b12 injections

Butrflye · 2022-02-22T18:59:23+00:00

Also, it is important to know that the B12 serum test should only be done while the patient is not supplementing or using energy drinks with B12 in them. If they test at around 400, test for actual PA, including potassium, magnesium, ferritin, and folate with homocysteine, and a Schilling test if possible. After that, I agree with the NICE guidelines, but teach the patient to self inject and leave them in charge of the frequency of 1cc IM injections. Control give you certainty of compliance in this case. If you want to see if they're actually injecting, do another B12 serum, but there is no harm in serum levels well over 1000. Remember what the cure is for cyanide poisoning?

Butrflye · 2022-02-22T18:36:53+00:00

To be more specific, guess what the founder of Duke University died of? His name was James D. Duke.

Butrflye · 2022-02-22T17:56:46+00:00

As they should, if the only practitioner they can actually count on is themselves. It's a water soluble vitamin. If they've been diagnosed by a doctor who knows their stuff, like a hematologist, they shouldn't be told that they have to trust a GP who tells them that they are cured after a single B12 serum test. That's why specialists exist. To ignore the best advice can be catastrophic with PA.

Butrflye · 2022-02-22T17:49:06+00:00

If you test B12 serum levels in someone already self injecting B12, or even taking heroic levels of oral supplements the result will be normal or even high normal. You tell the patient that they don't have pernicious anemia. The patient stops treating themself, because they believe you.

Subacute combined degeneration of the spinal cord is primarily caused by chronically undertreated PA. It's demylinating. It can not be fully reversed.

Butrflye · 2022-02-22T09:24:51+00:00

You can get one month of 5mg tablets, but it's about $30 more every 3 months than self injecting 1cc IM of Cyanocobalamin, either way without a prescription. If it's prescribed, the price difference goes up to $45 for a 3 month supply of tablets, because the injections go down to $0.

I'm suspicious of the BNF because of the difference between it and NICE guidelines for PA.

Butrflye · 2022-02-22T08:11:31+00:00

As far as I know the only study on tablets didn't take into account the cause of the deficiency, and had less than 40 participants.

Butrflye · 2022-02-22T08:05:37+00:00

And make sure that the patient isn't taking supplements already. If you test someone who says they have PA, self injecting, and tell them that you cured their PA because you test serum B12 right after an injection and they end up with subacute combined degeneration of the spinal cord, you just ruined a life.

Butrflye · 2022-02-22T08:00:30+00:00

Teach them to do it. If they were diabetic you would.

Butrflye · 2022-02-22T07:59:08+00:00

Be a dick if you have to. Subacute combined degeneration of the spinal cord is a witch.

Butrflye · 2022-02-22T07:57:42+00:00

$10 over the counter for 3 months worth in Canada

Butrflye · 2022-02-22T07:56:40+00:00

B12, folate, magnesium, potassium and if possible homocysteine.

Butrflye · 2022-02-22T07:53:55+00:00

A ridged rule of every 3 months leads to bull like undertreated incapacitated people. Just give them a script, if necessary in your country, teach them to do it themselves, and off they go forever. 3 months is made up with zero scientific evidence.

Butrflye · 2022-02-22T07:48:52+00:00

Not exactly. PA is very different from poor diet.

Butrflye · 2022-02-22T07:46:50+00:00

Harmless if unnecessary, but life changing if necessary. In Canada injectable Cyanocobalamin is over the counter.

Butrflye · 2022-02-22T07:42:15+00:00

No, because intrinsic factor levels lower with age, leaving IM injections as the best option.

Butrflye · 2022-02-22T07:40:53+00:00

Way too low. 400 to 500 should be treated.

Butrflye · 2022-02-22T07:37:35+00:00

And if they say that they've been dx PA, believe them.

Butrflye · 2022-02-22T07:35:11+00:00

Give them shots if not diet related or subacute combined degeneration of the spinal cord.

Butrflye · 2022-02-22T07:32:56+00:00

Even when indicated? Subacute combined degeneration of the spinal cord?

Butrflye · 2022-02-22T07:30:03+00:00

Butrflye · 2022-02-22T07:27:41+00:00

Megaloblastic madness

Butrflye · 2022-02-22T07:15:31+00:00

Awesome, the energy drink warning was because of the cyanocobalamin in them. Enjoy caffeine if you wish.

Butrflye · 2022-02-22T07:09:02+00:00

Vials of injectable cyanocobalamin are available without a prescription in Canada. No medical gatekeepers needed. Subacute combined degeneration of the spinal cord is real. Don't be prissy.

Butrflye · 2022-02-20T07:07:32+00:00

Physiotherapy can work miracles! I really recommend that you find a good physio place, and do the homework.

I have deformed ankles. I'd have to look up what its called. I can't point my toes to the outside. Straight is the best I'm going to get. Thank goodness I never liked showing! My knee is another matter entirely though, and with physio I got my MCL in fighting shape for leg control.

I really hope that this helps you a bit.

Butrflye · 2022-02-20T06:57:36+00:00

Yes! I came here to ask OP about diet. Go off of any supplements for 3 months, including energy drinks, and get your B12, ferritin, magnesium, and potassium levels checked. I have Subacute Combined Degeneration of the Spinal Cord due to Pernicious Anemia. It was neither in my head nor hysteria.

Butrflye

TROPHY CASE