I was interested and unsurprised to learn of this aspect of Clinical
Chemistry, whereby B12 transport systems may be so overwhelmed by IM B12
initiation regimes, that most is lost in the Urine. Parsimony may be
important, but my main concern is EASE ( Effectiveness, Acceptability,
Safety, Expense). How best to optimise the haematological/clinical
recovery ? And with a safety margin - for missed appointments, say. At
reasonable expense. So we plump straight for B12 replacement by
'overkill' injections, and refer to the practice Nurse, who hopefully
remembers to bill the NHS for reimbursements. Maybe that's why Oral B12
isn't too popular here, unlike Canada and Sweden ?
Note The BP directs that when vitamin B12 injection is prescribed or
demanded hydroxocobalamin injection shall be dispensed or supplied
Could the discrepancies between blood B12 levels, transport
saturations, and B12 stores explain the common experience (eg. Phil Jones
and myself) of patients feeling that they need their B12 more often than
the schedule ?? It would be nice to have a non-psychological explanation.
Competing interests:
I get paid for B12 injections
Rapid Response:
Re: Vitamin B12 into the bladder?
I was interested and unsurprised to learn of this aspect of Clinical
Chemistry, whereby B12 transport systems may be so overwhelmed by IM B12
initiation regimes, that most is lost in the Urine. Parsimony may be
important, but my main concern is EASE ( Effectiveness, Acceptability,
Safety, Expense). How best to optimise the haematological/clinical
recovery ? And with a safety margin - for missed appointments, say. At
reasonable expense. So we plump straight for B12 replacement by
'overkill' injections, and refer to the practice Nurse, who hopefully
remembers to bill the NHS for reimbursements. Maybe that's why Oral B12
isn't too popular here, unlike Canada and Sweden ?
Current UK prices are:
Cyanocobalamin (Non-proprietary)
(1) Tablets , cyanocobalamin 50 micrograms. Net price 50-tab pack = £6.24
Brands include Cytacon®
Liquid , cyanocobalamin 35 micrograms/5 mL. Net price 200 mL = £2.77
Brands include Cytacon®
Injection , cyanocobalamin 1 mg/mL. Net price 1-mL amp = £1.67
Brands include Cytamen®
Injection , hydroxocobalamin 1 mg/mL. Net price 1-mL amp = 92p
Note The BP directs that when vitamin B12 injection is prescribed or
demanded hydroxocobalamin injection shall be dispensed or supplied
Could the discrepancies between blood B12 levels, transport
saturations, and B12 stores explain the common experience (eg. Phil Jones
and myself) of patients feeling that they need their B12 more often than
the schedule ?? It would be nice to have a non-psychological explanation.
Competing interests:
I get paid for B12 injections
Competing interests: No competing interests