Jump to content
SurvivingAntidepressants.org is temporarily closed to new registrations until 1 April ×

Vitamin B12 aka cobalamin: Essential for mood, nervous system


Altostrata

Recommended Posts

  • Administrator

ADMIN NOTE PLEASE READ the first 6 posts of this topic.

 

We have seen that some people may find vitamin B12 supplementation to be activating, causing nervousness, anxiety surges, or sleeplessness. You might find it to be tolerable if you start with a tiny chip from a sublingual B12 tablet (methylcobalamin preferred; cyanocobalamin is most widely available) and very gradually increase the size of the chip over some weeks.

 

How to test for subclinical B12 deficiency:

 

Hannibal L, Lysne V, Bjørke-Monsen AL, et al. Biomarkers and Algorithms for the Diagnosis of Vitamin B12 Deficiency [published correction appears in Front Mol Biosci. 2017 Aug 08;4:53]. Front Mol Biosci. 2016;3:27. Published 2016 Jun 27. doi:10.3389/fmolb.2016.00027 Full text here.

 

Quote

Methylmalonic acid [MMA] continues to be the most sensitive and specific marker for vitamin B12 status in individuals of all ages with normal renal function. 

 


 

Among people seeking treatment for mood disorders, there may be a lot of undiagnosed subclinical vitamin B12 deficiency.

 

B12 is stored in the liver and used up in various metabolic transactions, particularly stress. It helps clean out toxins, homocysteine, and repair nerve cells.

 

As we age, our bodies absorb B12 poorly. But it's not just seniors who might have low B12! Anyone taking a stomach acid blocker is also blocking B12 absorption. Older people taking stomach acid blockers are doubly at risk for low B12.

 

Since B12 is generally found in animal products, vegetarians sometimes have difficulty getting enough. There are other factors that might cause B12 levels to be low, but show up as normal on regular blood tests -- that's why it's called subclinical B12 deficiency.

 

Subclinical B12 deficiency may cause low mood for which many people might seek an antidepressant. Many psychiatric symptoms may very well be just low B12.

 

Over the long run, subclinical B12 deficiency can be as destructive as frank B12 deficiency.

 

Researchers believe that a lot of people who have been institutionalized for dementia or Alzheimer's actually had longstanding subclinical B12 deficiency; low B12 is very common among people who have been diagnosed (or misdiagnosed) with Alzheimer's.

 

Here's a recent post from Dr. Andrew Weil's blog about the neurological effects of low B12:

 

Vitamin B12 and Senior Moments

 

Quote

As we get older, our bodies don’t absorb vitamin B12 as readily as they did during our younger years (B12 is found in animal foods - meat, poultry, fish, eggs and dairy products). And this decreasing absorption may help explain why brain size shrinks with age and seniors develop problems with thinking. Researchers in Chicago checked blood levels of B12 in 121 seniors taking part in the Chicago Health and Aging Project. The investigators also measured vitamin B12 in five metabolites that are considered markers for B12 activity; a protocol, which they said, could give a fuller picture of B12 status. The seniors were asked to complete 17 tests to assess their memory and thinking skills. More than four years later, the study participants underwent MRIs to measure brain volume and to look for other signs of brain atrophy. The research team found that low levels of B12 in the metabolites were associated with poorer thinking skills and smaller brain volume. Because the study was a small one, the investigators said their results must be confirmed by additional research, and cautioned against making dietary changes based on their results. The study was published in the September 27 issues of Neurology.

 

My take? It is interesting that these researchers concluded that testing B12 levels in the blood isn’t enough to assess its activity in the body, but this is not the first study to associate low levels of B12 with negative changes in brain anatomy and function. A study published in 2008 suggested that seniors with the highest levels of B12 were six times less likely to exhibit brain atrophy than participants whose B12 levels were lower....."

 

Edited by Altostrata
updated admin note

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment
Share on other sites

  • Administrator

How to take B12

 

If you have normal B12 metabolism and get lots of B12 through eating animal proteins (there's no other way to get it), you may not need B12 supplementation.

 

If you are feeling run down, are stressed, of a certain age, or are not eating well, you may need B12.

 

B12 is stored in the liver and can get depleted by poor diet, stress, or age. If you have not yet started tapering a psychiatric drug, you might as well take some to be on the safe side. It's cheap and excess just goes out in your urine. (If you have started tapering, see below.)

 

There are three ways to take B12: Through injections, sublingual (under the tongue) tablets, or regular tablets. The shots and sublingual tablets are most effective.

 

The most common form of B12 is cyanocobalamin, which releases a tiny amount of cyanide atoms as it is metabolised. It is unknown what this does, but there are other forms of B12. To avoid the cyanide, sublingual methylcobalamin is a better form to take by mouth and hydroxocobalamin by injection.

 

The usual B12 dosage is 1000mcg per day. Of 1000mcg/day of sublingual B12, a tiny amount, perhaps 10mcg is absorbed by the mouth mucosa. This bypasses any absorption problems that might exist in the small intestine (as does an injection).

 

If you suspect B12 deficiency, it's probably best to have a B12 shot before you start to taper a psychiatric drug, while your nervous system is still stable.

 

The MTHFR fallacy

Much has been made in recent years of poor metabolization of B12 (and other B vitamins) in people with MTHFR genetic variations. A large, incoherent field of practice has been built upon this by integrative, functional, and alternative practitioners.

 

Only a very small number of people have MTHFR genetic variations that require special treatment. The rest are normal MTHFR variations that can be "treated" by simply eating lots of fresh leafy green vegetables, which contain the appropriate type of folate and other important nutrients for our bodies (but not vitamin B12).

