all things vitamin b12

[continentalgrip]

This man says in this published paper that he experimented on himself and basically cured his MS with every other day adenosylcobalamin injections. https://www.sciencedirect.com/science/a ... 771730275X
Adenosylcobalamin is one of the four types of vitamin b12. Unfortunately it is the only type that isn't available for injection. He used veterinary grade it looks like. You can buy sublingual adenosylcobalamin online. It will not get your b12 level anywhere near as high as injections. But if you were to take say 3mg three times a day (holding under the tongue for 15 to 30 minutes, as b12 is a very large molecule that may not actually be absorbed sublingually very well), you might absorb a decent amount of adenosylcobalamin. I'm very curious if anyone else with MS has tried this?

I have not been able to contact the author of the paper. James Layne Boucher. It was written in 2017. I haven't been able to find out if any additional research every happened. Perhaps Boucher didn't actually have MS. But there is a lot of research that indicates b12 deficiency is related to MS. Frankly I'm disgusted at how little attention b12 is getting with MS. I am a study coordinator at a major teaching hospital by the way. I have coordinated MS clinical trials. There's tons of money in research provided it's with patented drugs (meaning where there's plenty of profit to be made). B12 can't be patented therefore there's no money in its research. There's never even been a randomized controlled trial looking at healing clinical symptoms of b12 deficiency.

[NHE]

Hi Continentalgrip,

You can buy sublingual adenosylcobalamin online. It will not get your b12 level anywhere near as high as injections. But if you were to take say 3mg three times a day (holding under the tongue for 15 to 30 minutes, as b12 is a very large molecule that may not actually be absorbed sublingually very well), you might absorb a decent amount of adenosylcobalamin. I'm very curious if anyone else with MS has tried this?

My personal experience correcting a combined B12 and folate deficiency with sublingual supplements is in disagreement with your statement. In 2014 I wound up in the hospital because I couldn’t move my legs. My sudden increase in disability was initially thought to be due to an MS attack. However, a B12 test panel revealed that I was grossly deficient in folate, at the bottom of the range in B12, had elevated homocysteine and had lost vibratory sensation in both legs. An MRI revealed that I had a 7 cm lesion on my cervical spinal cord consistent with subacute combined degeneration.

Surprisingly, I couldn’t get my doctor to prescribe B12 injections as he believed B12 was just a fad. I took sublingual supplements instead. I found that some didn’t work, e.g., Jarrow methylcobalamin. In contrast, others like Superior Source and Kirkland methylcobalamin, worked great. I mostly used the Superior Source supplement since it also contains methylfolate. At that time, I could feel the effects of the sublingual methylcobalamin within about 15-20 minutes after taking it.

Indeed, at one point I had run out of my normal B12 so I tried the Jarrow formula. After 4 days I was feeling very run down and out of both mental and physical energy. I decided that the Jarrow B12 wasn’t working. I then took some of the Kirkland methylcobalamin which we also had in the house. Within 30 minutes it felt like the sun was burning off the fog in my brain.

I took daily sublingual B12 for several years afterwards even though a followup B12 panel after 3 months showed I was no longer deficient. I continued the B12 because I found that it still gave me energy. About a year ago though, a B12 test revealed that my B12 was greater than 2000 pg/mL. I switched from 2 mg B12/day to 1 mg/day. Another B12 test revealed that I was at greater than 1000 pg/mL. This was an improvement, but still a little high. I now take 1 mg B12/week. It maintains my B12 level at 630 pg/mL. However, I would like to be closer to 1000 pg/mL so I may try tweaking my current regimen.

In summary, in light of my experience, I conclude that sublingual B12 supplements can indeed be very effective in correcting a B12 deficiency. If you find that one doesn’t work as I did, then try a different brand. For further info, the Superior Source tablets are fairly small and dissolve in about 1-2 minutes.

I should also note that I’ve used three different adenosylcobalamin supplements, each worked to maintain my B12 level. However, they didn’t cure my MS as you hypothesize. These were Source Naturals dibencozide, Nutricology adenosylcobalamin and Superior Source Advanced B12 which contains both adenosylcobalamin and methylcobalamin.

Lastly, be careful how much methylcobalamin you take. Even though I was taking 2 mg/day, I still felt like I couldn’t get enough B12. I tried 20 mg/day. After one week I became emotionally unbalanced so I went back to 2 mg/day. I attribute the negative side effects to out of balanced methylation cycles.

[DIM]

Be carefull, Superior Source sublinguals have large amounts of Lactose

[NHE]

Hi Dim,

Be carefull, Superior Source sublinguals have large amounts of Lactose

Just for fun I weighed the Superior Source B12 tablets. Each tablet weighs just 0.132g.

The tablets contain the following ingredients.

2 mg vitamin B6
1 mg methylcobalamin
1 mg methylfolate
1.5 mg stevia

As well as an unspecified amount of lactose, cherry flavoring and acacia gum.

