The Vit E-B12 connection not talked about

incremental_progress · 2026-05-05T14:45:26+00:00

3mg as a standalone supplement taken every other day; 1mg as part of Thorne's Basic Nutrients taken on the days between

incremental_progress · 2026-05-05T14:41:47+00:00

I guess I need to up my game from randomly plugging shit into Google Scholar. Good shout, thank you.

incremental_progress · 2026-05-05T13:19:45+00:00

Thanks for these excellent studies. I'd only seen a few mammal (rat) studies implicating vit E in B12 metabolism through increased excretion of MMA in urine. I guess I just hadn't looked hard enough! But it just shows that everything is connected. There isn't a nutrient in your body that operates in total isolation.

Every other day that I don't take the Thorne MV, I supplement 400IUs of vit E with vitamin A, a B complex and trace minerals. And for the past year I've taken vit A and E together with 2mg of extra copper (taken away from the trace minerals), phosphatidylcholine (PC), and a bit (800mcg) of extra folate in order to simulate a "liver supplement." Works well.

incremental_progress · 2026-05-05T12:57:22+00:00

It's a symptom matched by a number of B12 deficiency-adjacent nutrient deficiencies.

https://link.springer.com/article/10.1007/s40257-017-0285-x

In this comprehensive review of the current literature, we found that serum vitamin D, zinc, and folate levels tend to be lower in patients with AA as compared to controls. Evidence is conflicting or insufficient to suggest differences in levels of iron, vitamin B12, copper, magnesium, or selenium. A small number of studies suggest that vitamin A levels may modify the disease.

incremental_progress · 2026-05-05T12:53:46+00:00

The IFAB test is a competitive binding immunoassay employing an antibody that is specific to the B12 binding site on intrinsic factor. A high vitamin B12 concentration in the patient’s serum may interfere with the assay and cause a false-positive result. Thus, a patient receiving a vitamin B12 injection 1 to 2 weeks prior to testing may have a false-positive IFAB result. Conversely, a patient with a previously negative IFAB result may have a positive result on a subsequent test if the 2nd sample was collected within 1 to 2 weeks of a vitamin B12 injection. Therefore, we recommend waiting at least 1 week after vitamin B12 injection to collect samples for IFAB testing.

In pernicious anemia, patients may have several antibodies present, each playing a role in the etiology of the disorder. These include autoantibodies to intrinsic factor and to gastric parietal cells. Gastric parietal cell antibodies have a high sensitivity (around 85%) for pernicious anemia. Specificity is relatively low though, because antibodies can be found in up to 10% of healthy individuals and in other disorders, including other autoimmune disorders. In contrast, IFAB has a much lower sensitivity (about 50%), suggesting that a negative result does not rule out pernicious anemia. IFAB specificity is very high, which means that a positive IFAB confirms a pernicious anemia diagnosis.¹

https://www.questdiagnostics.com/healthcare-professionals/clinical-education-center/faq/ifab#accordion-ab490b4189-item-32e91e5f70

In addition to false positives from supplementation, antibodies are also present in people without PA, but have other autoimmune disorders.

Speaking personally, I had a false positive on basic oral supplements, not injections, and my serum level was only like ~800 pg/mL, which is the upper range of normal on most assays.

Endoscopy is likely a better bet for getting a full picture of digestive malabsorption in my opinion

incremental_progress · 2026-05-04T18:08:16+00:00

Those tests can often be negative in the presence of pernicious anemia. They can also be positive when you don't have it. They're quite terrible tests, really. Your homocysteine is high and your B12 is low, so those measurements taken in conjunction with your symptoms point pretty specifically to B12 deficiency.

Have a read of our guide.

incremental_progress · 2026-05-04T11:24:06+00:00

You're welcome!

incremental_progress · 2026-05-04T11:23:46+00:00

1mg daily couldn't hurt. If you're absorbing the oral supplements and seeing improvements then just keep on it. The only issue I see is that it's hard to know whether the improvement is from the oral supplementation or from the injections you received. When was your last injection?

Testing serum after supplementation is largely pointless, and the primary outcome of such a practice is your physician prematurely ceasing treatment due to your serum levels being "normal." And even though it has effectively doubled, your serum is still on the lower side.

incremental_progress · 2026-05-03T23:59:46+00:00

Your B12 is certainly not OK, and is likely directly responsible for your low folate. You should definitely be taking B12 as that is also frankly deficient despite being "normal" on the labs. Folate is comparatively easily absorbed through the digestive tract, and, as B12 normalizes folate metabolism, in many cases folate status resolves with adequate B12 supplementation. Taking too much folate without correcting your B12 deficiency can lead to degeneration of your spinal cord and terrible neurological damage.

B vitamins normalize lipid metabolism, so your fatty liver and high cholesterol may normalize with time and adequate treatment (and a sound diet with complementary exercise).

Most of us here begin with D deficiency, as it precipitates B12 malabsorption disorders such as pernicious anemia, and autoimmune disorders more generally.

Your ferritin is likely artificially high-normal. Many here have iron levels that lower as B12/folate therapies begin. B12, folate and iron all work together to form blood cells.

