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KevinkHz
New Member


Date Joined Nov 2009
Total Posts : 19
   Posted 11/1/2009 9:52 PM (GMT -7)   
My boyfriend has Crohn's disease and he is my greatest treasure. I feel a great need to be aware of his needs and to be responsible as much as he is for his health- and as a student going into the nursing program, my curiosity and willpower for answers grows stronger. My grandmother has CD as well, and so i grew up with at least the basic knowledge of what it is and the symptoms.
Last week he called me and said he would be needing vitamin B injections. During my research period i learned that scientists are aiming to prove that B12 in large doses administered orally may have the same effect as if injected. I am a bit skeptical of this claim but if anyone here has anything to say on this matter i would love to hear it.
Also, because of the deficiency i have noticed a dramatic change in the appearance of his upper lip. It is very raw, as if ulcerated...i've heard of aphthous ulcers but it looks nothing like a cancer sore. No pus no scab-like white elevation. Just raw red tissue all across the top lip. I'd like to know how i might treat this. Is there any sort of ointment or cream i could try to make this heal up?
 
 

Keeper
Veteran Member


Date Joined Jun 2008
Total Posts : 1058
   Posted 11/1/2009 10:48 PM (GMT -7)   
Vitamin E oil might be useful - not knowing much about it. If it is from Crohn's, vitamin E would likely help. There are several skin problems from rashes to ulcers that come with Crohn's. A topical steroid cream is another possibility, but you would need a prescription strength cream to be of any use.

B12 can be absorbed sublingually, but I don't know if you can get enough of it that way. There are two co-factors involved in the absorption and use of B12. The first, so-called "intrinsic factor" binds with it and aids the absorption of B12 from food sources. The second is involved in transporting it from the bloodstream into cells. If the deficiency has resulted in the loss of both factors, relatively huge amounts of B12 are needed to compensate for the loss of the co-factors. A large level of circulating B12 in the blood is needed to overcome the lack of the second co-factor.

pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20576
   Posted 11/1/2009 11:17 PM (GMT -7)   
I started out getting B12 shots from my doc, he then weened me onto 1200mcg time released tabs which have been working out just fine for the last 7 yrs now.

