I put this in another post, but it bears telling you all what my new GI said to me in a post of its own (and he's at a large university center, is reputable, and seems to be on his game with all of the information he gave me, as a new patient).

I have a *higher than normal* serum B12 level, on labs. He said that J pouch patients can have a skewed level; that it will come back quite high, but that the bacteria in the pouch is skewing the lab, and that if you see a *higher than normal* B12 in our population, this is actually showing a B12 deficiency on our part. I didn't know this, and no, I have not looked for literature to back this, but I trust he's on his game. He's a GI who specializes in pouch patients.

I have been extremely fatigued the past 2 years, and he thinks this might be part of my problem. He said other J pouch patients with similar complaints and *higher than normal* B12 labs are actually deficient, and that he's had many of them come back saying how much better they feel on B12 injections.

I gave myself my first injection today. I'm to take one shot every week for four weeks, then go to the routine one shot every month.

I am hopeful this might give me some relief from this overwhelming tiredness I feel all the freaking time! (and he did say you'd need injections, not the pills, to correct this)