High B12??

My primary dr called me just a few minutes ago (I needed a note to go over to the hospital to have 2 of the things on my 2 year lab list drawn at the hospital since my dr's office cant) anyhow she commented that my other labs already came back and that my B12 was 1288 and that it was to high and that I don't need B12 ever again (I think she said that jokingly). 

Anyhow why would my B12 be so high?  I am supposed to be malabsorbing?  Plus I sometimes skip my liquid B complex cause I forget to take it.  So I don't even take that daily.  But I do get it in a few times a week per instructions on the bottle, no more no less. 

So what else could cause this?  Only other vitamins I take are the regular ones, Centrum chewable multi, iron, calcium and protein.  Oh and the D3 I take prescribed to me. 

Anyone else?  It's 2 years post op. 

Any input would be nice.  Should I worry?  I will need to see the rest of the results because I want to know about my other Bs.  I don't want to stop taking my B complex completely because we need all the Bs you know.

Ahem....sorry, but your doctor is an idiot!  There is really no such thing as b-12 being too high, what your body doesn't need you eleminate. When I had mine drawn for my 3 yr labs, it was 1488. Six months ago it was over 2000. Both of my doctors said they didn't have any problem with it being high, keep doing what I'm doing.

Yes, you malabsorb, that's why it's so important that you get your levels up and keep them there. What if you got sick? You need for your body to be prepared for what ever comes your way.

I say keep doing what you're doing.

I agree with Susan......
 

What is the health risk of too much vitamin B₁₂?

The Institute of Medicine of the National Academies did not establish a UL for this vitamin because vitamin B₁₂ has a very low potential for toxicity. The IOM states that "no adverse effects have been associated with excess vitamin B₁₂ intake from food and supplements in healthy individuals" [7]. In fact, the IOM recommends that adults older than 50 years get most of their vitamin B₁₂ from vitamin supplements or fortified food because of the high incidence of impaired absorption in this age group of vitamin B₁₂ from foods that come from animals [7].

Here is the website   http://ods.od.nih.gov/factsheets/vitaminb12.asp

Thanks for the info.  I will keep doing what I am doing until Dr Baker or Addie says different.

I'm with you on this one. My B-12 is 2800. I know, outrageously high. I now take my sublingual B-12 on Mon., Wed., and Fri. I would rather it be high than low. I take 2 Centrum (WalGreen's brand), B Complex and Calcium daily. That's it. Luckily my iron is fine so thankfully I don't have to take it. Thank God because the constipation I have is so bad, I don't know what I would do if I had to take iron. I used to take 9 stool softeners a day. Now I have switched to Metamucil (with sugar cause I don't dump on sugar- just fat) and eat a Kelloggs Fiber plus bar daily. That seems to be better.

Tina

yeah, that iron can just you if you have problems with constipation. I Have been taking iron just for when im on my monthly cycle because I have been getting so drowsy and dizzy and very weak, and the heavyness just kills me and is so embarassing.... But, the constipation kills me everytime I take that iron no matter how much liquid I drink.... I just dont know what to do???? I hate to have to suffer through aheavy period, and the iron does help but then I suffer with constiaption.... Any help or ideas????

She is incorrect and you should absolutely NOT stop your B-12 supplements.

Importance of B-12
B-12 aids in the production of red blood cells AND the ability ability of the blood to carry oxygen.  Those are fairly important functions for the human body.  

B-12: Normies vs. RNY post-ops (also DSers, etc)
Most people have stomach acids that enable B-12 to be released from protein rich foods.  But "most people" have not had RNY.  RNY post-ops (and also any patients on medications that significantly reduce stomach acid production such as GERD & anti-convulsant meds, etc) do not have the necessary quantities of stomach acid to release the B-12 from protein rich foods (lack of sufficient hydrochloric acids mean that the pepsinogens can't be converted to pepsin which is necessary for the B-12 extraction from protein).  Ergo, we can't extract B-12 from food the way most normies can. 

Most people have sufficient intrinsic factor that allows B-12 to be absorbed in the terminal ileium.  (Intrinsic factor is produced in certain areas of the stomach, etc.)  Intrinsic factor is impaired in RNY post-ops: therefore B-12 cannot be absorbed in the terminal ileum. 

So, not only can we not extract the B-12 from protein sources: we could not absorb it in our terminal ileum even if we COULD extract it.  So RNY post-ops should ALWAYS supplement with B-12 because they will NEVER be able to extract and absorb B-12 the way normies do.  (Even if you get lucky with being able to extract it better than most post-ops, what is the likelihood of you also getting lucky and being able to absorb it better than most post-ops.  That would be an almost impossible coincidence of unbelievable luck x 2.)

The malabsorption will NEVER GET BETTER with regards to this.  Producing adequate amounts of stomach acids or intrinsic factor is not a matter of the body compensating for absorption. 

B-12 stores vs. B-12 usage (How long does it take deficiency to occur?)
B-12 stores can last for a long time (3 - 5 years).  This is because the body stores large amounts of B-12 in relation to how much B-12 the body actually uses. 

