Treating b12 deficiency. I may have REALLY messed up.

on 1/10/20 4:26 pm - savannah, GA
RNY on 12/04/12

First off I have to admit something awful. I am either 7 or 8 years out from my rny and I have been terrible with vitamin compliance. I've probably only had a total of 6 months of b12 supplements. I don't know why, it's the dumbest thing I've done so far. I guess it was the mind set of gaining weight means if I can absorb calories then it's getting what it needs. I'm a nurse, I know that's not true but I guess I just messed up. Recently I started feeling extremely tired. Ive never taken naps and all of a sudden had to sleep halfway through the day. So I decided to go back on my vitamins. Bariatric multis and dry d3 and sublingual b12. I've been back on about a week now and no longer napping but now my body feels terrible. It stated with my feet tingling and burning, random itches, foot and hand vibrations and *****ling. Tonight I've been hit with yawns, yawns that won't stop for almost an hour even though I'm not sleepy. Im assuming these symptoms are from the nerve impulses restarting, I don't know. Ok so another big problem is that I have no health insurance, none. It's not available to me, so my choices are deal with it and hope for the best of go to ER. Doesn't seem like an ER problem but I just don't know if it is something I can get under control on my own. Does anyone have any experience treating a severe b12 deficiency and did you have anything like this happen?

-Anna  HW: 401 | SW: 377 (12/04/12) Blog:










H.A.L.A B.
on 1/10/20 5:43 pm

Sorry you are dealing with that. Sometimes even smart people do irresponsible things.

I hav ed been talking b12 since right post op, and 2 years post op I disco5that my body doesn't store well the B12 and I started gettweekly B12 shots. Even sublingual, up to 5000 IU aper day, my b12 stayed around 400-500. With weekly injections my B12 is now around 900-1100, when tested app 7-8 days after injection.

Beside B12, B1 is also very critical for nerves.

I understand you don't have insurance but I would get labs done paying cash.

Places like quest, or labcorp can take your blood and test it, if not for every vitamins, but for some that are critical.

Like with almost anything, not enough can be bad, but too much can also create a problem. Without testing, knowing the current status of your vitamins and minerals, it is very difficult to guess what can be causing your issues.

Hala. RNY 5/14/2008; Happy At Goal =HAG

"I can eat or do anything I want to - as long as I am willing to deal with the consequences"

"Failure is not falling down, It is not getting up once you fell... So pick yourself up, dust yourself off, and start all over again...."

Laura in Texas
on 1/10/20 6:45 pm
RNY on 09/17/08 with

On your profile it says you are in Savannah, Georgia. I just googled health care clinics in Savannah, GA and this one popped up:

Have you contacted them? It says "Services are provided at an affordable rate to qualifying uninsured, under insured, and homeless persons with limited income".

If this is no longer where you live, search for clinics near you. Many "Planned Parenthood" offices offer annual wellness visits.

As Hala mentioned, you can order labs yourself. I just checked and the B12 test is $26.

Laura in Texas

53 years old; 5'7" tall; HW: 339 (BMI=53); GW: 140 CW: 170 (BMI=27)

RNY: 09-17-08 Dr. Garth Davis

brachioplasty: 12-18-09 Dr. Wainwright; lbl/bl: 06-28-11 Dr. LoMonaco

"May your choices reflect your hopes and not your fears."

on 1/10/20 8:57 pm


Do not beat yourself up. There are plenty who will do that for you. Now is the time to start fixing the problems. You can do this. Will it be fast or easy- NO. It is already encouraging that you are beginning to get some responses. Read thru and do your own research...since you have no medical team..I can give you my input and my schedule/reasons for my findings.