 

Vitamin B12 cannot be found in vegetables, it exists only in animal products and in B12 supplements. Practitioners who treat MTHFR make a big deal about those who cannot tolerate B12 supplements, they are supposed to have difficulties in "methylation" that require expensive, elaborate supplement regimes.

 

This is unnecessary. People with MTHFR variations can take sublingual methylcobalamin. See below.

 

What to do if you can't tolerate a vitamin B12 supplement?

Some people do have difficulty taking B12 supplements and other B vitamin supplements -- they find the B vitamins in this form cause surges of anxiety, palpitations, sleeplessness, etc. (symptoms of nervous system activation).

 

If you have been tapering psychiatric drugs or have withdrawal syndrome, your nervous system may well be sensitized to B vitamins. You need to be very careful about all B supplements, they may be too strong for you and trigger activation.

 

If you get a bad reaction to vitamin B12 supplements, you might want to try a very small amount of vitamin B12 sublingual methylcobalamin first, perhaps a crumb of a 1000mcg tablet. You can take a tiny crumb daily for a week, then build up to 2 crumbs and eventually to an entire tablet.

 

If you get activation symptoms, you're taking too much, take less. You may be able to tolerate only a tiny crumb for months.

 

(I suggest methylcobalamin because, being already methylized, this compensates for any MTHFR-related "methylation" difficulties. It's fine for people who don't have MTHFR variations, too.)

 

My own experience

I apparently had low B12 when I went off Paxil, and B12 (hydroxycobalamin) shots helped me a lot in the first year of severe discontinuation syndrome. I started taking them in month 10 and I wish I had found out about it earlier.

 

I had been taking Zantac for two years while I was taking Paxil, and I suspect that caused a subclinical B12 deficiency, along with my being an older person.

 

I started out with B12 shots (hydroxycobolamin). They gave me a warm, tingling, relaxing feeling all over my body and relieved, to some extent, some of my withdrawal symptoms. I gave myself a 1000mcg shot every week for many months. I was probably very low in B12.

 

A few years later, I suffered a terrible setback, lost the ability to sleep, and was advised to stop all B vitamin supplements because of potential activation in my nervous system sensitized by post-withdrawal syndrome. I stopped supplementing B12. (The rest of the story is here.)

 

A few years after that (I had recovered my sleep), blood tests showed I was low in B12 (I was an even older person). I had had tests showing I had 2 common MTHFR genetic variations, which may or may not mean difficulty processing B vitamins.

 

I tried taking a 1000mcg subllngual methylcobalamin and found it uncomfortably activating (electrical sensations). I decided to try a tiny crumb and build up from there. Over 6 months, I increased to a normal 1000mcg tablet per day. My B12 blood levels rose. Now I take a 1000mcg tablet a few times a week to keep the stores in my liver topped up.

Edited by Altostrata
updated

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment
Share on other sites

  • Administrator

How vitamin B12 gets depleted

 

B12 is mostly absorbed in the small intestine.

 

B12 deficiency can be instigated by taking drugs that block the absorption of B12 in the gut, such as antibiotics; tetracycline; "acid blockers" omeprazole, lansoprazole, ranitidine, cimetidine, or antacids that are often used to treat gastroesophageal reflux; chemotherapy; metformin for diabetes; phenobarbital; and phenytoin (see Drugs that Deplete: Vitamin B12 (Cobalamin)).

 

The body stores a three- to five-year supply of B12 in the liver and in normal people deficiencies take a long time to develop. When shortages do occur, they are often due to a lack of intrinsic factor, an enzyme that allows vitamin B12 to be absorbed in the intestinal tract. Intrinsic factor diminishes with age and older people are more prone to B12 deficiencies.

 

Vegetarians are prone to B12 deficiency because B12 has to come from animal-based foods (an indication humans are naturally omnivorous).

 

Stress, such as that of antidepressant discontinuation, can significantly deplete B12 as it is used up in the catecholamine cycle in the production of stress hormones.

 

Stomach disease can cause B12 deficiency.

 

Some people have a genetically determined inability to absorb B12 in the small intestine. Because vitamin B12 is important to red blood cell formation, extreme deficiency leads to an oxygen-transport problem known as pernicious anemia.

 

Pernicious anemia can cause mood swings, paranoia, irritability, confusion, dementia, hallucinations, or mania, eventually followed by appetite loss, dizziness, weakness, shortage of breath, heart palpitations, diarrhea, and tingling sensations in the extremities.

 

(If you have this, you will have had other long-term health problems.) See http://www.nlm.nih.gov/medlineplus/ency/article/000569.htm:

 

"...Risk factors include a family history of pernicious anemia, Scandinavian or Northern European descent, and a history of autoimmune endocrine disorders. Pernicious anemia is seen in association with some autoimmune endocrine diseases such as type 1 diabetes, hypoparathyroidism, Addison's disease, hypopituitarism, testicular dysfunction, Graves disease, chronic thyroiditis, myasthenia gravis, secondary amenorrhea, and vitiligo...."

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment
Share on other sites

  • Administrator

Diagnosis of subclinical B12 deficiency

 

Low B12 may not show up in a normal blood test. It may be circulating in the blood because it's not being properly absorbed in the gut.

 

(If you have subclinical B12 deficiency, your red blood cells may enlarge. I believe this gives you a high volume of red blood cells, which makes the serum B12 number meaningless. The red blood cells also have trouble carrying oxygen.)

