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Vitamin B12 Injections: Vitamin B12 Shots

Vitamin B12 injections (or vitamin B12 shots) are one option to start getting vitamin B12 benefits. But how do you know if you need injections?

First of all, you need to have your B12 levels checked by having a simple blood test done. This can be ordered by your provider. Be a little patient, as it can take up to a week for the results to come back.

Generally speaking, deficiency is diagnosed by looking not only at lab results, but also at your symptoms. If you are having vitamin B12 deficiency symptoms your provider may recommend supplementation in the form of injections. When patients are having symptoms and have a level below 350ug/ml then we start supplementation.

Why Can't I Take Oral B12?

I get this question alot when discussing vitamin B12 deficiency. The main reason is that most people have a lack of intrinsic factor, the protein that binds to B12 and carries it across the gut to the rest of the body. If you don't have enough of this "carrier protein" all the oral B12 in the world will not help you. It simply isn't being absorbed properly.

Vitamin B12 Shots

B12 injections Ok. Now your provider has told you that you need to start taking B12 as injections to build the levels back up. Remember, this vitamin is stored in the liver so it may take up to a year to build it back up.

Now all providers have a bit of a different approach. In our clinic we start by giving 1000mg injections once a week for four weeks. After that you would need one injection a month for a year and then another blood test to check levels.

Rarely, I do have some people who must have injections every other week. As mentioned before, I treat the patient, not the lab result. If a patient tells me, that after they drop down to monthly injections, their symptoms worsen...well then we increase the frequency of injections.

Vitamin B12 injections can be given either intra-muscularly (IM) or sub-cutaneously (SQ).

At the one year mark, if the blood levels are good, I advise people to switch to the sublingual vitamin B12 . This is a pill that is absorbed under the tongue, not through the GI tract like oral pills. Once again, going back to just oral would not work out to well as eventually you would become deficient again.

Many times, in fact, when I tell a person they have to start vitamin B12 injections, they respond: "Oh yeah..my doctor used to give me those years ago!"

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References:
1. Schrier SL. Etiology and clinical manifestations of vitamin B12 and folic acid deficiency. http://www.uptodate.com/home/index.html. Accessed Jan. 19, 2010.
2. Vitamin B-12. The Merck Manuals Online Medical Library: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec01/ch004/ch004i.html#sec01-ch004-ch004j-379. Accessed Jan. 28, 2010.
3. Vitamin C. The Merck Manuals Online Medical Library: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec01/ch004/ch004j.html#sec01-ch004-ch004k-403. Accessed Jan. 28, 2010.



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