need to find a separate b12 supplement to get your intake high enough.
beyond the b-complex, it's always smart to get a good multivitamin/multimineral, but again those are maintenance amounts for healthy people with less than ideal diets.
i don' t believe ordinary supplements are enough for people with chronic illness.
besides b12, the next more important thing to look at is your vitamin d3 level. do you know yours? this one's really important - most ms-ers are insufficient to seriously deficient. for optimal immune function, you need to get your serum d3 level into the 100-250nmol/L range. 150 is the number i aim for personally. and the metabolite that needs to get tested is called 25-hydroxycholecalciferol, which you can also just call 25-hydroxyvitamin d3.
daily d3 doses for healthy people can be as high as 4000IU, depending where you live and the time of year. it takes much higher amounts each day when you are low and need to boost your levels in a hurry.
it's important to keep your electrolytes in mind too. calcium, magnesium, and zinc are the ones i harp on about most:
-calcium try for 1000mg per day
-magnesium 500-600mg per day (from mag citrate, if supplementing - try to get some of it from eating steamed dark leafy greens daily! also never take it all at the same time as vitamin d3 supplements)
-zinc 25-50mg per day
(this will really help out your liver function, which in turn boosts the uric acid in your blood - usually low in ms patients.
if your zinc is low it also affects your body's vitamin A, with consequences for your eyes and gene expression.
in my case, fixing my zinc level also seems to have really improved my vitamin d3 absorption - i am way more responsive to d3 supplementing now, and d3 is hydroxylated first in the liver, and the d3 receptors have 'zinc fingers'...).
other electrolytes: potassium intake relative to sodium is important also. depending on your diet, might be useful to think about cutting back salt and boosting the high potassium foods.
anyway i know that's a lot but you can just take what you want from it, try what seems reasonable to you. any questions, just ask.
i am including my signature for links to more reading on nutrition.
my approach: no meds so far - just nutrient-dense anti-inflammatory whole foods, and supplements where needed
info: www.whfoods.com, www.nutritiondata.com