 

B12 deficiency can be "subclinical," meaning blood tests are normal, and still be very serious. In its extreme state, B12 deficiency is anemia. Symptoms of subclinical B12 deficiency include leg aches and pains, confusion, depression, anxiety, tiredness.

 

The following tests screen for subclinical B12 deficiency: measurement of serum methylmalonic acid, homocysteine levels, and holotranscobalamin II (holoTC) (see citations below). (However, B12 shots or sublingual tablets may a lot cheaper than these tests and if your nervous system is stable, have very little risk.)

 

(I found my US health insurance covered the cost of the tests.)

 

For interpretation of the tests, see Lab Tests Online and confer with your physician. For example, here's the page for homocysteine results interpretation: https://labtestsonline.org/understanding/analytes/homocysteine/tab/test

 

------------------

Int J Geriatr Psychiatry 1997;12:67-72

Plasma methylmalonic acid in relation to serum cobalamin and plasma homocysteine in a psychogeriatric population and the effect of cobalamin treatment.

Nilsson K, Gustafson L, Faldt R, et al.

 

------------------

http://jnnp.bmjjournals.com/cgi/content/full/69/2/228

 

J Neurol Neurosurg Psychiatry 2000;69:228-232 (August)

Homocysteine, folate, methylation, and monoamine

metabolism in depression

Teodoro Bottiglieria, Malcolm Laundya, Richard

Crellinb, Brian K Tooneb, Michael W P Carneyc, Edward

H Reynoldsa

 

-------------------

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2339679&dopt=Citation

 

Am J Hematol. 1990 Jun;34(2):132-9.

Low holotranscobalamin II is the earliest serum marker

for subnormal vitamin B12 (cobalamin) absorption in

patients with AIDS.

Herbert V, Fong W, Gulle V, Stopler T.

 

-------------------

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14656029&query_hl=7

 

Clin Chem Lab Med. 2003 Nov;41(11):1478-88.

Functional vitamin B12 deficiency and determination of

holotranscobalamin in populations at risk.

Herrmann W, Obeid R, Schorr H, Geisel J.

Edited by Altostrata
updated

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment
Share on other sites

  • Administrator

Folate and B12

 

Ordinarily, folic acid (folate) works with vitamin B12 and they should be taken together. Deficiencies of either can lead to anemia or neurological symptoms, even dementia.

 

Folic acid can mask a B12 deficiency and vice versa, so it's wise to take them together and cover both bases.

 

However, folic acid can be stimulating for people with hypersensitive alerting systems, i.e. people with withdrawal syndrome.

 

If your nervous system can tolerate it, you might as well get your folate in a multivitamin supplement PLUS take additional B12. Multivitamins usually contain an insignificant amount of B12.

 

Low folate is also implicated in anemia and heart disease.

 

An integrative doctor recommended that I take a special type of folate, because she said I wasn't absorbing folate properly. I apparently inherited a genetic mutation (MTHF) that predisposes towards heart disease -- folate and B12 are important to maintain a healthy heart (and brain!!!) -- and faulty folate metabolism is part of that.

 

Metafolin, Deplin, or Metagenics FolaPro (l-5-methyl tetrahydrofolate or MTHF) are folate alternatives for people to take who cannot metabolize the usual form of folic acid in supplements. There is no reason to take a folate alternative if you don't have the MTHF mutation.

 

These folate alternatives are quite expensive, while ordinary B12 and folate supplements are very inexpensive.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment
Share on other sites

  • Administrator

Of course, taking an antidepressant doesn't remedy a folate or B12 deficiency or any other kind of vitamin or mineral deficiency. So if your symptoms have been caused by this and you have been taking antidepressants for years, your vitamin or mineral deficiency has just been getting worse.

 

(There is no evidence that B12 or folate have any effect on serotonin.)

 

Low zinc is quite common and can lead to all kinds of awful symptoms.

 

Vitamin D has been found to be more and more important to general health. Deficiencies are common, particularly in cloudy climes in the winter. Supplementation up to 1200 IUs a day might also be a good idea. Vitamin D3 is the best form to take.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment
Share on other sites

Stress, such as that of antidepressant discontinuation, can significantly deplete B12 as it is used up in the catecholamine cycle in the production of stress hormones.

 

"...Risk factors include a family history of pernicious anemia, Scandinavian or Northern European descent, and a history of autoimmune endocrine disorders. Pernicious anemia is seen in association with some autoimmune endocrine diseases such as type 1 diabetes, hypoparathyroidism, Addison's disease, hypopituitarism, testicular dysfunction, Graves disease, chronic thyroiditis, myasthenia gravis, secondary amenorrhea, and vitiligo...."

That's me. Thanks, Alto.

Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

Link to comment
Share on other sites

  • Administrator

You have a family history of pernicious anemia, Bar?

 

That could be a big part of your mood problem right there.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment
Share on other sites

Thanks Alto,

 

I wrote a post here many months ago about this and had a battery of blood tests done, as my doctor did not take me seriously,

that B12 could be related to the problems im having now, and was not prepared to listen when i tried to tell him, that this does not show up in the normal

battery of bloods the surgery offers.

 

Im printing this off and taking it with me, to see if he is prepared to listen now!!!!!!!!!!!!!

Began taking 30mg Seroxat on 15th Jan 1997 for grief issues. Remained at that dosage until Dec 05, did doctor ct, akathesia set in along with being non functional and overly emotional, brain fog. Doctor prescribed prozac, propranelol and diazeapam to counteract side effects, and told me to ct those 3 after 2.5/3 months use, induced wd seizure on 2nd day after ct. Was reinstated on seroxat 20mg in april 06, remained at that dose until Nov 07 and began a very slow taper lasting 56 months, finally DRUG FREE on 11th may 2011.