I identify completely. In caring for others we often neglect ourselves... I was a nurse for 20 years and got out, in a few more years I became a caregiver for my husband for a while and then both parents in addition..Like you I got in trouble. There were not enough hours in the day to care for Myself PLUS, 2 completely helpless adults and one with severe neuropathy. It has been a long ride to get my strength and iron back up.., Parents passed 4 years .ago and before i recovered ,hubs became very ill. After extensive ablation surgery(2 year recovery) he is finally doing much better...I have frequent gastritis,.. experimenting with additional enzymes to reduce the gastritis from food intolerances... and do not tolerate all my vitamins daily...I take iron about every other day in some form.. Tonight i had turkey liver from a fresh baked turkey..Epsom salts foot soaks will give magnesium without a pill to take. and stop muscle cramps from a change in activity level.

I am no longer short of breath on longer stay dizzy, or have postural hypotensiion. I am still pale, already the lightest skin tone.My racoon eyes are lightening.My refills are improving. I do still crave ice chips...Currently down to about a gallon a day from a high of 5 gallons..(when.working in excessive high temps.)

I had my early WLS surgery 24 years ago.I lost all medical insurance 3 months later.I have had insurance for 1-2 years at intervals between...but am now in a 5 year lack.

They found my severe anemia in 2000, , HGB was so low internist would not give me any results until after he had transfused 2 units of PRBC's/I also had a twisted intestine, so ended up with tubes from both ends. one for oil enema and other to low intermittent suction x 5days.. That gave me a hemoglobin of 8.7 and within 6 wks. a diet of liver , 2 ounces 2x a day had brought it up to 9.2...( i made liver patties like mackeral or salmon (.one lb chicken liver. eggs, vanilla or chocolate protein supplement, a little flour,- enough to thicken, chicken seasoning.-blend) and put them on a hot griddle and cooked thoroughly in small portions.i froze them and made a new batch each week.y pre teen daughter even loved them!)

The best OTC supplement i have found is desiccated organic is available from buffalo or beef, 180 capsules cost around 21$..(use start page search bar)... Dose on my bottles says 2 caps are a dose. (up to 3 times a day , IF tolerated... be sure to add these slowly..).I take 2 caps a day/ i do not eat liver enable s me to absorb iron from the rest of my food. I have a loss of most of the intrinsic factor,According to the INTERNIST who treated me... ( Is a side effect in some people, of major gastric surgery) which is required for utilization of iron. People with Crones' disease and who have had large portions of intestines removed sometimes lack this enzyme .. Foltrin( a rx) works but it is too strong for me to use now... it has the intrinsic factor. Some Maternal -pre natal vitamins have the intrinsic factor., most of them are horse pills and i can not swallow the larger ones..Walgreens has large prenatal with intrinsic factor.. I have band at base of esophagus... so can not swallow them without feeling like it is stuck.

. I would use a sublingual B complex... avail at dollar general for about 5$ @ double the dose.( one cc listed on bottle..)..It has high B-6 which is used for nerve rebuilding....since already having some changes from just B 12.

Remember, we learned in nursing school that gastric secretions destroys much of the B that enters the GI Tract. Yes we have been re -routed. but we do know that sublingual is absorbed under the tongue and mucus membranes of the mouth. You already know that coffee and Tea both will block absorption of iron.

Tingling..twitches, itches all are nerve responses. Has your blood sugar been off..?... either low or high will give early neuropathy.. I am also having beginnings of neuropathy mine is primarily pin *****s...My blood sugar has been unstable for 40 years. a constant struggle...low more than high..My Hubby uses lions mane and astralgus for nerve pain... look them up and do your research.Neither are expensive. They are most effective when used early in nerve distresses.

Hope this gives you some places to start... and encouragement for the journey. Take care of yourself. There is only one YOU.

on 1/11/20 11:45 pm

St. Johnswort (the flowers and topmost aerial parts, in capsules or tincture - standardization is not necessary here) is also a specific for peripheral neuropathy. Nerves rebuild slowly; 6 months of herbal use is not unusual. I am still unsure of how our altered guts utilize these plant medicines - are we in need of higher doses, similar to our need for higher levels of vitamins? I am not familiar with research done on this topic, though there likely has been some done, perhaps by the Germans (who are very pro-herbal medicine). At any rate, wishing you the best of health.

on 1/12/20 6:21 am

St Johnswort IS one option, I just don't tolerate it.. tried it a while back. The mushroom is a food... and the astralagus is a adaptogen... adaptogens do just that adapt to the need off each person regulating various functions..There are reasons to avoid some.. If one has a fever should not take them- because they will cause the fever to remain.

