Vitamin B12 makes the difference between tiredness and alertness

Two things I have learned post-sleeve (and these are important):

• The Vitamin B12 in a multi-vitamin PILL (or gummi) does NOT work in a sleeved stomach.
  
• A Vitamin B12 PILL (or gummi) will NOT work in a sleeved stomach.
  

The reasons are complex, you can look it up but basically the interaction between mouth saliva and stomach acid isn't sufficient to digest and absorb Vitamin B12 in your sleeved stomach.

So what can you do? You need 1000 mg of Vitamin B12 per month. Anything less and you WILL feel tired/lethargic all the time!

You basically have two options:

1. A 500ml injection of Methylcobalamin B12 in your butt twice a month. Do not use the far cheaper Cyanocobalamin injections, it doesn't work nearly as well....I found this out through experience!
2. A 1000mcg sublingual (under the tongue) B12 supplement. Again, look for the word "Methylcobalamin". This is for people who cannot stand needles. You CAN take two tablets if you still feel tired but about 50% of the population absorbs "too much" B12 at this level and it causes insomnia for them.

I just switched from Cyanocobalamin injections to Methylcobalamin injections 10 days ago and my energy level has increased tremendously! I couldn't figure out why so I went and did a little research.

Sounds like what I need, I'm always sooooo tired. Ty for sharing.

Here is a link to some govt literature about Vitamin B12 absorption rates.

The kicker: In a person with a REGULAR SIZE (unsleeved) stomach, hydrocholric stomach acid and saliva make for an absorption rate of only 56%!!!!
Take away 85% of your stomach in a sleeve and you have an absorption rate of....let me get my calculator....8 percent. That's a 92% waste rate for pills and gummis.

so do pills help at all?

I need to try this .... as I am sooo tired, about 4.5 week out of a sleeve! thanks

I have a scrip from my doc and give myself an injection every two months, i sure see the difference if i forget.

A few years ago I had a pretty nasty lung infection (pneumonia). After three rounds of antibiotics I was still sick and exhausted. I did change specialist at some point because I didn't feel that the first doctor was really efficient. The new one was really smart, the first thing she did was getting me tested for vitamin deficiency, as usual my iron was low, but also my D and B12. The doctor did tell me that I couldn't heal properly without good level of D and B12. So since that time I take B12 in my multi, but also twice a week a sublingual B12.
This Summer I got sick again but that time I knew the trick so my doc did get me tested right away. I was again low in iron and D but B12 was ok.
Vitamin D is also important, because like for B12, not enough D will also make us tired and more prone to infections.
One of my friend who's an opera singer had the same issues (that I had years ago) with her lungs, her doctor was also clueless about vitamin deficiency. I had to tell her to get tested! And she was low in B12 and D..
I'm amazed that today, with all that progress in the medical field simple basic things like vitamin testing are not done regularly. That would save huge amount in expensive treatment and consults!!....hum wait....may be that's actually why some (bad) doctors don't even bother!

Quote:

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Originally Posted by lil_lisa

so do pills help at all?

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The sublingual ones seem to help. The regular pills are essentially useless for sleeved folks because they no longer have the proper "tools" in their stomach to unlock the B12.

I just get the shots twice a month. I order B12 injection kits from India, first rate stuff @ $2.30 per syringe in bulk (vs. $15 per shot at Any Lab Test Now).

I was vitamin deficient pre op, D, B's and iron. I have been borderline anemic since I started my moons at age 14.

Part of my pre op preparations and life style changes was to add itamin supplements. I started pretty early on, in fact right after my Initial 90-day medical and nutritionist appointments. My first labs post op D, B and iron were normal. And my second one my B12 was elevated, I was told to cut down on B12 to once a week.

I think this B-Complex is the bomb!
Attachment 26178

My doctor (not surgeon, although they talked) also suggested I might need B12 shots once a month due to (as you point out, Bob) my "new stomach"'s inability to contribute to the process.

I'll ask him about the sublingual pills.

Bob, thanks for raising this topic.

Here's my two cents' worth on the subject:

I'm 2 years, 1 month post-op. Just got the annual battery of post-WLS blood tests last month. My B12, iron, D3, etc. etc. etc. levels are great. I do take a B12 pill once or twice a week in addition to my daily full-spectrum vitamin/mineral.

My understanding from what my bariatric doc's team has advised and what I've read online is that there's considerable variance among sleeved patients in terms of how their bodies process food and nutritional supplements and how many nutrients, including B12, they absorb. Also, specific prescription meds they take may also affect how their bodies absorb (or don't absorb) nutrients.

Therefore, I would caution that sleeved patients' B12 situations are not nearly as cut-and-dried or as precise as the OP makes it sound.

In my opinion, what is critical is that every sleeved patient continue for the rest of their lives to get a full blood panel workup every year and take nutritional supplements or alter their diets in ways that are appropriate for their individual situation.

For the record, I'm a HUGE fan of eating post-WLS in ways that feed your body very well. Veggies, fruits, a variety of animal and plant protein sources and whole grains do a body well. Nobody thrives on a diet of fast-food and a lot of sugar and alcohol -- no matter how many or few calories they're taking in. Treats are great as long as they're actually treats, not a large portion of our intake.

This is working for me now. But, of course, things can and might change. Hence, the annual battery of blood tests.

I take 2 B12 Vitamins, 2 D Vitamins. 2 Multi Vitamins, 2 C Vitamins and 1 monthly B12 injection. The reason for 2 of each is well because that's what the bottle says to take. My level were checked every 6 months and now will be checked once a year. I find it extremely important for me anyway to take these vitamins consistently because boy if I skip a day or 2 I definitely feel it. Anyway with all of that my levels are always spot on so it must be doing the body good. And thanks for bringing this up because it definitely brings awareness especially if people aren't too sure about what they should be taking and now they can speak with their PCP or Bariatric Dr. about what's best for them.

It’s a few years later, but I’m hoping you might share with me what supplements you’re finding success with. Also I’d like to hear about how you’re feeling and your labs! I’m new and seeking positive posts like these to ease my mind on this sleepless night. ❤️�� thank you

Wonder why my surgeon and nutritionist don't know this.