Link to comment
Share on other sites

  • Administrator

Great idea, angie.

 

If he doesn't listen, you might just get some sublingual B12 and take it. Occasionally people with withdrawal syndrome are hypersensitive to it, but other than that, it's quite safe.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment
Share on other sites

I've been taking Vit B 12 for around six months now, and could feel that I had more energy after about a week. I've been taking it in the pill form. I don't like the taste of vits or meds so no sublingual anything for me if I can avoid it.

 

 

Charter Member 2011

Link to comment
Share on other sites

Great info Alto. I just ordered some in liquid for under the tongue. That way it'll be easy to try small amounts too. I hope it helps me. I pretty much have a vegetarian diet. I eat just a tiny bit of meat on occasion.

Taper from Cymbalta, Paxil, Prozac & Antipsychotics finished June 2012.

Xanax 5% Taper - (8/12 - .5 mg) - (9/12 - .45) - (10/12 - .43) - (11/12 - .41) - (12/12 - .38)

My Paxil Website

My Intro

Link to comment
Share on other sites

  • 6 months later...
  • Administrator

Just wanted to caution: Some hypersensitized people find B12 too stimulating, try a fraction of a dose to begin with.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment
Share on other sites

"...Risk factors include a family history of pernicious anemia, Scandinavian or Northern European descent, and a history of autoimmune endocrine disorders. Pernicious anemia is seen in association with some autoimmune endocrine diseases such as type 1 diabetes, hypoparathyroidism, Addison's disease, hypopituitarism, testicular dysfunction, Graves disease, chronic thyroiditis, myasthenia gravis, secondary amenorrhea, and vitiligo...."

That's me. Thanks, Alto.

 

Not sure how I missed your question about pernicious anemia, Alto.

 

I'm not aware of pernicious anemia, but several of the conditions listed are in my family or myself: Graves, Addison's, Hashimoto's thyroiditis*, diabetes (very borderline)*, vitiligo*, secondary amenorrhea*, AI antibodies*, dementia is a given in females on mother's side, which scares the cr** out of me. My sister and I used to refer to it as "the inevitable dingbattedness that runs in our family" but see it is now obvious dementia (unspecified, not Alzheimer's). Eastern European descent. Non-alcohol fatty liver disease (NAFLD) -diagnosed. Just throwing that in after reading the liver/B12 connection (but what is the liver NOT related to??)

Still suspect some pituitary and/or adrenal dysfunction.

* = self

Also MTHFR genetic mutation as discussed previously. Curious if B vitamin injections (vs oral) are handled differently by body with this mutation? (I feel like there's an obvious answer to that, but thinking is very foggy today). Very low mood this past week that is reminiscent of severe PMS that started in 40s although I've been without period for ~2 years. I attended a talk by a hormone doc years ago and recall him saying that even after periods cease (meno-pauses), women still experience PMS because hormones are still fluctuating some. (Audible groan from all in attendance - women and men!) *I'm not sure if that is true*

 

I've also taken a few of the drugs know to deplete B12: several antibiotics, birth control, and recently metformin although I've held off on that on some instinctual level (or plain fear of drugs). I find it interesting that those same drugs were on list of drugs associated with candidiasis.

Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

Link to comment
Share on other sites

  • 1 year later...

I have been reading about the different types of vitamin B12, and found this article to be very interesting. I ordered some of the methylcobalamin as a spray, and got it in the mail today. will let you know how things progress.

Here is a very interesting article:

 

http://www.psychiatrywithoutdrugs.co.uk/methylcobalamin.htm

Effexor 75 mg for 3 yrs.

Effexor XR 75 mg for 10 yrs.

Effexor XR 150 mg for 5 years.

Currently at 37.5 and weaning slowly

Link to comment
Share on other sites

  • Administrator

Thanks, Coleen.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment
Share on other sites

  • 4 weeks later...

My psychiatrist told me to up my iron, and then upon buying the iron I was told to take it with B12, so I bought sublingual and my energy has improved substantially.  There is b12 deficiency in my family too.  I tried to ask for those special deficiency tests, but the psychiatrist said no, it's fine in my blood work so she wouldn't go further.  I would have liked to try the shots, but I don't know how to get them without a prescription, or a prescription without evidence of low b12 in the blood.  Any ideas?

16 yrs ago started zoloft for fatigue & bodily pains

went off 4-ish yrs ago

suffered major symptoms of mostly waves of anxiety & panic, also some mania & depression approx. 6 mo's later

went back on effexor 150,

down to 75,

went off to have a baby, off for about 6 months no symptoms

back on 25, then 50 a month post baby with major postpartum depression & anxiety waves,

finally okay on 75 but wondering if I'll be on for the rest of my life

Link to comment
Share on other sites

  • Administrator

In the US, GPs would give the shots.

 

Absorption from sublinguals is fine, it's just slower than the shots.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment
Share on other sites

  • 1 year later...

I need some advice.

 

I was recently to the doctor and after a blood test she said that I am low in iron and B12. She suggested me to take both supplements. I don't mind taking iron, but the 250mcg of B12 made me extremely anxious. I took only 2 pills and then I had to stop. I will go again to the doctor in a couple of weeks. What should I tell her? How can I take it, because I apparently need it, but without the anxiety, that is unbearable? 

 

I know, my question is not really related to withdrawal, but maybe somebody else had such an experience.

 

I had relatives with pernicious anemia, so this may happen to me too in the future, but for now I need to find a way to take some extra B12 without going crazy. Are the B12 shots better? Or they also will trigger the anxiety?

