if not b12 injections + supplements, perhaps
instead of or
in addition to other supplements are an excellent idea - everything is interconnected and working together.
healthy well rounded whole foods, per public health dietary recommendations are a first step many ignore (even the health care pros who work on the reactionary side of the health/disease managment equation). yes improvements to food guides should be made, but even with the resources we do have, many aren't in the habit of following them. in current typical food environments, it's just too easy to make decisions that aren't really in our best interests.
re b12, what is the form and dose of b12 you have injected? you might be able to save $$ and get a more bioavailable / active product if you go with an over the counter sublingual methylcobalamin option.
sublingual b12 goes straight into the bloodstream with comparable efficacy to injection. with sublingual strips at times i've taken 1000 - 2000 mcg per day when your daily requirement is more like 24 mcg.
each person's response to supplementation will vary depending on status for other cofactors. from your description, it doesn't sound like you are dealing with pernicious anemia. good news
You might see better response to b12 by adding a potent multivitamin and multimineral to your regimen. re potent, there are products for athletes which deliver extra nutritional punch. they're designed for health maintenance for someone active and generally adhering to dietary guidelines. they can also be thought of as a bit of a booster for someone who is in poorer health and healthy maintenance doses are less likely to do the trick. i have used athletic multis in the past, even when less active, to help top up depleted stores in tissue.
i mentioned
magnesium above given its links to some of your stated symptoms.
magnesium is also an important cofactor for
vitamin d synthesis in skin and
vit d absorption from dietary or supplementary sources.
a cofactor story.
before: i took high dose d3 (50K x 10 days =
500,000 IU d3) and got a
50 nmol/L (20 ng/ml) boost in serum level.
then i figured out and fixed issues with cofactors such as magnesium and zinc, without realizing the impact of cofactors on vit d3.
after: i took a second, smaller round of high dose d3 (50K x 8 days =
400,000 IU d3) and got a
170 nmol/L (or 70 ng/ml) boost in serum level.
moral: interactions are really important!
recent forum post on
AS and vit d:
http://www.thisisms.com/forum/undiagnos ... ml#p245665
per the above
you can probably expect to be in the 22 ng/ml ballpark. having all the cofactor info in mind, i would never personally suggest to anyone that they aim for anything higher than 40 ng/ml D3 in serum, without ensuring good well rounded status for essential nutrients in general. there's loads of related debate along those lines on the forum.
imho it would be very wise to ensure that your daily intake of magnesium meets basic requirements. it is well recognized that many don't meet daily needs for magnesium or for d3. attention to both is good. magnesium provides a foundation for working on d3. just working on the d3 alone can lead to misconceptions about the dose needed to achieve a desired improvement in serum level.
ppl who want to work on d3 should first ensure that mag intake is at least 7 mg/kg body weight/day and no more than 10 mg/kg body weight/day. there are all kinds of resources which will tell you how many mgs of magnesium are available from a given serving of food. supplements like the aforementioned magnesium glycinate (my personal fave -
NOT magnesium
bisglycinate) can certainly help top you up. 'food first' is the best way to think about it however
hope that extra info helps!