I wasn’t planning on getting the shot. Doc just offered it at the end of the visit and I was like, uh … I guess.
Then today I had my easiest and quickest feeling run in months.
Coincidence or is this actually a useful thing? No, I don’t have any sort of deficiency that I know of.
Probably helped
That means you probably had a deficiency, and that's probably why your doctor went through with that treatment
Btwelve wrote:
I wasn’t planning on getting the shot. Doc just offered it at the end of the visit and I was like, uh … I guess.
Then today I had my easiest and quickest feeling run in months.
Coincidence or is this actually a useful thing? No, I don’t have any sort of deficiency that I know of.
Doper!!!
As I learned on Letsrun, you just got turbo cancer blood clots injected into you!!!!!!! At least you'll have solid 5g coverage for a few weeks, until...
Why would a doctor offer you something you didn't need?
Did a well known coach suggest you see said doctor???
Unfortunately, it has a negative effect on your grammar.
Anecdotally, I've had patients describe feeling energized after a B12 shot.
The true symptoms of B12 deficiency (loss of sensation, megaloblastic anemia etc) don't usually occur until levels are very low (like <100)
I generally target B12 levels > 350. Once the levels drop below 300, we see increases in serum homocysteine and methymalonic acid (which rely on B12 as a cofactor for conversion). High MMA and HCY levels are strongly associated with Alzheimer's Disease (caveat, B12 supplementation has never been shown to treat or prevent dementia).
Oral supplementation works just as well as injection as long as you have a functioning terminal ileum.
As people get older, they naturally lose the ability to cleave B12 from animal protein. Other issues (e.g. bacterial overgrowth, PPI use) may make the issue worse. So even with a normal diet, you can have low levels.
I usually start with patients taking 1000mcg daily and then decrease to 250 once their levels are in a good spot, only reaching for injections if their levels don't come up (or if they were critically low to start)
Was the B12 methylcobalamin or cyanocobalamin?
MTHFR gene mutation limiting methylation of Folate and B-12 is something like 40%+ of the population...could matter and could have been slightly deficient but not enough to cause severe effects like the Doc mentioned^
Love to see a post from a medical doctor on this site. You speak the language well. Do you mind me asking specialty and years of practice?
PGY 11 wrote:
Love to see a post from a medical doctor on this site. You speak the language well. Do you mind me asking specialty and years of practice?
Geriatric Medicine - entering seventh year of practice this summer.
babaganosh wrote:
Anecdotally, I've had patients describe feeling energized after a B12 shot.
The true symptoms of B12 deficiency (loss of sensation, megaloblastic anemia etc) don't usually occur until levels are very low (like <100)
I generally target B12 levels > 350. Once the levels drop below 300, we see increases in serum homocysteine and methymalonic acid (which rely on B12 as a cofactor for conversion). High MMA and HCY levels are strongly associated with Alzheimer's Disease (caveat, B12 supplementation has never been shown to treat or prevent dementia).
Oral supplementation works just as well as injection as long as you have a functioning terminal ileum.
As people get older, they naturally lose the ability to cleave B12 from animal protein. Other issues (e.g. bacterial overgrowth, PPI use) may make the issue worse. So even with a normal diet, you can have low levels.
I usually start with patients taking 1000mcg daily and then decrease to 250 once their levels are in a good spot, only reaching for injections if their levels don't come up (or if they were critically low to start)
Super helpful, but you should please specify whether that's pmol/L or pg/ml for those who aren't familiar.