 

I am a couple of months off Paxil, I am ok for now, but I don't want to spoil the good progress I am making.

 

Maybe I should cut the B12 pill in small pieces, I have a lot of exercise in cutting pills.

July 2011 - nasty anxiety crisis (lost job, became not functional, couldn't exit the house alone)
August 2011 - started 10mg Paxil  and October 2011 - 20mg (one month on 20mg)
November 2011 - starting slowly to decrease the dose at the pace my body supported. Down to 2.5 mg in January 2013 (17.5, 15, 12.5, 10, 7.5, 5, 3.7, 2.5) - at least one month at each step. Got a new job.
April 2013 - stopped completely, crashed after 2 weeks, and reinstalled 2.5mg, recovered fast.
September 2013 - started decreasing again, slower, down to 1 mg in December 2013
December 2013 - free of Paxil
March 2014 - another crash, exactly 3 months after stopping, after 2 weeks of horrors, reinstalled 1 mg - feeling better after one week.
March 2014 - July 2014: going slowly down: 1mg, 0.9mg, 0.77mg, 0.64mg
end of July 2014 - Paxil free, hopefully forever this time.

Jan 2024 update - Still Paxil free, feeling good. 

Link to comment
Share on other sites

I need some advice.

 

I was recently to the doctor and after a blood test she said that I am low in iron and B12. She suggested me to take both supplements. I don't mind taking iron, but the 250mcg of B12 made me extremely anxious. I took only 2 pills and then I had to stop. I will go again to the doctor in a couple of weeks. What should I tell her? How can I take it, because I apparently need it, but without the anxiety, that is unbearable?

 

I know, my question is not really related to withdrawal, but maybe somebody else had such an experience.

 

I had relatives with pernicious anemia, so this may happen to me too in the future, but for now I need to find a way to take some extra B12 without going crazy. Are the B12 shots better? Or they also will trigger the anxiety?

 

I am a couple of months off Paxil, I am ok for now, but I don't want to spoil the good progress I am making.

 

Maybe I should cut the B12 pill in small pieces, I have a lot of exercise in cutting pills.

You may have better response to B12 as methylcobalamin (see link in Colleen's message). If you have any glitches in your methylation system, your body might not be able to convert B12 to its active form of methylcobalamin.

 

Just a thought!

Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

Link to comment
Share on other sites

  • Administrator

B12 shots can also make you anxious.

 

You may wish to try a fraction of a tablet of the B12 you've got, or get methylcobalamin liquid and titrate it.

 

The methylcobalamin form is the most absorbable form you can get in tablet or liquid.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment
Share on other sites

I need some advice.

I was recently to the doctor and after a blood test she said that I am low in iron and B12. She suggested me to take both supplements. I don't mind taking iron, but the 250mcg of B12 made me extremely anxious. I took only 2 pills and then I had to stop. I will go again to the doctor in a couple of weeks. What should I tell her? How can I take it, because I apparently need it, but without the anxiety, that is unbearable? 

I know, my question is not really related to withdrawal, but maybe somebody else had such an experience.

I had relatives with pernicious anemia, so this may happen to me too in the future, but for now I need to find a way to take some extra B12 without going crazy. Are the B12 shots better? Or they also will trigger the anxiety?

I am a couple of months off Paxil, I am ok for now, but I don't want to spoil the good progress I am making.

Maybe I should cut the B12 pill in small pieces, I have a lot of exercise in cutting pills.

You could try liver :).

1st round Prozac 1989/90, clear depression symptoms. 2nd round Prozac started 1999 when admitted to dr. I was tired. Prozac pooped out, switch to Cymbalta 3/2006. Diagnosed with bipolar disorder due to mania 6/2006--then I was taken abruptly off Cymbalta and didn't know I had SSRI withdrawal. Lots of meds for my intractable "bipolar" symptoms.

Zyprexa started about 9/06, mostly 5mg. Tapered 4/12 through12/29/12

Wellbutrin. XL 300 mg started 1/07, tapered 1/18/13 through 7/8/13

Oxazepam mostly continuously since 6/06, 30mg since 12/12, tapered 1.17.14 through 8.26.15

11/06 Lithium 600mg twice daily, 2.2.14 400mg TID DIY liquid, 2.12.14 1150mg, 3.2.14 1100mg, 3.18.14 1075mg, 4/14 updose to 1100mg, 6.1.14 900 mg capsules 7.8.14 810mg, 8.17.14 725mg, 8.24.24 700mg...10.22.14 487.5mg, 3.9.15 475mg, 4.1.15 462.5mg 4.21.15 450mg 8.11.15 375mg, 11.28.15 362.5mg, back to 375mg four days later, 3.4.16 updose to 475 (too much going on to risk trouble)

9/4/13 Toprol-XL 25mg daily for sudden hypertension, tapered 11.12.13 through 5.3.14, last 10 days or so switched to atenolol

7.4.14 Started Walsh Protocol

56 years old

Link to comment
Share on other sites

  • Administrator

Or red meat. Grass-fed is best, the fat contains omega-3 fatty acids.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment
Share on other sites

I did try liver :). And I bought another package to prepare soon. I eat read meat at least once a week, but it is not enough for B12 intake.

 

Anyway, I tried a quarter of the B12 250mcg, so 62.5 mcg yesterday ( plus the liver). It was not very bad. I just had an increase of anxiety/trembling/ cortisol surge when waking up this morning. But I slept well, and this is going away after a few minutes. So it is acceptable.

