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Fatigue and AnemiaFatigue and Anemia
           
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Vitamin B-12
May 9, 2001

Thank you for your site, I've learned much. About Vitamin B-12, after a full blood workup, it has been found that I am deficient in vitamin B-12 which may account for in part, my feeling tired a lot of the time. My Dr. has suggested that a level of between 100 and 200 micro grams is considered normal. I have chosen to take a daily supplement as opposed to another visit to the Dr.s' office for a monthly injection. My pharmacist has indicated that vitamin B-12 taken orally is poorly absorbed by the body and that in order to reach normal levels of between 100 and 200 micro grams, she has advised that I take up to 1200 micro grams daily. First, is too much Vitamin B-12 toxic and second, are the comments of my pharmcist correct, that Vitamin B-12 taken orally is poorly absorbed? What can you tell me about Vitamin B-12, what is considered to be a normal level of Vitamin B-12( I am 48 years old male, 5ft. 9in., 185 pounds, active runner, lift weights, cyle)? I look forward to your response.

"Positive in Canada"

Response from Dr. Frascino

Dear Positive in Canada,

The common medical dogma states that people with pernicious anemia (anemia resulting from B12 deficiency) are unable to absorb sufficient vitamin B12 from their diet and therefore require intramuscular injections on a regular basis. More recent research has questioned that assumption. It's now believed that oral supplementation is indeed effective and certainly more convenient than the shots. Treatment of pernicious anemia at a dose of 1000-2000 micrograms per day has been as effective as the intramuscular injections in recent studies. You don't mention if you are anemic, just that your blood work showed vitamin B12 deficiency and that you've been fatigued. Certainly, the 1200 microgram dose suggested by the pharmacist should be plenty. You can have your blood level re-checked in a few weeks to see if the supplementation has put you back into the normal range. For the "normal range," check your laboratory report, as it is reported out in different units and with different ranges, depending on how the laboratory performs the test. Check your hemoglobin as well to see if your decreased B12 has caused any anemia.

Keep running, lifting, cycling, and that "positive" attitude.

Best of luck.

RJF


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