Hello crazy forum people

Vitamin E oil might be useful - not knowing much about it. If it is from Crohn's, vitamin E would likely help. There are several skin problems from rashes to ulcers that come with Crohn's. A topical steroid cream is another possibility, but you would need a prescription strength cream to be of any use.

B12 can be absorbed sublingually, but I don't know if you can get enough of it that way. There are two co-factors involved in the absorption and use of B12. The first, so-called "intrinsic factor" binds with it and aids the absorption of B12 from food sources. The second is involved in transporting it from the bloodstream into cells. If the deficiency has resulted in the loss of both factors, relatively huge amounts of B12 are needed to compensate for the loss of the co-factors. A large level of circulating B12 in the blood is needed to overcome the lack of the second co-factor.

b-12 shots seem to be more effective to me.

His best bet is to get a shot right away, and then follow up with oral B12 for a month. At the end of the month, a test can be done to see how much B12 he was able to retain...at the time this blood work is done, he should get another B12 shot, just to be on the safe side, because it could be two weeks before he finds out what the lab said.

OPTIMAL B12 is in the high 600s. Anything below 400 needs aggressive supplementation. Below 300 needs a shot.

Yes, it is true that in people who DON'T have Crohn's large oral doses of B12 might do the trick. But in people who do have the disease, particularly in the terminal ileum, where B12 is absorbed, often no amount of oral B12 is going to do the trick.

Sublingual B12 is controversial -- not because it isn't safe, but because of unproven claims about effectiveness. 

njmom's numbers look like pmol/liter (picomole per liter) which is one of a couple of units used. Other test numbers are reported as micrograms per liter, so that's the difference.

Good question- i'll just google it lol

BeeSting said...
njmom.,....could you please answer me what 600 means...or below 300....is it micrograms? is it milliliter?.... or what exactly does those number describe? The reason why I ask is that I asked for B12 last week my doctor told me that my B 12 was not low...it was 240. Is it considered normal, is he wrong? /Bee

Beesting, all US and I believe European labs use the same way of measuring. This means the number 240 from LabCorp is the same as 240 from Quest or any other US lab. The number 240 means 240 pg/mL.

The link below takes you to  a sample lab report that says the normal range for B12 is 210-1100. Doctors often don't know any better, so if the lab says it is in normal range, they just read the report and say it is normal to have 240, so you are OK. 

http://www.labtestsonline.org/inc/reports/SampleReport.html 

While 240 might or might not be normal, it is NOT healthy. As any endocrinologist should know, at under 300 you could be presumed to be vitamin B12 deficient. Other tests, like the MMA tests, are more sensitive for early detection of B12 deficiency than the standard B12 test.

When my daughter tested at exactly 300 in B12, her endocrinologist said B12 deficiency was a possibility, so her gave her a shot to get the B12 in her system ASAP. He could have subsequently, before giving her the shot, tested for MMA, etc, but why bother? The important thing was to supplement ASAP, not spend more weeks running more tests.

As the following link shows, B12 deficiency can be suspected anytime the number is below 400. In fact, the diagram says that the only time you are definitely NOT B12 deficient is when it is over 400.  http://www.aafp.org/afp/20030301/979.html

The following link talks about why the so-called "normal" ranges for B12 are not optimal, and suggests optimal B12 should be 800. It says that in Japan, the bottom of the range is 500. At the very least, the B12 MUST be more than 400, with optimal B12 in 600s or higher. http://www.stopthethyroidmadness.com/lab-values/

The following link goes to an article written by Sally Fallon and Mary Enig, which talks about the importance of B12, and says:

"American medical opinion defines blood levels lower than 200 pg/mL as an indication of deficiency. This number is based on the level associated with the most severe manifestation of deficiency, pernicious anemia. In contrast, the lower limit in Japan and some European countries is 500-550 pg/mL, the levels associated with psychological and behavioral manifestations such as dementia and memory loss." http://www.westonaprice.org/basicnutrition/vitaminb12.html

Post Edited (njmom) : 11/2/2009 5:06:00 PM (GMT-7)

Some of us have been on b12 shots for years because of rapid transit time.

What do you mean when you say 'transit time?'

pb4- absolutely. Some people are asymptomatic but B12 affects mainly the blood, nervous system and brain. Produced by the duodenum and combined with IF (produced in the stomach) and absorbed by the terminal ileum. Some of the absorbtion malfunction could be due to surgery to the small intestine (when it becomes smaller lol forgive the pun) and also because of damaged, diseased intestine.
In an extreme case of B12 deficiency, one may start experiencing spinal degeneration.

I don't know about salt for mouth ulcers - I imagine it would sting like the devil. I used to do something like that though. I would place a zinc gluconate tablet on the sore (probably canker sores) and let it sit there for an hour or so. It is a bit rough on the poor sore and I noticed that it throbbed a bit. The sores were usually gone in a day or two after that. Once though, I had a reaction to it and my lip swelled up for a couple of days. I told everyone who asked that it was a case of wife abuse....

Sometimes the pills come out so fast they still whole in my d (yes I got the rubber gloves out and checked, they were not disgested properly), so that is why I have been on the shot. I have comtemplating the sublingual, because I really do not like shots, but b-12 shot has work well for me.