July 2011 - nasty anxiety crisis (lost job, became not functional, couldn't exit the house alone)
August 2011 - started 10mg Paxil  and October 2011 - 20mg (one month on 20mg)
November 2011 - starting slowly to decrease the dose at the pace my body supported. Down to 2.5 mg in January 2013 (17.5, 15, 12.5, 10, 7.5, 5, 3.7, 2.5) - at least one month at each step. Got a new job.
April 2013 - stopped completely, crashed after 2 weeks, and reinstalled 2.5mg, recovered fast.
September 2013 - started decreasing again, slower, down to 1 mg in December 2013
December 2013 - free of Paxil
March 2014 - another crash, exactly 3 months after stopping, after 2 weeks of horrors, reinstalled 1 mg - feeling better after one week.
March 2014 - July 2014: going slowly down: 1mg, 0.9mg, 0.77mg, 0.64mg
end of July 2014 - Paxil free, hopefully forever this time.

Jan 2024 update - Still Paxil free, feeling good. 

Link to comment
Share on other sites

  • Administrator

Good to hear, arwen. Maybe your body needs this important B vitamin.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment
Share on other sites

  • 2 months later...

A short update about my B12 experience: After a few weeks taking small amounts of B12 (a quarter of 250mcg pill or less per day, liver, red meat), my blood test  for B12 was still pretty low. I realized I have to do something about it. 

 

I made an effort to take more B12. I bought methylcobalamin sublingual ( instead of the old cyanocobalamin pills I tried initially), and started taking 1000mcg per day. I was surprised to notice that it was not worse than before, not more activating (still some increased anxiety, but nothing comparing to the horror of withdrawal, not even a year ago), it even feels I am tolerating it better now. I hope next time I go for the blood test it will be much better.

July 2011 - nasty anxiety crisis (lost job, became not functional, couldn't exit the house alone)
August 2011 - started 10mg Paxil  and October 2011 - 20mg (one month on 20mg)
November 2011 - starting slowly to decrease the dose at the pace my body supported. Down to 2.5 mg in January 2013 (17.5, 15, 12.5, 10, 7.5, 5, 3.7, 2.5) - at least one month at each step. Got a new job.
April 2013 - stopped completely, crashed after 2 weeks, and reinstalled 2.5mg, recovered fast.
September 2013 - started decreasing again, slower, down to 1 mg in December 2013
December 2013 - free of Paxil
March 2014 - another crash, exactly 3 months after stopping, after 2 weeks of horrors, reinstalled 1 mg - feeling better after one week.
March 2014 - July 2014: going slowly down: 1mg, 0.9mg, 0.77mg, 0.64mg
end of July 2014 - Paxil free, hopefully forever this time.

Jan 2024 update - Still Paxil free, feeling good. 

Link to comment
Share on other sites

B12 is critical and if you are NOT a vegan and do eat alot of meat and you are deficient you have a problem with the absorbtion, probably a lack of intrinsic factor. Oral supplementation with B12 is poor...what makes you think that if you didnt absorbed it from food you will absorb it from pills? Deficiency needs IM injections. And dont get retested for b12 after you took b12...for like a month. It could show up falsely elevated. Also make a cbc to see the status of your cells. Severe deficiency causes macrocytosis (enlarged cells).

serum B12, methylmalonic acid(mma) and homocysteine...you need them all together. Why ? Because its hard to diffrrentiate between b12 and folate deficiency...folate can mask b12's hematological changes.

So, if your MMA is high that means only one thing...LOW b12, whatever your serum B12 is.

High homocysteine means low b12 or low folate(possibly both).

Aim for a B12 of 700 at least. Its crucial for DNA synthesis, myelin synthesis,production of neurotransmitters...etc. It has a huge role in the methylation cycle.

 

In a deficiency oral supplemention should be just along with IM injections...

On various meds since 2004(Luvox, Paxil-5 years, Zoloft, Trazodone, etc) for anxiety.
CT Luvox 20th September 2013, started Klonopin 1mg (now on 0.25mg). Hellish depression, burning head, crying spells,extreme emotional rollercoaster, severe fibro-neuropathy like pains-never had any of this prior to meds. 31 months off and its worse and worse no life AT ALL.

Link to comment
Share on other sites

@arwen...1000mcg is acceptable. A quarter of 250mcg is nothing. I was taking 2000mcg along with IM injections.

 

You may feel worse at start...it takes a while...the liver stores b12 reserves for up to 5 years so if we find we are low in B12 it means we were low for at least 5 years.

 

But again this is just a small part of the puzzle. Folate has the same importance. There are people who got rid of longlasting agoraphobia with folate only to crash even worse after a few days of taking methylfolate. Its a complex thing..all is balance.

On various meds since 2004(Luvox, Paxil-5 years, Zoloft, Trazodone, etc) for anxiety.
CT Luvox 20th September 2013, started Klonopin 1mg (now on 0.25mg). Hellish depression, burning head, crying spells,extreme emotional rollercoaster, severe fibro-neuropathy like pains-never had any of this prior to meds. 31 months off and its worse and worse no life AT ALL.

Link to comment
Share on other sites

We are at the beginning of an unusual experience at our house. My 13-year-old has not been feeling well. I thought she possibly had orthostatic hypotension and/or anemia as she eats little meat and loses a bit of blood all the time in her urine for a reason the doctors haven't been able to find. In the lab work up, they did a Vit B12 level, and it was the only abnormal finding (and she does have orthostatic hypotension)...it's ELEVATED. Looking on the web, there is just no "healthy" reason for it to be elevated. It is caused by a blood, liver, or kidney problem.

