Doctor insights on:
B12 Absorption With Colectomy
How can I keep my energy levels since I had a total colectomy with j pouch? Not anemic, B12 and thyroid are find.
Fluids: You might be dehydrating since you have more bms and less time to reabsorb water with no colon. ...Read more
My son (22) had a colectomy, his colon was removed and subsequent J Pouch etc. He recently is very fatigue, weightloss etc could this be a b12 defiec?
Unlikely: B12 absorption and the intrinsic factor that are involved in the process are all part of the small intestine function. The colon is more of a storage area, water retriever than anything else, so loss doesn't often give significant problems. Fatigue is a good reason for an office evaluation. ...Read more
Is responding to B12 sublingual but not to oral caps B12 enough evidence that I have absorption problems?
No: Additional testing is necessary by your gastroenterologist or internist. ...Read more
If I am taking B12 "sublingually", then, would drinking a small cup of coffee disturb the B12 absorption?
NO: By the time it dissolves under your tongue- it should be absorbed and not affected by coffee. ...Read more
How much of B12 supplement can my body absorb per day? Does taking more 5000 mcg in 5 times (in 2hours gap) mean more absorption than 1000mcg one time?
Sublingual B12: Is best. Get the kind that melts under your tongue and with folate (folic acid) if possible. 500 to 1000 mcg is a common dose. If you swallow the B12 you will get much lest benefit because it has to go through your GI system. Peace and good health. I see you struggle w/fatigue. You may find the MicroNutrient Test from Spectracell lab in Tx helpful. ...Read more
Does fat content increase the absorption of vitamin D2, or this only apply to D3? Does vitamin D2 interact with B12? How do I optimize D2 absorption?
Optimizing D absorpt: Vit D3 is superior to D2. Both are fat soluble. Absorption is enhanced with food and fat. To optimize effects, be sure you have vit K2 going in as well -- approx 100 mcg of vit K2 for every 1000 iu of D3 is appropriate. ...Read more
Acid has a profound: Effect on iron. Acid is better. Not an issue with b12, as the issue is intrinsic factor from the stomach which is a cofactor in B12 absorption. ...Read more
It does not matter: I would say that there is no reason to chew the tablet, but either way absorption should not be affected either way. ...Read more
Any way to cure the intrinsic factor in the digestion system for the absorption of vitamin B12 complex?
Yes and No: Most intrinsic factor deficiencies are due to either partial gastrectomy or auto-antibodies that attacked the parietal cells of the stomach. In both, the damage may already be done. However, you can get B12 in the body in a few ways. 1) take a higher dose of B12 starting at 2mg (literature supported), 2) take sublingual drops (salivary gland absorption), 3) get im injections of methyl b12. ...Read more
Am 70yrs. I had bad depresion for 14 month, eat once daily and sleep 3 hrs. Does that cause macrocytic anemia. B12, folic ok. Can it be bad absorption?
Yes.: I may have answered this already. Depression can cause poor appetite and may cause malnutrition over a long period of time. However if your B12 and Folic Acid are normal, then I do not believe you have macrocytic anemia. The cause of macrocytic anemia is due to the absence of intrinsic factor in your stomach causing malabsorption of nutrients that can cause macrocytic anemia. ...Read more
I understand that metformin can worsen peripheral neuropathy by impairing B12 absorption, but can it worsen pn via other pathways if B12 levels are ok?
Can vitamin B12 deficiency or a congenital B12 absorption problem cause my 10 year old to still be wetting his pants?
If you have below average 145ng/L B12 levels but Ferritin and folate are normal and you do have B12 deficit Symptoms ie numb hands at night a week before next B12 injection which is due every 2 mths would B2 also be a problem for absorption. Like B12?
No: The mechanisms for absorption of B2 and B12 are very different. ...Read more
Can hpylori bacteria cause macrocytic anemia for 70 yrs man. Had it from 2 yrs and treated. Folic, B12 ok. Can it be no absorption though normal vit.?
No: H. Pylori does not causes macrocytosis. If B12 is below 400, consider checking methylmalonic acid as it still could be B12 deficiency. In a 70 year old, maxrocytosis could be a sign of bone marrow disorder, called myelodyspalstic syndrome. Also, certain drugs can cause macrocytosis. ...Read more
Do I take vitamin b complex with magnesium or can I take vitamin B12? For better absorption of magnesium. Currently also take vit D3 thanks
OK but not 4 absorb.: It is perfectly fine to take b complex/b12 with magnesium but won't enhance absorption. Magnesium is best absorbed on an empty stomach ; b vits can cause stomach upset on empty stomach. B vits, esp. B6, often work in synergy with mag. The best-absorbed forms of mag. Are glycinate ; taurate; citrate is ok too. Epsom salt baths ; topical "magnesium oil" are also good ways to get magnesium into you. ...Read more
Serum b12> 1999 mma 0.4, homocysteine high 19. No folate (folic acid) or iron deficiency normocytic anemia not responding to procrit. Is this an absorption issue?
Anemia: Can be caused by blood loss or bone marrow suppression as well. More information is needed (how long have you had a normal iron, folate (folic acid) and b12 level. What is your reticulocyte count? (is your bone marrow producing new RBC's)? How low is your HCT and has it come up or gone down with B12. Is the RDW elevated (do you put out large and small RBC's at the same time? Any blood loss? ...Read more
Yes: It depends on the reconstruction. If you have a j pouch and the contents are moving through rapidly and you have not adapted, a patient may have many stools per day and the area around the anus may be raw. Local treament with creams to the area are helpful. If it remains, your doctor can add things to thicken the stool or medicine to slow it done until you adapt. Good luck. ...Read more
Depends: This is highly dependent on why this surgery is indicated. If the person is not too elderly or have other risk factors such as crohn's disease or extensive cancer, then a j-pouch may be appropriate. This is performed by a trained surgeon who has the proper knowledge. Some patients do not have a choice due to their disease condition and will need an ileostomy. ...Read more
Yes, for Certain dx: Constipation, common problem that is managed by medicines and diet the vast majority of the time. For certain conditions (colonic inertia, megacolon- where patients aren't going to the bathroom for >5days) surgery is an option. Often entails removal of the colon and sewing the small bowel to the rectum. Done laparoscopically. Tremendous improvemnt in quaility of life when properly selected. ...Read more
Depends on the: Indications for the surgery. Crohn's disease should never be treated with a j pouch. Then it is an issue with the patients preferences and life style and skills of your surgeon. J pouch usually requires a temporary ileostomy and thus an extra operation to close the temporary ileostomy. These are issues to discuss with the surgeon and contact your local ostomy association, meetings and ask members. ...Read more
No: If everything is healed there would be no additional risks. ...Read more
Best to ask: Your surgeon!!!! . Not sure how far out from your surgery you are and why the bowel resection was done, and how the repair was made. All of these will determine an appropriate answer to your question. Your surgeon should have given you a recommended diet. If not call their office and get one!! ...Read more