Since lactose is the first listed inactive ingredient and if we assume a 75% lactose content, then each B12 tablet may contain around 0.095g of lactose.

For comparison, I had 194.73g of unsweetened yogurt this morning. According to the label, each 170g serving has 8g of natural milk sugars in it. Assuming all of those are lactose, then my morning yogurt had 9.16g of lactose in it.

Comparing the Superior Source B12 tablets to my morning bowl of yogurt, each B12 tablet has just 1.04% of the lactose found in the yogurt. I would then have to take 96 B12 tablets to get the same amount of lactose.

I conclude that the Superior Source B12 tablets do not contain a large amount of lactose.

[DIM]

I thought you were lactose intolerant as my wife, so even small amounts count for you!

[NHE]

I thought you were lactose intolerant as my wife, so even small amounts count for you!

No, I’m not lactose intolerant. I don’t drink milk, but yogurt and cheese are no problem.

[continentalgrip]

Let me post that again so it doesn't get lost. Adenosylcobalamin for MS. https://www.sciencedirect.com/science/a ... 771730275X
If adenosylcobalamin injections were available I'd say to take those. But they aren't. Unless you want veterinary grade. For a b12 deficiency then yes, you should take frequent injections, preferably of methylocobalamin. But I'm talking about MS, not a more typical b12 deficiency. So no, what I'm saying doesn't disagree with your experience NHE. In fact I wrote a long article on reddit detailing all the published research indicating that people need to take injections, not sublingual, for b12 deficiency. But again, I'm talking about adenosylcobalamin specifically for MS, which doesn't come in injections.

I'M REALLY CURIOUS IF ANYONE WITH MS HAS TRIED ADENOSYLCOBALAMIN? In the paper I posted the author says he basically cured his MS this way.

[jimmylegs]

hi CG, afraid i have not.
i had b12 defc'y when i recd my msdx in 06. i spent a fair amount of time and energy trying to blame it all on b12 when ultimately the logic just wasn't there. there were and are lots of modifiable and non-modifiable factors in play besides b12, including other nutrients, genetic predisposition, location, gender, and age.
i made drastic dietary changes and among other things, used sublingual methyocobalamin to get my undetectable b12 levels back up to a decent level - which at the time, to my mind was at least 500pmol/l.

i have in the past been pretty excited by certain concepts documented in med hypotheses
for any interested readers, i note the relative h-index rankings of med h and jama
https://www.scimagojr.com/journalsearch ... 33&tip=sid
https://www.scimagojr.com/journalsearch ... 91&tip=sid
https://en.wikipedia.org/wiki/H-index

i also note this article's citations
one of which notes "while adenosylcobalamin injections restored memory and speech as well as improved balance and mobility in another study, though only one patient was involved [266]." and provides some useful suggestions in its 'Conclusions and future directions' section.

while science is getting around to those, best of luck with your search!

[NHE]

Let me post that again so it doesn't get lost. Adenosylcobalamin for MS. https://www.sciencedirect.com/science/a ... 771730275X

The paper is published in the journal Medical Hypotheses. The journal's own Aims & Scope statement describes the journal as...

Medical Hypotheses will publish papers which describe theories, ideas which have a great deal of observational support and some hypotheses where experimental support is yet fragmentary.

and

Medical Hypotheses was therefore launched, and still exists today, to give novel, radical new ideas and speculations in medicine open-minded consideration, opening the field to radical hypotheses which would be rejected by most conventional journals.

As such, the journal is a place to publish theories, speculations and "radical hypotheses" for which the author has little to no direct supporting experimental data.

For a b12 deficiency then yes, you should take frequent injections, preferably of methylocobalamin. But I'm talking about MS, not a more typical b12 deficiency. So no, what I'm saying doesn't disagree with your experience NHE.

You wrote...

You can buy sublingual adenosylcobalamin online. It will not get your b12 level anywhere near as high as injections. But if you were to take say 3mg three times a day (holding under the tongue for 15 to 30 minutes, as b12 is a very large molecule that may not actually be absorbed sublingually very well), you might absorb a decent amount of adenosylcobalamin.

Sublingual B12 supplements do work. Some brands are very effective. Although B12 is indeed a large molecule, sublingual B12 is absorbed. By taking 2mg/day I raised my B12 level to greater than 2000 pg/mL or twice the top of the standard range. Moreover, by taking 20mg/day I raised my level to the point where it negatively impacted my psychological status within just one week. I attribute this effect to altered methylation cycles. See the following diagram. https://tinyurl.com/folate-pathway

[continentalgrip]

Yes. I'm aware it's a low impact factor, etc. I don't need a lecture about b12 or the journal. I have 4 scientific degrees. I'm published. I have been a reviewer for a journal. Also I'm as close to an actual expert on b12 as exists in this world. Just simply asking if anyone with MS has tried adenosylcobalamin. The author perhaps was misdiagnosed with MS. He reports extreme improvement within hours. Raising his one arm above his head for the first time in years, etc. Please no more lectures about things I already know about. Thanks!

