Pernicious Anemia and B 12 question for nutritionists, RNs, MDs and anyone who knows!?

Question

If someone has pernicious anemia, will sublingual B 12 treat the deficiency, or would the person need to have B 12 shots. I understand about the inability to absorb B 12 via the intestines. . . .

Answer 1

In theory, it makes sense because sublingual route bypasses the intestines and the medication goes directly to the blood-stream. But it depends how good a particular preparation is. Does it really absorb completely or mostly? The best way to confirm would be checking the blood B12 level at baseline and repeating it after a few months of taking the sublingual B12 to see if anything changes.  

Answer 2

1. If you have pernicious anaemia, I would strongly advise that you seek the advice of BOTH, a doctor and a dietician/nutritionist for regular follow-up. Please don't follow the advice of other responders and only go to one - you need a multidisciplinary approach (more than one professional!) involved in your care in order to get the best treatment plan for you.

2. People with pernicious anaemia have a deficiency of intrinsic factor. As you say, an intramuscular shot of vitamin B12 (cobalamin) is the conventional treatment, as this allows the B12 to be absorbed the most. However, these are painful, inconvenient and can also be costly.

3. Sublingual and oral B12 replacement has been shown to work. However, some sources suggest that higher doses may be needed (because, as you say, of the different absorption of B12 by these routes), while others suggest that similar doses to the intramuscular shot are satisfactory to achieve a therapeutic success.

4. This is a specialist area and treatment must be tailored to the individual patient. What works for other patients may not work for you. Any treatment will need to be followed up with blood tests to assess your B12 and folate levels. I would advise you contact the doctor looking after you in the first instance to perform the necessary blood tests and try an oral/sublingual regime. They can then monitor your blood levels in order to get the balance right. Dietary intake etc. can also play a role in certain patients, so this all needs to be tailored to your individual case. Hope that helps.  

Answer 3

The problem with using sub-lingual B-12 pills is that the B-12 must go through the stomach to be broken down by the protein enzyme found there or the body won't be able to use it easily.  The next thing is that ALL B-12 vitamins are typically sourced from animal organ extracts.  The liver stores B-12, but if you do not eat meat, you will become deficient in that vitamin.  

The body is not stupid; it recognizes B vitamins that are not from once living sources and not put through the body's normal systems.  Many products are being promoted that are actually damaging to the body.  Very little is understood by the public in regard to nutrition and even less is understood by doctors.  The B-12 shot is not a vitamin, but a chemical activator that will elicit a body response, but within a short time of taking more shots, the DNA is damaged from these and other forms of so called vitamin pills that are not really vitamins.  In order for the body to absorb and utilize any vitamin, there are cofactors that must be in place to make this happen.  Single element vitamins are simply not found in nature for good reason.  Any vitamin component or chemical activator masqueraded as a vitamin will cause an imbalance and damage DNA; simple as that.  

If you have been diagnosed as having pernicious anemia, you most likely have many other things going on that need to be addressed to make you healthy.  To take a shot and expect your health to be marvelous is not good science.  

I strongly suggest you find a Certified Nutritional Therapist to help you.  Doctors are NOT the place to look for nutritional advice.  The CNT can help you by testing you to find out what nutrients you are deficient in and then recommend supplements and diets that will help put you on the road to being healthy.

good luck