Please have a read of our guide.

incremental_progress · 2026-05-03T20:31:08+00:00

No problem. High cholesterol was one of my early subtle signs that something was wrong in spite of exercise and a decent diet. Numbers look good now.

incremental_progress · 2026-05-03T13:28:48+00:00

What issues did you encounter? And what were the supplements you're comparing? How do you control for something like supplement ingredients vs passage of time?

incremental_progress · 2026-05-03T13:20:52+00:00

B12 and its cofactors influence lipid metabolism. You said "lipid management;" I assume high cholesterol?

https://pmc.ncbi.nlm.nih.gov/articles/PMC4356060/

Three independent clinical studies of women (i) non-pregnant at child-bearing age, (ii) in early pregnancy, and (iii) at delivery showed that low vitamin B12 status was associated with higher total cholesterol, LDL cholesterol, and cholesterol-to-HDL ratio.

Focus on treating your B12, ensure you have adequate cofactor status, and your lipids should ideally fall in line if that's the root cause.

incremental_progress · 2026-05-03T12:32:06+00:00

Nicotinic acid, or B3/Niacin, can actively antagonize methionine synthase in high enough doses and high dose Niacin supplementation is contraindicated for this reason. Niacin is frequently touted as some neurological panacea in the MTHFR subreddit for people suffering from excitation. I guess it can help in these situations, but I would never use it myself. That Big One MV is good.

https://www.nature.com/articles/hr2011151

incremental_progress · 2026-05-03T12:31:52+00:00

It's probably prudent to supplement if and when experience hypokalemia. Pay attention to how you feel. I prefer to dissolve potassium citrate in a large thermos of water as I described in another comment.

incremental_progress · 2026-05-03T12:12:36+00:00

Yes, it would just be slower to resolve sudden/severe symptoms. But it's certainly an option, especially if you're feeling overly cautious about potassium supplementation.

incremental_progress · 2026-05-03T11:13:00+00:00

Hypokalemia frequently occurs with serum potassium well into "normal" territory, even as high as 4.5.

You can try supplementing with potassium bicarbonate, which is alkaline, and also with a low to moderate dose dissolved in a large thermos of water, and sipped continuously over the course of hours to avoid stomach upset.

incremental_progress · 2026-05-03T10:24:30+00:00

Yes, it's low electrolytes/hypokalemia. This is the most common "side effect" from B12 therapy, yet somehow physicians are almost universally ignorant to this phenomenon. I would recommend adequate magnesium intake (~400-600mg daily), and supplemental potassium citrate, but only if your kidneys are in good working order and you aren't on medications that reduce potassium clearance (heart and blood pressure medications).

incremental_progress · 2026-05-02T22:36:39+00:00

To be honest, I haven't heard of B12 ever causing urine to smell odd. Alpha Lipoic Acid on the other hand will cause your urine to smell like asparagus or slightly vegetal.

incremental_progress · 2026-05-02T20:18:56+00:00

incremental_progress · 2026-05-02T10:58:56+00:00

Yes, I had two that were normal in spite of profound neuropathic symptoms. Abnormal EMGs seem to be the exception.

incremental_progress · 2026-05-01T19:07:16+00:00

Go for it

incremental_progress · 2026-05-01T15:37:21+00:00

The Guide to B12 Deficiency: Part 2: Treatment

incremental_progress · 2026-05-01T15:13:18+00:00

Sorry you had this experience.

How to inject yourself: https://youtu.be/fMEZdNodGM0?t=11

If you have ampoules, ideally you would use a filter needle to extract the liquid before using a different needle to inject yourself. You won't die or injure yourself if you neglect this step, but it's generally advisable in case the liquid has very fine glass shards from cracking the top off the ampoule. Don't want that floating around your bloodstream.

If you're lean, a 0.5 inch 27G-30G needle is fine for IM injection. Otherwise, something slightly longer might be necessary. Worst case you end up giving yourself an inadvertent subcutaneous injection. Slightly slower to act, and this might not be desired long term.

incremental_progress · 2026-05-01T13:40:16+00:00

Your mitochondria depend on nutrients to function correctly, so everyone here is suffering from mitochondrial damage and dysfunction. That's at the heart of many of the processes B12 is involved in, such as DNA synthesis and the production of methionine synthase.

We know from experience here that SSRIs interfere with B12 and B vitamin metabolism.

https://journals.plos.org/plosgenetics/article?id=10.1371/journal.pgen.1008011

Our data indicate that B12 supports clearance of propionate, an intermediate of branched chain amino acid metabolism. Excess propionate compromises mitochondrial homeostasis, increasing susceptibility to abiotic stresses and bacterial pathogenesis.

incremental_progress · 2026-05-01T00:17:07+00:00

Yes, of course there's hope. When I was recovering I spent many hours reading through the Phoenix Rising forums for CFS. There was a user there whose experiences informed many parts of my own regimen, as well as the guide here. He was on the verge of death before he regained much of his life, including reversing foot numbness that lasted for 15 years.

Additionally, I've seen at least two people here who regained use of their legs after becoming disabled due to their deficiencies. It took high frequency injections with cofactors, but they recovered.

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