Illeostomy folks, watch your B12 levels!

[Shamrock4806]

"Fatigue, brain fog, and tingling in your hands or feet could point to a problem with your B12 levels, even if your bloodwork is technically “normal.” "

"Standard serum B12 tests are not always reliable, so testing methylmalonic acid (MMA) and homocysteine can help uncover a functional deficiency even if B12 levels look normal on paper."

https://www.mdpi.com/2077-0383/13/8/217 ... thy%20risk

https://www.ncbi.nlm.nih.gov/books/NBK4 ... look%20for

I started taking Centrum Silver multivitamin multimineral almost daily and the problem I was having with neuropathy disappeared. But I do start getting fatigued if I don't take them for a few days and slight finger or toe tingling returns.

[JerryNYC]

It is important for people with ileostomies to take supplements of Vitamin B12 (also known as cyanocobalamin). This is because B12 within foods is absorbed mostly at the very end of the small bowel (ilium) and this portion of the ilium is generally removed during the surgical creation of an ileostoma. Swallowed B12 replacement pills are not very effective for the same reason; the B12 will travel down the digestive tract but will not be well-absorbed into the blood if the place where it is normally absorbed happens to be missing. Years ago, it was common to get periodic B12 injections to allow its direct absorption into the blood. But it is much easier to take sublingual (under the tongue) B12 tablets. This area under the tongue is loaded with tiny blood vessels and if you let the pill completely disappear under the tongue for a few minutes, the B12 will go right into the blood. The medical literature indicates that it is more effective to take small doses (50 micrograms daily) rather than large doses (in the 1000s of micrograms) monthly. I get 50 microgram B12 pills from Amazon.com, although some Health Food stores may carry them. As always, it is recommended to consult your doctor.