[jimmylegs]

congrats on all your achievements. i understand that you are not one of the interested readers for whom i'd posted info about h index. again, best of luck finding someone with the answers you're after.

[NHE]

Continentalgrip,
You appear to have missed it, but I did answer your question. Perhaps you may wish to reread my post.

viewtopic.php?p=262703#p262703

[NHE]

In fact I wrote a long article on reddit detailing all the published research indicating that people need to take injections, not sublingual, for b12 deficiency.

There are a plethora of studies that show sublingual B12 to be effective.

For example...

Sublingual vitamin B12 compared to intramuscular injection in patients with type 2 diabetes treated with metformin: a randomised trial
N Z Med J. 2016 Jun 10;129(1436):67-75.

MAIM: To compare a single 1mg intramuscular hydroxocobalamin injection with a 3-month course of 1mg/day sublingual methylcobalamin supplements on serum vitamin B12 concentrations in participants withtype 2 diabetes treated with metformin.

Method: Participants on metformin treatment with vitamin B12 concentrations below 220pmol/L were recruited through hospital diabetes clinics and primary care practices. They were randomised to receive either the injection or sublingual treatment. The primary outcome was serum vitamin B12 level after 3 months adjusted for baseline assessed by analysis of covariance (ANCOVA). The trial was registered on the Australia New Zealand Clinical Trial registry (ACTRN12612001108808).

Results: A total of 34 participants were randomised; 19 to the tablet, and 15 to the injection. The mean (SD) age, duration of diabetes, and duration of metformin use were, 64.2 (7.3) years, 13.7 (6.4) years, and 11.6 (5.0) years, respectively. After 3 months, the mean (SD) vitamin B12 was 372.1 (103.3) pmol/L in the tablet group (n=19) compared to 251.7 (106.8) pmol/L in the injection group (n=15), ANCOVA estimated difference -119.4 (95% CI -191.2 to -47.6), p=0.002. After 6 months, the mean (SD) serum B12 was 258.8 (58.7) pmol/L in the tablet group (n=17) and 241.9 (40.1) pmol/L in the injection group (n=15); ANCOVA estimated difference -15.2 (95% CI -50.3 to 19.8), p=0.38. Higher metformin dose was associated with lower serum B12 at 3 months, but not at baseline or 6 months.

Conclusion: Decreased serum vitamin B12 level in patients with type 2 diabetes who are treated with metformin can be corrected through treatment with either hydroxocobalamin injections or methylcobalamin sublingual supplements.

There are others, for example...

Efficiency of the sublingual route in treating B12 deficiency in infants
Int J Vitam Nutr Res. 2021 Aug 25.

Objective: To evaluate the efficiency of the sublingual route for the treatment of vitamin B12 deficiency in infants. Background: Vitamin B12 deficiency is common in children. In breastfed infants, the main reason is maternal B12 deficiency. Parenteral administration is commonly prescribed. However, patient compliance is not satisfactory due to repeated painful parenteral applications. It is also known that the oral route is efficient in high doses. In recent years, the sublingual route has been tried. This route stands out due to its easy applicability and low cost. However, there are few efficacy studies in infants for the sublingual route.

Materials and methods: The study included 49 infants aged 6-12 months. All infants with marginal or deficient B12 levels (<300 pg/mL) were incidentally detected and treated with sublingual methylcobalamin. Each dose was 1000 μg and administered once a day in the first week, every other day in the second week, twice a week in the third week, and once a week in the last week. Serum vitamin B12 levels were measured before and after the treatment. Paired Sample T-Test was used to compare variables.

Results: All infants had normal physical development and had no hematological or neurological issues. It was learned from the parents that the infants tolerated treatment well, and no side effects related to the treatment, such as vomiting or rash, were observed. Before and after the treatment, the mean vitamin B12 levels were 199±57 pg/mL and 684±336 pg/ml, respectively. The difference between the means was statistically significant (p<0.001).

Conclusion: According to the study, it seems possible to treat vitamin B12 deficiency via a sublingual route in infants. In addition, methylcobalamin can be an alternative to the commonly used cyanocobalamin.

I conclude from these studies that sublingual B12 works just as well as IM B12 injections.

[jimmylegs]

i like this one:

Comparison of sublingual vs. intramuscular administration of vitamin B12 for the treatment of patients with vitamin B12 deficiency (2019)
https://pubmed.ncbi.nlm.nih.gov/30632091/
"...This is the largest study that documents therapy with SL preparations of VB12 sufficient and even superior to the IM route. The SL overcomes the challenges of IM injections and should be the first line option for patients with VB12d."

[NHE]

Yes, I saw that paper as well. However, their post treatment numbers, if correctly reported in the abstract, were surprisingly low and still deficient.

The mean ± SD difference between sVB12 levels before and after administration of VB12 supplements was significantly higher in the SL group vs. IM injection group (252 ± 223 vs. 218 ± 184 ng/L, p < 0.001).