Question:
Do we still produce intrinsic factor?

I was wondering whether or not we still produce intrinsic factor and how (if at all) does it affect our absorbtion of B-12? I have a friend that doesn't produce it anymore and says that her doctor says that people who don't have the intrinsic factor anymore don't absorb enough of sublingual B-12 for it to really make a large difference and that we should be doing B-12 injections instead. I was wondering if this is true or not? Thanks!!    — Christie N. (posted on April 16, 2003)

April 16, 2003
OK, let's sort this out. If you are under 50 and still have your loweer stomach intact (even if transected), then yes, you produce B12 (unless you have a disorder of some other kind). If you have had the lower portion removed, then no. OK, that's one issue. The other is that the B12 food sources have to be able to mate with the IF in order for B12 to be absorbed. THAT is what we cannot do. Mate them together. So, swallowing a pill or liquid doesn't help. If it worked, you could do liver. (note I said YOU, that would not be ME). However, you could eat B12 sources all day & do no good. B12 subligually works for many people, IF You are faithful to it. B12 injected sub cu (short needles) gets about 80% absorption, but IM gives you 100%. The only way to know your own particular status is by checking your labs. And I mean, checking with your own eyes. I started shots when my levels hit 330. (normal is aout 200, less than that & you "feel" sick). It took several months to figure out the correct frequency for me. I spotted it long before any of my docs noticed it. They'd have waited til it went below 200. I did not want to "feel" sick. And so far, have felt no ill effects.
   — vitalady

April 16, 2003
My surgeon must have an opinion on this. I would assume that we do have inhibited IF. He prescribes a post-op vitamin (Ferocon/Trinsicon) that contains IF, so that the iron and B-vitamins in the capsule along with it are properly absorbed. The vitmains are designed for use in ppl with 'gastrectomy', which presumably includes WLS patients.
   — Patricia E.

April 16, 2003
Ahh this is a big question that appears to have no clear cut answers. I asked my surgeon about this. I take regular pills by mouth and my labs are great. I take 2 pills daily. Some people cant do this and there B 12 sink. My surgeon says its individual to the patient, but most of his patients are like me, fine on regular pills by mouth. Do get your labs checked regurally whatever you do. BTW my wife gets 2 shots a month, she refuses for whatever reason to take the b 12 pill. Its so small and inoffensive I really dont understand it.
   — bob-haller

April 17, 2003
I have the same surgeon that Bob has. I swallow a pill every day, B12 500mcg. and my 6 months B12 level was >2000. So it is absolutely NOT true that you have to do SL or shots. Everyone is different and things do change, so never stop getting your labs done.
   — Dana S.