:)
bee propolis caps 500mg one cap twice/day
omegas 369 caps one cap twice/day
probiotics 10 billion cfu once/day
vitamins C-calcium ascorbate (easy on the gut) and vitamin A each once/day
Prodiem fibre supplement one cap before bed
I've also altered my diet (no junky stuff at all, processed, fast-foods, refined sugars, ect) and exercise regularly.
I went from 30+ bloody BM's/day with lots of lower back pain to an average of 5/day no bleeding no back pain and completely formed stools, still have severe urgency issues.
~~~~~~~~My bum is broken....there's a big crack down the middle of it! LOL :)~~~~~~~~


MMMNAVY
Veteran Member


Date Joined Jul 2006
Total Posts : 6927
   Posted 11/2/2009 5:16 AM (GMT -7)   
b-12 shots seem to be more effective to me.
Forum Co-moderator - Crohn's Disease/Thyroid Disorders:_All comments have the caveat contact your local health care provider.

I will find a way or make one. –Phillip Sidney 1554-1586

All that I am and all that I shall ever be, I owe to my Angel Mother.

The Bucket List- Have you found joy in your life?  Has your life brought joy to others?

Make sure your suffering has meaning…


Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 11/2/2009 7:27 AM (GMT -7)   
I agree with Navy the shots work much better for me. I read a study awhile back that said even healthy folks can't asborb enough of the vitamin when taken orally. They said folks are able to absorb much more if taken in sublingual or via injection. Good luck!
Gail*Nanners* Co-Moderator for Crohns Disease and Anxiety/Panic Forum
Crohn's Disease for over 33 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, Calcium  w/Vit D, and Xanax as needed. Resections in 2002 and 2005. Also diagnosed with Fibromyalgia, Osteoarthritis, and Anxiety. Currently my Crohns is in remission, but my joints are going crazy!
It's scary when you start making the same noises As your coffee maker.
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

njmom
Veteran Member


Date Joined Apr 2006
Total Posts : 1884
   Posted 11/2/2009 9:44 AM (GMT -7)   

His best bet is to get a shot right away, and then follow up with oral B12 for a month. At the end of the month, a test can be done to see how much B12 he was able to retain...at the time this blood work is done, he should get another B12 shot, just to be on the safe side, because it could be two weeks before he finds out what the lab said.

OPTIMAL B12 is in the high 600s. Anything below 400 needs aggressive supplementation. Below 300 needs a shot.

Yes, it is true that in people who DON'T have Crohn's large oral doses of B12 might do the trick. But in people who do have the disease, particularly in the terminal ileum, where B12 is absorbed, often no amount of oral B12 is going to do the trick.

Sublingual B12 is controversial -- not because it isn't safe, but because of unproven claims about effectiveness. 


BeeSting
Regular Member


Date Joined Nov 2008
Total Posts : 392
   Posted 11/2/2009 10:00 AM (GMT -7)   
njmom.,....could you please answer me what 600 means...or below 300....is it micrograms? is it milliliter?.... or what exactly does those number describe? The reason why I ask is that I asked for B12 last week my doctor told me that my B 12 was not low...it was 240. Is it considered normal, is he wrong? /Bee

Keeper
Veteran Member


Date Joined Jun 2008
Total Posts : 1058
   Posted 11/2/2009 2:17 PM (GMT -7)   
njmom's numbers look like pmol/liter (picomole per liter) which is one of a couple of units used. Other test numbers are reported as micrograms per liter, so that's the difference.

KevinkHz
New Member


Date Joined Nov 2009
Total Posts : 19
   Posted 11/2/2009 4:45 PM (GMT -7)   
Thank you so much, this is excellent information, and i will take heed. Yea they say that sublingual is effective because it is absorbed right into the lymphatic system. Is that correct? In any case, you were right on and i appreciate the relpy. =]
njmom said...

His best bet is to get a shot right away, and then follow up with oral B12 for a month. At the end of the month, a test can be done to see how much B12 he was able to retain...at the time this blood work is done, he should get another B12 shot, just to be on the safe side, because it could be two weeks before he finds out what the lab said.

OPTIMAL B12 is in the high 600s. Anything below 400 needs aggressive supplementation. Below 300 needs a shot.

Yes, it is true that in people who DON'T have Crohn's large oral doses of B12 might do the trick. But in people who do have the disease, particularly in the terminal ileum, where B12 is absorbed, often no amount of oral B12 is going to do the trick.

Sublingual B12 is controversial -- not because it isn't safe, but because of unproven claims about effectiveness. 


KevinkHz
New Member


Date Joined Nov 2009
Total Posts : 19
   Posted 11/2/2009 4:47 PM (GMT -7)   
Good question- i'll just google it lol
BeeSting said...
