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OK, thanks for the heads up with that. Over the years I have failed consistently with B12. I reallly dislike taking the pills, which leads to me not taking them, so then I never know if B12 is helpful or not. I could tolerate shots a lot better. 

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Taking B vitamins can be tricky without getting blood levels and also checking your genetics to determine if you can properly metabolize B vitamins. There are pretty critical genetic mutations that may require you to take specific forms of B vitamins. I would recommend going to your doctor and having B6, B12, folate, methylmalonic acid, and homocysteine levels checked. These data points will help you to determine if you need supplemental B vitamins.

For example, I have COMT and MAO-A mutations that greatly inhibit my ability to break down serotonin, norepinephrine, epinephrine, and dopamine. Taking methylated B vitamins can help my cause. I'm about to go have my levels checked to see if I should start taking it.

As @jt07 pointed out, a lot of the over the counter forms of B12 come as cyanocobalamin. However, some people can't metabolize this well and need methylcobalamin. The same can be said for vitamin B6 as well as folate which is usually present in over the counter supplements as folic acid. Some people can't metabolize folic acid and folic acid supplementation can actually make things worse. Taking L-5-methylfolate is a better choice for these people. But like I said, you need to start by getting B6, B12, folate, and homocysteine levels checked. Then if you have high homocysteine levels, use hyperhomocysteinuria as a diagnosis code (excuse for the insurance company) to test for MTHFR gene mutations or others that may prevent you from properly metabolizing folate or other B vitamins. You will likely have to have high homocysteine levels in order for insurance to cover the gene testing.

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I agree with @jt07 ... best by shot.

Also, FWIW ... My stomach doesn't have the intrinsic factor, which is needed to absorb B12, and any B12 supplements (pill kinds) won't absorb no matter what.  Which is why I need the shot, because it goes directly in my muscle, and doesn't involve my stomach.

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35 minutes ago, browri said:

Taking B vitamins can be tricky without getting blood levels and also checking your genetics to determine if you can properly metabolize B vitamins. There are pretty critical genetic mutations that may require you to take specific forms of B vitamins. I would recommend going to your doctor and having B6, B12, folate, methylmalonic acid, and homocysteine levels checked. These data points will help you to determine if you need supplemental B vitamins.

@browri Is this testing something that most doctors will oblige to? I've asked several GP's in the past and they all seem to react like testing for vitamin deficiencies (apart from vitamin D) is totally unecessary, superfluous....like I'd have to present with some rare terrible disease like the plague or something for it to be worth it.

I then asked my pdoc, mentioning if I could be someone with one of these gene mutations & she said she can't do or authorize the testing, it must be from a GP. Maybe I'm just a hypochondriac, but I often wonder if some of my chronic symptoms could possibly be due to the absorbtion or gene mutation issues that you mention.

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8 minutes ago, Blahblah said:

@browri Is this testing something that most doctors will oblige to? I've asked several GP's in the past and they all seem to react like testing for vitamin deficiencies (apart from vitamin D) is totally unecessary, superfluous....like I'd have to present with some rare terrible disease like the plague or something for it to be worth it.

I then asked my pdoc, mentioning if I could be someone with one of these gene mutations & she said she can't do or authorize the testing, it must be from a GP. Maybe I'm just a hypochondriac, but I often wonder if some of my chronic symptoms could possibly be due to the absorbtion or gene mutation issues that you mention.

You can do it two ways. You can complain to your doctor about energy and fatigue problems and tell them it responds fairly well to OTC B vitamins. Then they have your B vitamin levels tested when you aren't taking the OTC supplements. If they're low and your homocysteine levels are high, then they can use it as an excuse to bill the insurance company for genetic testing.

The other route is to go and get genetic testing through Ancestry.com or 23andme. Then you can download your own genetic data once they have processed it and you can load it into the Methylation Analysis on geneticgenie.com. If you come back with any of the mutations, you can take the report to your doctor and basically say "Hah. I told you so.". However, those results SHOULD NOT be interpreted without the guidance of a doctor, because how you act on those mutations has to be very carefully planned usually. You may need to take certain B vitamins but not others and you may have to take some of those B vitamins in very specific formulations that you can get OTC but not at your local pharmacy. Any deviation could actually make things worse. For example, in my situation there are certain mutations that I'm heterozygous for that indicate I shouldn't be taking supplemental B12 but others that indicate I should be. And I need to be taking B2. But I don't really need supplemental L-methylfolate. Do you see what I mean? Some of the B-complex vitamins out there can actually be a bad thing depending on the person's unique situation.

Edited by browri
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