Supplements

[Nutritionnewbie]

Hello.  I am borderline B12 and vitamin d deficient.  I am getting b12 shots and taking vitamin d supplements and will be rechecked in a couple of months.

My doc hasn't been too informative so I've been trying to do some reading on my own.  It seems I should maybe be taking other things to help with these deficiencies, but it all seems a bit conflicting.

Can someone give me an idea if I should or should not be taking anything else to help optimize my levels? Thanks.

[Red_Star]

My vitamin B12 serum was down to 122pmol/L (165pg/mL) - i have juvenile pernicious anaemia.  My vitamin D serum was down to 30nmol/L (12ng/mL).  I am currently taking 2000mcg daily of sublingual B12 spray and 2000IU daily of vitamin D. This may change depending on my lab results.

There is no set time to take vitamins and minerals. That said, B12 may keep you awake if you take closer to bedtime.  The fat soluble vitamins A, D, E and K are better absorbed with food containing a little fat or oil.

Vitamin B12:
Recommended Daily Allowance: 2.4mcg
Tolerable upper limit: none (B12 is non toxic)

Vitamin D:
Recommended Daily Allowance: 600IU
Tolerable upper limit: 4000IU

There is a lot of conflicting information on vitamin D which i assume is due to the different outcomes from nearly 1000 clinical trials done so far. It looks like the Vitamin D Council has taken into account all the negative and positive clinical trials and still made the higher range recommendations based on the overall results.

As for the B12 serum reference range, this is far too low in most countries. So far only Japan and Europe have increased the lowest B12 serum range to 500 or 550 pg/mL (369 or 405pmol/L).  All forms of B12 will boost serum levels but evidence suggests methylcobalamin may be superior to both hydroxycobalamin and cyanocobalamin especially for neurological damage.

[Nutritionnewbie]

Thank you Red Star.

I read the vitamin D council info, but when researching each separately, some info seemed contradictory and/or dangerous (like building up too much calcium when taking vit D and then causing calcium deposits that break off and can cause problems) and I'm not a "medical" person, so I just don't know which info is true and which is just overly cautious, etc.

And I get nervous trying to figure it out on my own, but when i asked my pcp about magnesium, she said I could but it wasn't necessary.  

I just think they take more time for serious conditions, but I have honestly felt terrible for years and have exhausted other causes (plus have other symptoms and bloodwork).

So, have you done these supplements yourself and can you give me the protocol you follow (how much, when, how often and any other useful info)?

And, some symptoms have improved (not yet gone) but the fatigue lingers.  In researching the b12, I've read that methylb12 is better for energy, but not the neuropathy.  Any thoughts/experience with this?

For reference, my b12 was 282 and my vit D was 11.

Thanks again.

[Red_Star]

Vitamin B12 - optimal: over 800pg/mL or 600pmol/L.
Vitamin D - optimal: between 50 - 80ng/mL or 125 - 200nmol/L.

***

Excerpt from the Vitamin D Council - Vitamin D Cofactors:

"In order to receive the most health benefit from increased levels of vitamin D, the proper cofactors must be present in the body. Vitamin D has many cofactors, but the ones listed below are the most important. Magnesium should be considered the most important one of all.

Magnesium
Vitamin K
Vitamin A
Zinc
Boron"

***

All B vitamins work synergetically (together).

As for vitamin B12 absorption, there are a few steps that are needed for dietary B12 absorption:

* Good levels of stomach acid (HCI): B12 must first be separated from the protein that binds it. This requires HCI.

* Intrinsic factor (IF): B12 cannot pass through the intestinal wall and into the bloodstream without IF.

* Good bacteria in the gut: an imbalance in the beneficial bacteria of the digestive system can separate B12 from IF.

B12 replacement includes sublingual (under the tongue); oral supplements (absorption of up to 1% of large oral B12 dose without IF); nasal spray;  B12 transdermal patches; B12 injections.

Excerpt from Vitamin B12 Deficiency - American Family Physicians:

"Because most clinicians are generally unaware that oral vitamin B12 therapy is effective, the traditional treatment for B12 deficiency has been intramuscular injections. However, since as early as 1968, oral vitamin B12 has been shown to have an efficacy equal to that of injections in the treatment of pernicious anemia and other B12 deficiency states."