njmom.,....could you please answer me what 600 means...or below 300....is it micrograms? is it milliliter?.... or what exactly does those number describe? The reason why I ask is that I asked for B12 last week my doctor told me that my B 12 was not low...it was 240. Is it considered normal, is he wrong? /Bee

KevinkHz
New Member


Date Joined Nov 2009
Total Posts : 19
   Posted 11/2/2009 4:56 PM (GMT -7)   
I took a pilgrimage to answers.com today (hey it's worth a try right? Heh.. heh). Someone posted that when they have a lip ulcer they put salt on it...
Seriously??! I used to get cancer sores all the time when i was younger b/c of tomato sauce and other things but my instincts tell me that salt would just exacerbate the problem. Anyone? Anyone?!! Take a stab?!

njmom
Veteran Member


Date Joined Apr 2006
Total Posts : 1884
   Posted 11/2/2009 5:03 PM (GMT -7)   
Beesting, all US and I believe European labs use the same way of measuring. This means the number 240 from LabCorp is the same as 240 from Quest or any other US lab. The number 240 means 240 pg/mL.
 
The link below takes you to  a sample lab report that says the normal range for B12 is 210-1100. Doctors often don't know any better, so if the lab says it is in normal range, they just read the report and say it is normal to have 240, so you are OK. 
 
 
While 240 might or might not be normal, it is NOT healthy. As any endocrinologist should know, at under 300 you could be presumed to be vitamin B12 deficient. Other tests, like the MMA tests, are more sensitive for early detection of B12 deficiency than the standard B12 test.
 
When my daughter tested at exactly 300 in B12, her endocrinologist said B12 deficiency was a possibility, so her gave her a shot to get the B12 in her system ASAP. He could have subsequently, before giving her the shot, tested for MMA, etc, but why bother? The important thing was to supplement ASAP, not spend more weeks running more tests.
 
As the following link shows, B12 deficiency can be suspected anytime the number is below 400. In fact, the diagram says that the only time you are definitely NOT B12 deficient is when it is over 400.  http://www.aafp.org/afp/20030301/979.html
 
The following link talks about why the so-called "normal" ranges for B12 are not optimal, and suggests optimal B12 should be 800. It says that in Japan, the bottom of the range is 500. At the very least, the B12 MUST be more than 400, with optimal B12 in 600s or higher. http://www.stopthethyroidmadness.com/lab-values/
 
The following link goes to an article written by Sally Fallon and Mary Enig, which talks about the importance of B12, and says:
"American medical opinion defines blood levels lower than 200 pg/mL as an indication of deficiency. This number is based on the level associated with the most severe manifestation of deficiency, pernicious anemia. In contrast, the lower limit in Japan and some European countries is 500-550 pg/mL, the levels associated with psychological and behavioral manifestations such as dementia and memory loss." http://www.westonaprice.org/basicnutrition/vitaminb12.html

Post Edited (njmom) : 11/2/2009 5:06:00 PM (GMT-7)


KevinkHz
New Member


Date Joined Nov 2009
Total Posts : 19
   Posted 11/2/2009 5:07 PM (GMT -7)   
This is very valuable information and I thank all of you. I think i'll be comin here often...i hope i'll be able to help you all one day.

Post Edited (KevinkHz) : 11/2/2009 5:11:56 PM (GMT-7)


MMMNAVY
Veteran Member


Date Joined Jul 2006
Total Posts : 6927
   Posted 11/2/2009 6:07 PM (GMT -7)   
Some of us have been on b12 shots for years because of rapid transit time.
Forum Co-moderator - Crohn's Disease/Thyroid Disorders:_All comments have the caveat contact your local health care provider.

I will find a way or make one. –Phillip Sidney 1554-1586

All that I am and all that I shall ever be, I owe to my Angel Mother.

The Bucket List- Have you found joy in your life?  Has your life brought joy to others?

Make sure your suffering has meaning…


pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20576
   Posted 11/2/2009 7:05 PM (GMT -7)   
B12 shots or pills never changed my rapid transit time down any...infact I've never even heard that B12 can make a difference or has anything to do with one's transit time. B12 has to do with the nervous system which is why tingling (pins and needles) are often the first signs of lack of B12 for a person, meaning their nerves are being affected from lack of B12 and if they don't start getting B12 then they will experiance permanant nerve damage.
bee propolis caps 500mg one cap twice/day
omegas 369 caps one cap twice/day
probiotics 10 billion cfu once/day
vitamins C-calcium ascorbate (easy on the gut) and vitamin A each once/day
Prodiem fibre supplement one cap before bed
I've also altered my diet (no junky stuff at all, processed, fast-foods, refined sugars, ect) and exercise regularly.
I went from 30+ bloody BM's/day with lots of lower back pain to an average of 5/day no bleeding no back pain and completely formed stools, still have severe urgency issues.
~~~~~~~~My bum is broken....there's a big crack down the middle of it! LOL :)~~~~~~~~