.. Herbs and Naturals have many options.Research of r-ALA used at 600mg range 2x a day is often prescribed by naturalists. It takes about 2 mnths for it's effectiveness to be known individually. One side effect that is common from it is dropping of blood pressure.. My hubby has been fighting neuropathy since toxin exposure daily in water and living conditions or 40yrs. Much of info i have on this is from his trials. Continual nerve pain to the groin has been reduced to continual nerve pain at sock level....

For people in beginning stages of neuropathy pin *****s, shock sensations, itches...need to find a restorative for nerve rebuilding, quickly-as this is very progressive. The myelin sheath is attacked and the nerve is exposed and dies . The search for Myelin sheath rebuilders is key to "undoing" the damage.

on 1/13/20 3:44 am
RNY on 08/21/12

Treating B12, or most other vitamin deficiencies, is not difficult. Any sublingual B12 will get the job done.

But how much to take is impossible without getting labs drawn. Most things aren't dangerous if you take too much, but some things are.

If you are 7 or 8 years out, have been bad at taking supplements, and have not had labs done, you really, really need to. Really. Then you can take proper doses, or whatever else you have to.

6'3" tall, male. Maintaining a loss of 280 pounds.

Highest weight was 475. Consult weight 04/12 was 411. RNY on 08/21/12 at 359 lbs. Current weight 195.

M1 -24; M2 -21; M3 -19; M4 -21; M5 -13; M6 -21; M7 -10; M8 -16; M9 -10; M10 -8; M11 -6; M12 -5.

on 1/13/20 3:14 pm

Hoping you get the answers you are looking for, above. Everyone has some really great information to provide.

LisaK/ UnstapledLisa
on 1/14/20 6:37 am - plymouth, MN

As others have suggested try to find a low cost clinic, also there are wls vitamin companies that are willing to work with bariatric patients.

I did take my vitamins and still couldn't orally supplement enough, so I had to be supplemented with IV b12 and ferritin for years.

I did get irreversible neurological defects from being so low in b12 for so long and I do know people who died from vitamin deficiency by not taking their vitamins.

I have a different take which also doesn't include shame when it comes to non compliance with vitamins.

I honestly believe it's a form of self sabotage one that most people don't realize they need to talk over sometimes with a mental health professional.

I realize certain things happen to some in the wls community and not to others and it's normal to think either complications or weight gain can't happen to oneself.

But if you wouldn't get in a car (which I can NO longer drive due to the severity of neurological issues I ended up with because of severe deficiencies) without proper fueling it with gas and oil, it may take some serious introspection with professional assistance or reaching out to the community like you are now.

This does not resolve on it's own, ever. You have to somehow figure out how to get in all your vitamins and how to make sure you absorb them by getting labs done.

It's not something that also necessarily stays hidden, meaning for how bad you will feel on the inside, it will start showing on the outside, no matter how much weight one keeps off (or even if they regain, wls peeps have to take their vitamins and making sure they are absorbing them, for the rest of their lives) as it will age you on the outside.

I had to take vanity out of the situation in my case with the issues I had, because it didn't matter how good I looked once I got as sick as I did. Then the opposite happened and I got sicker than I ever dreamed and nearly died a very long slow death due to complications.

So I am saying in the kindest way, you need to at least get physical help with getting vitamins in you and then seeing if you are absorbing them, a refusal to do that, you really want to think about why there may be self sabotage going on by not taking them.

Keep asking for support and help as you need it, that's why so many forums exist for wls support, it's not just to support preops or newbies, but wls peeps, lifelong.

peace. Lisa