Get Daily Dallas News HeadlinesSign Up “I can’t get vitamin B12 injectable for my patients with pernicious anemia because it is all on back order” a physician told me last night at a medical meeting. Well, this has never happened before. Where did it go? My doctor-friend had 4 patients with such significant vitamin B12 deficiency that they were losing sensation in their legs and had sufficient weakness that drove them to seek medical therapy. She could find no (vitamin) B12, presumably due to some kind of local or national shortage.Detective Dr. Sadler may have found the answer.In my emails that day was an ad for vitamin B12 injections for “energy” at a local health spa. Does Vitamin B12 really give you energy? The second “really” was for my dry humor emphasis.For as long as I can remember, outside of professional medical practice, vitamin B12 benefits have been advertised to give you energy and stamina. I spent a lot of time last night researching reputable information sources on vitamin B12.
After an extensive review of the literature, I found no significant medical studies to support Vitamin B12 and energy enhancement in otherwise normal individuals. Of course, there is information available, but please review its sources and carefully review the content. Nothing I found was impressive. If you find something, please email me.Is there a placebo effect with taking vitamin B12? In medical school, a spent a month with a physician team located in a small mid-western town of 1200 people. A significant source of the physicians’ income came from giving anybody and everybody that beautiful amber-red injectable material called “vitamin B12”. I don’t think they felt any better than my patient Monday who was told to take colloidal silver for energy. The placebo affect works.Is there danger in taking too much vitamin B12? Megadoses of vitamin B12 carry very little risk but toxicities have been reported in vitamin B6, which occasionally accompanies a high dose vitamin B12 tablet.
Refer to my previous blogs on vitamin /supplement safety. Remember from previous blogs that people on multiple supplements/vitamins have shorter lives than those who choose to get their nutrients from natural sources (foods).In my patient presenting with leg numbness and weakness along with fatigue and documented lab abnormalities consistent with vitamin B12 deficiency, that amber-red solution is a “miracle”. I am grateful for it. My medical friend with multiple patient needs for the injectable B12 will have to wait until there is more available. In the meantime, B12 tablets will have to suffice.For those of you who feel you need a “shot” to feel better: we are finding that oral vitamin B12 is as good as B12 injected. Even people with intestinal problems related to malabsorption (loss of intrinsic factor). Just remember, in a typical Western diet, a person will eat much more than the recommended daily allowance and they will maintain a large vitamin B12 reserve, which can last between 2-5 years.
People at risk for Vitamin B12 deficiency include those with:: third world countries sufferers, elderly patients on limited diets, and strict vegans : gastric bypass patients, people with prolonged use of acid blocking meds such as Zantac and Prilosec : chronic indigestion, recurrent stomach ulcer patients or those with chronic diarrhea, among many othersAre you tired all the time? Do you believe you suffer from vitamin B12 deficiency? Please go to your physician’s office and get tested. But don’t just get tested for a vitamin deficiency as you should consider there are many other health issues including heart and lung problems, iron-loss anemia, depression, etc that could be the cause of your symptoms.You may choose to pay for an injection, but the truth is that oral vitamin B12 is absorbed as well or “better” for your purposes. It is also far cheaper than paying for a prescription medication and the cost of injecting it.So, please, leave the injectable vitamin B12 in our medical offices.
Our supplies are running low. Home Drug Shortages Cyanocobalamin Injection Last Updated: July 14, 2015 Products Affected - Description There are no products affected. Reason for the Shortage American Regent had cyanocobalamin injection on shortage due to manufacturing delays.1 Fresenius Kabi has cyanocobalamin injection available.2 Cyanocobalamin injection, American Regent 1000 mcg/mL, 1 mL vial, 25 count (NDC 00517-0031-25) 1000 mcg/mL, 10 mL vial, 25 count (NDC 00517-0032-25) American Regent has cyanocobalamin 1 mL, 10 mL and 30 mL vials available.1 Fresenius Kabi has cyanocobalamin injection 1 mL vials available.2 Implications for Patient Care Cyanocobalamin is used to treat vitamin B12 deficiency, including pernicious anemia.3 Cyanocobalamin nasal spray is not labeled for initial treatment or patients with vitamin B12 deficiency that includes nervous system involvement.4 When switching patients from cyanocobalamin injection to the nasal formulation, ensure patients understand differences in dosing as well as how to administer.
Alternative Agents & Management Consider reserving supplies of cyanocobalamin injection for patients who require initial treatment, or patients who have nervous system involvement. Cyanocobalamin nasal spray (Nascobal®) may be an appropriate alternative for patients who have successfully received treatment with cyanocobalamin injection and have no nervous system symptoms. The dose of cyanocobalamin nasal spray is one spray in one nostril once weekly. Ensure patients understand priming requirements.4 Copper Injection — Resolved — No Commercially Available Preparations American Regent (personal communications). March 31, April 13, June 21, July 22, August 10 and 23, October 10, November 10, and December 12, 2011. January 31, March 5, April 11, May 18, June 29, July 16, September 5, October 4 and 26, November 5, 12, and 28, and December 10, 2012. January 2 and 23, February 20, March 29, May 30, June 18, July 23 and 31, August 8 and 15, September 10, 17, and 25, October 28, November 5 and 26, and December 19, 2013.
January 2, 14, and 20. February 10 and 28, March 12, April 22, May 27, June 19, July 28, August 27, September 24, October 23, November 4 and 26, 2014; January 9, February 25, April 3, May 19, and July 14, 2015. Fresenius Kabi (personal communications). January 30, March 5, April 11, May 18, June 28, July 16, September 5, October 4, 11, and 30, November 5, 12, and 28, and December 11 and 21, 2012. January 24, February 20, March 29, May 29, June 17, July 22 and 30, August 8 and 9, September 10, 18, and 25, November 1, 4, and 26, and December 20, 2013. January 2, 13, and 20. February 4 and 28, March 11, April 21, May 28, June 17, July 25, August 22, September 24, October 23 and 29, November 26, 2014; January 7, February 24, April 3, May 20, and July 9, 2015.In: McEvoy GK, Snow EK, Kester L, Litvak K, Miller J, Welsh OH, eds. AHFS DI (Lexi-Comp Online). Bethesda, MD: American Society of Health-System Pharmacists; Nascobal (cyanocobalamin) nasal spray [product information]. Spring Valley, NY: Par Pharmaceuticals;