 

Well, I have been on a milligram of vitamin B12 since August, built up to it gradually over five weeks. In September a new PCP ran a bunch of tests that included it and mine was higher than the machine could measure, it just came out "greater than 1500." I thought that was normal for supplementing, but apparently it is not. In my case, for several reasons, I think my liver and kidneys have just been so overwhelmed with the poly pharmacy. I have an email in to my doctor as to what I should do now. With my daughter...good practice in trying to train your thoughts not to rush ahead of where real life is. But I just wanted to throw out the possibility of too much vitamin B12 into the discussion.

1st round Prozac 1989/90, clear depression symptoms. 2nd round Prozac started 1999 when admitted to dr. I was tired. Prozac pooped out, switch to Cymbalta 3/2006. Diagnosed with bipolar disorder due to mania 6/2006--then I was taken abruptly off Cymbalta and didn't know I had SSRI withdrawal. Lots of meds for my intractable "bipolar" symptoms.

Zyprexa started about 9/06, mostly 5mg. Tapered 4/12 through12/29/12

Wellbutrin. XL 300 mg started 1/07, tapered 1/18/13 through 7/8/13

Oxazepam mostly continuously since 6/06, 30mg since 12/12, tapered 1.17.14 through 8.26.15

11/06 Lithium 600mg twice daily, 2.2.14 400mg TID DIY liquid, 2.12.14 1150mg, 3.2.14 1100mg, 3.18.14 1075mg, 4/14 updose to 1100mg, 6.1.14 900 mg capsules 7.8.14 810mg, 8.17.14 725mg, 8.24.24 700mg...10.22.14 487.5mg, 3.9.15 475mg, 4.1.15 462.5mg 4.21.15 450mg 8.11.15 375mg, 11.28.15 362.5mg, back to 375mg four days later, 3.4.16 updose to 475 (too much going on to risk trouble)

9/4/13 Toprol-XL 25mg daily for sudden hypertension, tapered 11.12.13 through 5.3.14, last 10 days or so switched to atenolol

7.4.14 Started Walsh Protocol

56 years old

Link to comment
Share on other sites

Because B-12 allegedly helped with sleep wake disorder which I seemed to have somewhat similar symptoms to, I decided to try some B-12 since it was cheap and I was desperate to stay awake.  After taking it put me to sleep during the day, I quickly ditched that experiment.   Shouldn't have done it but desperation unfortunately ruled.

 

Wow, that is interesting your 13 year old has an elevated B-12 level even though she eats little meat.   In your cause, unfortunately, it isn't surprising.

 

I guess I should be grateful I don't have much luck with supplements as I wonder if I did, if I would suffer adverse affects.   Hard to say.

 

Best of luck with everything and sorting things out.

 

CS

Drug cocktail 1995 - 2010
Started taper of Adderall, Wellbutrin XL, Remeron, and Doxepin in 2006
Finished taper on June 10, 2010

Temazepam on a PRN basis approximately twice a month - 2014 to 2016

Beginning in 2017 - Consumption increased to about two times per week

April 2017 - Increased to taking it full time for insomnia

Link to comment
Share on other sites

  • 3 weeks later...

 

Metafolin, Deplin, or Metagenics FolaPro (l-5-methyl tetrahydrofolate or MTHF) are folate alternatives for people to take who cannot metabolize the usual form of folic acid in supplements. There is no reason to take a folate alternative if you don't have the MTHF mutation.

 

These folate alternatives are quite expensive, while ordinary B12 and folate supplements are very inexpensive.

This is where I am so confused, Alto. I've been taking Deplin 15mg for about 6 years (it was added by my pdoc to my SSRI) and was only recently tested for the MTHF mutations by an integrative doctor who said I shouldn't need it if I didn't have the mutation. Well, it turns out I *don't* have the mutation, but sure enough, any time I've tried to go off the Deplin (always CT, I've tried 3 or 4 times over the years b/c, as you mention, the cost is very high), within a week, I've been crying over everything, my mood depressed, I'm more anxious. Recently, when I added the Deplin back in, I felt better within hours. So doesn't it seem that this type of folate *must* be doing something for me? 

 

I asked about it over at Ben Lynch's site and his reply was basically that there's a lot involved in mythelation; it's more than just the mutation, and if its working, stick with it....Not the most thorough or helpful response--completely vague. 

Started Zoloft 07/06, continued through 07/08 (2-month taper, going downhill 6 weeks after stopping [w/d?]) 

Lexapro started 12/08, Lexapro increased/Buspar and Topamax added in '09, continued through 08/10 (3-month taper, disastrous results after 3 week [w/d?]) 

200 mg Zoloft started around 9/10; been between 150 and 200 mg Zoloft since then, also on Topamax and Deplin, and tried things for sleep like Trazadone (worked for a while), and Ambien, Lunesta, and Mirtazapine (all failed) 

--Started tapering 200mg Zoloft--

6-26-14 (150 mg); 7-14-14 (100 mg); 8-20-14 (50 mg); 10-25-14 (25 mg); 11-18-14 (12.5 mg); 12-2-14 stopped Zoloft 

anxiety started 3 days off, depression 12 days off; both severely intensified at 5 weeks off with a work-related trigger and got progressively worse for 10 days 

Reinstated Zoloft 12.5mg on 1-15-15 (one day at 25mg) after 6 weeks and 2 days off 

Also taking 100mg Topamax and 15mg Deplin 

Link to comment
Share on other sites

  • Administrator

You may wish to taper off Deplin if abrupt discontinuation causes symptoms.