KevinkHz
New Member


Date Joined Nov 2009
Total Posts : 19
   Posted 11/2/2009 7:30 PM (GMT -7)   
What do you mean when you say 'transit time?'

pb4- absolutely. Some people are asymptomatic but B12 affects mainly the blood, nervous system and brain. Produced by the duodenum and combined with IF (produced in the stomach) and absorbed by the terminal ileum. Some of the absorbtion malfunction could be due to surgery to the small intestine (when it becomes smaller lol forgive the pun) and also because of damaged, diseased intestine.
In an extreme case of B12 deficiency, one may start experiencing spinal degeneration.

pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20576
   Posted 11/2/2009 7:54 PM (GMT -7)   
Even without having surgery (having CD alone) in the small intestines can cause issues with B12 absorption, I've never had surgery internally for my CD but I was not absorbing B12 sufficiently enough to be put on B12 supplementation.

Tranist time= how long (or quickly) it takes for food to move through the digestive tract).

:)
bee propolis caps 500mg one cap twice/day
omegas 369 caps one cap twice/day
probiotics 10 billion cfu once/day
vitamins C-calcium ascorbate (easy on the gut) and vitamin A each once/day
Prodiem fibre supplement one cap before bed
I've also altered my diet (no junky stuff at all, processed, fast-foods, refined sugars, ect) and exercise regularly.
I went from 30+ bloody BM's/day with lots of lower back pain to an average of 5/day no bleeding no back pain and completely formed stools, still have severe urgency issues.
~~~~~~~~My bum is broken....there's a big crack down the middle of it! LOL :)~~~~~~~~


Keeper
Veteran Member


Date Joined Jun 2008
Total Posts : 1058
   Posted 11/2/2009 10:55 PM (GMT -7)   
I don't know about salt for mouth ulcers - I imagine it would sting like the devil. I used to do something like that though. I would place a zinc gluconate tablet on the sore (probably canker sores) and let it sit there for an hour or so. It is a bit rough on the poor sore and I noticed that it throbbed a bit. The sores were usually gone in a day or two after that. Once though, I had a reaction to it and my lip swelled up for a couple of days. I told everyone who asked that it was a case of wife abuse....

pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20576
   Posted 11/2/2009 11:38 PM (GMT -7)   
It does sting, when I was a kid and got canker sores on the rare occassion my mom used to make me gargle with salt water, sadistic to say the least.


:)
bee propolis caps 500mg one cap twice/day
omegas 369 caps one cap twice/day
probiotics 10 billion cfu once/day
vitamins C-calcium ascorbate (easy on the gut) and vitamin A each once/day
Prodiem fibre supplement one cap before bed
I've also altered my diet (no junky stuff at all, processed, fast-foods, refined sugars, ect) and exercise regularly.
I went from 30+ bloody BM's/day with lots of lower back pain to an average of 5/day no bleeding no back pain and completely formed stools, still have severe urgency issues.
~~~~~~~~My bum is broken....there's a big crack down the middle of it! LOL :)~~~~~~~~


MMMNAVY
Veteran Member


Date Joined Jul 2006
Total Posts : 6927
   Posted 11/3/2009 8:38 AM (GMT -7)   
Sometimes the pills come out so fast they still whole in my d (yes I got the rubber gloves out and checked, they were not disgested properly), so that is why I have been on the shot. I have comtemplating the sublingual, because I really do not like shots, but b-12 shot has work well for me.


Forum Co-moderator - Crohn's Disease/Thyroid Disorders:_All comments have the caveat contact your local health care provider.

I will find a way or make one. –Phillip Sidney 1554-1586

All that I am and all that I shall ever be, I owe to my Angel Mother.

The Bucket List- Have you found joy in your life?  Has your life brought joy to others?

Make sure your suffering has meaning…

Post Edited (MMMNAVY) : 11/3/2009 8:49:53 AM (GMT-7)


aoccc
Regular Member


Date Joined Feb 2005
Total Posts : 455
   Posted 11/3/2009 9:10 AM (GMT -7)   
aww everyone likes to bite the lip ones. It is a fun pain.
SCD since 01, remission since 01, occasional random junk food breaks :)
No meds ever.

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