The average body USES very small amounts of B-12 per day (2.4 ug/d).  By contrast, the average body STORES very large amounts of B-12 (2000 ug).  That alone should tell us how important B-12 is to the human body - that it keeps that much "in stock" when it is only pulling such a small amount "from inventory" every day.  It must be REALLY important not to run out of that particular "item". 

So with stores that average 2000 ug, it may take your body a while to become deficient.  But if/when you do, it may already be too late due to the way vitamin levels are checked (via the blood).  B-12 is stored in the body's organs (just as calcium is "stored" in bones).  When the BLOOD gets too low on B-12, it pulls it from the body's organs (just as it pulls calcium from the body's bones when it becomes low in calcium).  So the BLOOD is the LAST PLACE that ALMOST ALL VITAMIN DEFICIENCIES will show up.  (I'm not bashing blood testing as a method to check vitamin levels.  It is currently the best way to test vitamin levels on a LIVE body.  I certainly don't expect them to cut out a hunk of my kidneys or liver every year to test actual B-12 levels or chip off some bone every year to test my calcium levels.)  My point is, since the blood is somewhat of a leach as far as vitamins are concerned - it sucks what it needs from everywhere else.  So by the time the BLOOD is telling the blood tester (via results) "there's not enough B-12 here"... there is REALLY not enough B-12 there.  By that time, there is hardly any "on the shelf", there is NONE "behind the counter" OR "in the back".  So then you have to scramble ordering a truck to restock your store before you run out completely.  He may or may not be able to bring you enough in time.  Only the consequences if he doesn't is much worse than an irate customer.  But I'm rambling.

What is MOST troubling?  According to most studies, the prevalence of B-12 deficiency INCREASES every year.  This is probably partly due to how long it DOES take for someone to go deficient (according to their blood work), but also probably due to non-compliance with long-term vitamin supplementation.  I also believe part of it may be due to LACK OF or MIS-information by patients and medical staff.  (Example: Your lady telling you you didn't need it ever again - even jokingly.  Also many post-ops mistakenly believing that they are absorbing their vitamins better as time passes: the body compensates for micro/macro absorption differently and we will NEVER compensate for vitamin/mineral malabsorption the way we do typical absorption.)

Side Effects of B-12 deficiency (just to name a few of the more horrific)
polyneuropathy
paresthesia
PERMANENT neural impairment
extreme delusions
hallucinations
overt psychosis

When to worry (when are RNYers deficient)
B-12 deficiency is typically defined at levels <200 pg/mL.  HOWEVER, about 50% of patients with obvious signs & symptoms of deficiency have normal B-12 levels.  So even when 50% of people's blood work may still be telling them that they are fine... they are obviously not fine.  Not everyone is the same and about 1/2 apparently need a little more B-12 than the rest of us and no one knows who that 1/2 is until it's too late.  Do any of you really want your right leg paralyzed or to start seeing sponge bob square pants laying in bed beside you before you realize, "Oh crap.  I did need more B-12.") But again, I'm rambling. 

Since the blood is the last place any deficiency shows up, I personally start to worry when ANY of my labs (other than B-12) come back on the low end of normal OR if I see a steady downward trend in any of my labs.  For B-12 specifically (and any of the B vitamins really), I worry anytime they are not "high".  (B-12 is water soluable with no upper limit established because it is next to impossibly to OD on B-12.  Your body expels what you don't need: ergo you pee it back out.) 

I use an excel spreadsheet to track my lab results every time they are done.  That way I can see for myself whether or not I'm starting a trend downward, etc.  This way I can help head off trouble BEFORE it starts instead of scrambling to TREAT trouble AFTER it starts. 

Personally, I take 5 500ug sublinguals of B-12 each morning.  (I know that's just equivalent to 1 "superdose 2500ug sublingual", but the smaller ones dissolve under my tongue better.  So I do 5 regular sublinguals instead of the 1 superdose bigger sublinqual.)  My labs show me "high" on B-12 every year.  Since it's B-12 though, that's a good thing. 

If you'll notice on yours labs, most ALL of them have an "acceptable level" where there is a lowest through highest range.  If you are below the "lowest" number, it says "LOW" next to it.  If you are above"the "highest" number, it says "HIGH" next to it.  Now look at your B-12 lab results.  There usually IS not lowest through highest range.  Depending on the lab, it usually just says "above 800" or ">1200" or something like that, then it has "LOW" or "HIGH" next to it.  There is not lowest through highest number range - or if there is a lowest range, there usually is no highest.  I have had mine done at a couple of different labs and each did it different - but NEITHER had an "upper range" limit for B-12 because there IS no upper range limit for B-12.  I'm rambling again.  Sorry.

Anyway, the article about bariatric nutrition and vitamin supplementation is a good source to read about this kind of stuff. 

Hope that helped and hope this finds you still taking your B-12.

Wen

Thanks Wendy for all the info.  I'm still taking my B complex. 

The B-12 in a B complex vitamin doesn't count.  RNYers can't absorb that. 

We have to rely on passive absorption (sublingual, injection or nasal spray).