b12 - sublingual or tablet

Smiller's post got me thinking about my B12, and now that I'm a couple of months in, I bought a tablet B12 instead of a sublingual.  Does anyone know if there is an issue that we need to continue with sublinguals for best results?  I was working under the assumption that the sublingual was necessary right after surgery (like chewables) but that normal pills other than the horse size are equally effective if tolerated.

Thoughts?

Brian,

I had a problem with B-12 absorption before surgery, so I was already taking a pill every week, plus a shot once a month. Post-op, I take two sublinguals a week, plus my monthly shot. Between them, I am getting enough in.

Personal belief, sublingual, like a liquid, gets into your blood faster and I don't have to worry about it not dissolving / absorbing before passing. My Dr. nor my nutritionist have advised me to change up.

Hope that helps.

I prefer the liquid B12 myself.  Second choice is the sublingual.

What I understand is that B12 is normally absorbed by the part of the intestine that is by-passed in RNY. That is why you need the sublingual B12 rather than tablets.

Fortunately, B12 is relatively inexpensive, so it's not a problem to purchase the sublinguals.  Thanks for the info!

The only isssue that I have with our sublinguals in that they're too sweet. 

Now I am taking a monthly shot.  After 1 yr out will go with the sublinguals.

And Jason life is GOOD east of the bay LOL. I'am on the wrong side

Life is definitely good east of the bay. Unfortunately, I work on the wrong side and see no hope of that changing anytime soon.

To digest the B12 we need stomach acid, that is why they do the RNY instead of the old stomach stapling, it hooks the stomach back into the small intestine.  With the 2 1/2 feet not in the digestive tract we have a problem getting the B12 out of our food but the pills work just fine.  My mother had stomach stapling in 1981 and needed a monthly shot until they came out with the sublingual, but us RNYers do great with the pills.

I am 5 years post and have only used the pills and my blood work shows my B12 way above average.

There is no evidence that "sublingual B12" is actually absorbed sublingually (B12 is a charged, polar molecule and fairly large, which suggests that it can't be absorbed through mucous membranes).  There is a lot of evidence that oral megadoses of B12 (whether by nasal spray, "sublingual" or just plain oral tablets) are absorbed adequately in an intrinsic-factor-independent way simply by mass action.

Taking at least 500-1000 mcg (i.e. 0.5 - 1 mg) of B12 as an oral tablet should yield results indistinguishable from the same amount as a sublingual tablet.  There's nothing wrong with "sublingual B12", but there's also no difference between it and an ordinary oral tablet of B12 which you swallow directly.  In both cases, the B12 enters the gut in such large quantities that a physiologically adequate amount will be absorbed even in the absence of intrinsic factor and stomach acid.

I take 1000 mcg of B12 as an oral tablet daily, and if anything, my B12 levels are supraphysiologic: 1300 pg/mL.  At 18 mos. post-op, this is no different from my 3 mo. post-op labs when I was taking 1000 mcg sublingually.

/Steve