 

Given this is the B12 topic, you may wish to join the discussion in Folic acid, folate, L-methylfolate, and Deplin (vitamin B9)

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment
Share on other sites

  • 2 weeks later...

Hi guys - I am sorry if this is a duplicate post.  I read something somewhere about B12, but can't find it, despite my most fervent searches.

 

I have been on B12 injections for a year for fatigue, low energy, brain fog, etc.  Since then, I began tapering at 10% every 4 weeks.  The B12 helped the energy, but I had a lot of edginess, morning dread, anger, hyperness.  I quit the injections a week or two ago, but I am back where I was before the injections with extreme fatigue.  In fact, all I can do is sleep.  Feel groggy, can't think, can't focus my eyes.  I took some sublingual B12, but it hasn't really helped.

 

I am thinking of taking my B12 shot again because I can't be sleeping all the time!  I thought, looking back, that the Paxil caused the low energy as it is sedating and now that I am on a lower dose, I have more energy.  I do normally have super high energy with the B12.  I am afraid this is my future without B12 - sleeping, listlessness, low libido, sluglike.

 

Does anyone have any experience with this?  I think I read Alto had an article about B12 deficiency causing something - maybe depression.  Maybe that's what I am feeling?  Any help is appreciated.  Can't keep up with my kids or my life at this rate.

1998- Began taking 20 mg. of Paxil for homesickness 2001-CT and crash/hospitalized 1 week for anxiety. Tried quitting, changing to other ADs, gave up. 2014 -Weaned @ 10% every 4 weeks. Latest 5-14 11.7 mg., 6-14 10.5 mg., 8-21 9.5 mg., 9-17 7.7 mg.,10-14 6.9 mg., 11-14 6.2 mg., 12-14 5.6 mg., 1-15 5.0 mg. 2-15 4.5 mg. (miscalculated may actually be 3.3), up-dosed to 3.7 3-17-15. Hydroxyzine HCl 25 mg. as needed (antihistamine) for anxiety.

Link to comment
Share on other sites

  • Administrator

a-mom, here is the topic you were looking for.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment
Share on other sites

Yay!  Thank you!  I ended up taking my B12 injection after reading about it's helpfulness with depression and positive affect on nerves and nerve cells.  I can't believe I felt so bad when I was NOT taking it.  Does this mean that it was in fact helping with my depression/mood problem?  Although I have been on Paxil 16 years, the way I felt was reminiscent of the way I felt BEFORE Paxil - slept a lot, sluggish, depressed...  I didn't notice an effect on anxiety.  I don't have anemia or any diagnosed medical condition.  A naturopath is treating me for fatigue and hormonal deficiencies.

 

In my web-stalking about this topic, I found an interesting article on a woman who was on all sorts of psychotropic medications and electric shock therapy for severe depression, auditory hallucinations, etc., and nothing helped her at all.  She was diagnosed with B12 deficiency, had an injection (or series of them), and was completely "better" in a short period of time.

 

I am sorry if this is in the wrong place BTW...

1998- Began taking 20 mg. of Paxil for homesickness 2001-CT and crash/hospitalized 1 week for anxiety. Tried quitting, changing to other ADs, gave up. 2014 -Weaned @ 10% every 4 weeks. Latest 5-14 11.7 mg., 6-14 10.5 mg., 8-21 9.5 mg., 9-17 7.7 mg.,10-14 6.9 mg., 11-14 6.2 mg., 12-14 5.6 mg., 1-15 5.0 mg. 2-15 4.5 mg. (miscalculated may actually be 3.3), up-dosed to 3.7 3-17-15. Hydroxyzine HCl 25 mg. as needed (antihistamine) for anxiety.

Link to comment
Share on other sites

  • 2 months later...
  • Moderator Emeritus

I haven't read this thread yet - I'm looking for something else and stumbled onto this - but I wanted to comment that I had a crash this week.

 

And I wondered - since I've been taking sublingual B12 (I am NOT in SSRI withdrawal), I have to keep it separately from my other tablets, the ones in my tray, because it melts and makes a gooey mess.  So I keep the bottle NEXT to the tablets.

 

On the day in question, I forgot to take my B12.  For whatever reason.  

 

And I wonder about the contribution to my crash.

 

I'll read more here soon.

"Easy, easy - just go easy and you'll finish." - Hawaiian Kapuna

 

Holding is hard work, holding is a blessing. Give your brain time to heal before you try again.

 

My suggestions are not medical advice, you are in charge of your own medical choices.

 

A lifetime of being prescribed antidepressants that caused problems (30 years in total). At age 35 flipped to "bipolar," but was not diagnosed for 5 years. Started my journey in Midwest United States. Crossed the Pacific for love and hope; currently living in Australia.   CT Seroquel 25 mg some time in 2013.   Tapered Reboxetine 4 mg Oct 2013 to Sept 2014 = GONE (3 years on Reboxetine).     Tapered Lithium 900 to 475 MG (alternating with the SNRI) Jan 2014 - Nov 2014, tapered Lithium 475 mg Jan 2015 -  Feb 2016 = GONE (10 years  on Lithium).  Many mistakes in dry cutting dosages were made.


The tedious thread (my intro):  JanCarol ☼ Reboxetine first, then Lithium

The happy thread (my success story):  JanCarol - Undiagnosed  Off all bipolar drugs

My own blog:  https://shamanexplorations.com/shamans-blog/

 

 

I have been psych drug FREE since 1 Feb 2016!

Link to comment
Share on other sites

×
×
  • Create New...

Important Information

Terms of Use Privacy Policy