I was just started on B12 injections twice a month. Is anyone else doing this and have they had success?
Kate

Yes, I self inject every week or every other week. I find them helpful overall (nerve support, energy - although I wish that would last a bit longer). I use the methyl form of B12.

Yes, I self enject B12 (1000mcg) every other week, too. Vitamin B12 is absorbed through the part of small intestine called terminal-ileum, which is normally removed during the j-pouch surgery, and it is quite common for the j-pouchers to have B12 deficiency after the surgery.

I usually have iron deficiency, too. I can hardly tolerate oral iron supplements. Iron is absorbed through duodenum that is the first segment of the small intestine after stomach. However, when we ,IBD patients, have flare-ups, our bodies shut down iron absorbtion, which eventually causes chronic diseae-related anemia.
Even if I can put up with the pain and cramps, it sometimes takes months to reach the normal blood levels. That's why I self inject iron once or twice a month. This is kind of risky. You got to know where and how to inject iron, not recommended if you are not experienced.

I also have iron deficiency anemia and take 324mg ferrous gluconate twice a day without a problem. The ferrous sulfate made me sick. You may want to switch if taking the ferrous sulfate.

Is B12 injections being discussed here as a treatment for pouchitis or vitamin deficiency?

There are a variety of reasons necessitating additional B-12, whether by diet(pills) or injections, and I disagree that the terminal ileum is removed in j-pouch surgery. There are indications for women requiring B12 (mainyl pernicious anemia) that don't necessarily apply for men, and your age does make a difference. The required gastric intrinsic factor to absorb ingested B12 can dimish as we age; often additional B12 supplements fix this. For other issues where the amount ingested does nto raise the serum level, B12 shots are typically the answer. I'm a 52 yo man, J-poucher for 4 years, eat an admittedly poor diet, and have had my B12 checked (normal level). I'm not aware of any science indicating B12 is effective to prevent or mitigate pouchitis. If someone is, please post the citiations here.

If you suspect you are B12 deficient, suggest to your physician to also check your serum methylmalonic acid (MMA levels) as well as B12. Increased serum MMA is a big reason why older folks get B12 shots. They are relatively inexpensive if you self-inject, and don't discount the potential placebo effect, either.


Cheers,

Mark

No, I'm not aware that B12 could prevent or mitigate pouchitis either. However, according to a response by Jan in this thread (http://j-pouch.org/eve/forums/...1071921/m/4711083303) chronic pouchitis can lead to B12 malabsorption.

Agreed. As I understand how the prcedure was done on me (2-step), the terminal ileum is not lost, but it's what is used to create the pouch. And not all of it by any means, only the last 10 cm or so. Given this, chronic pouchitis, when serious, certainly inflames the lining and potentially the ability to absorb B12.

Mark

Regarding iron and B12 deficiencies...

First of all, as j-pouches do we not absorb iron as well as "normal" colon people? I thought iron was absorbed in the small intestine. Is it typcially only people who are having bleeding issues (cuffitis, tears, skin irriation, etc.) that see these iron deficiencies?

I understand why we can have B12 deficiencies, but I thought I read somewhere in a forum that it takes years of having no colon to actually get B vitamin deficiencies. Is that true?

Thanks :-)

Hi all!
Thanks for all the information. As I understand it having chronic pouchitis has let me to becoming B12 deficient. I am also Vitamin D deficient which necessitates prescription D as well.

I was not aware of this risk from having pouchitis-I started getting crazy lethargic, brain fog, almost spacey at times when they noticied this in labs.

I take Xifaxin, allopurinol and entocort daily for pouchitis prevention but still having absorption issues. I take my multivitamin at night which seems to help a bit.