vitamin B-12 shots

In my 40yrs with my j-pouch I’ve always been tired but never really fatigued until a few months ago.(Before Covid)  It was so bad I could barely get out of bed. It was because I was dehydrated & had a UTI, I didn’t think I was dehydrated, I was drinking so much, but I was. Got fluids at the hospital and been fine since. 
I had B-12 shots for about 6 months I found they did nothing for me.

Fatigue is the worse, I hope you find relief 

I do get my B12 checked now and then. It’s never been low for me. The terminal ileum, where B12 is absorbed, is considerably longer than a few inches. 

Thanks to you both.  I'm so sorry for your struggle ytcrockpot.  I struggle more in the summer - the heat, etc.  Scott - thanks for your advice - I can just get the B 12 checked next time I do bloodwork.  It's probably too good to be true - easy fix, etc.  I do ok with my pouch at times - it just seems harder as I age - but in a way - that's probably what many people would say about all kinds of things bothering them as they age.  I try to stay positive.  I don't always do so - but I try to reboot my attitude - a lot.  It's good to know you all are here.  I'm thankful to you both for answering.

I’ve also had my B12 checked due to feeling of fatigue; however my B12 was within range apparently, although my potassium was low but not low enough to warrant tablets.

Since creation of my colostomy, I’ve often experienced bouts of tiredness; well, it’s more a lack of desire or motivation and at the time, I didn’t recognise it.

More recently, I believe I don’t consume enough salt.

I believe our salt level has to be constantly maintained through-out the day; not just 3 or 4 salty snacks 3 times a day but continuously through-out the day; I guess copying how our colon would extract salt from our waste before evacuation.

Thanks - I agree!!  Others are lowering their salt as they age - I'm topping it off - ad I do forget sometimes and think I'm getting it in propel or other electrolyte type drinks.  But plain salt does indeed help me.  I think during Covid I've been inside so much (I live in Dallas - so hot) and alone and that anxiety adds to the situation.  So - it's both a mental battle and a physical one - (as it alwasy in in life  I appreciate you reminding me about this.  I don't think I ate much of anything salty today!  For me - about once a month - or maybe every 6 weeks - I go splurge on a McDonalds cheeseburger and fries.  This is my go and it becomes an enormous craving - and I know - I need that salt.  I think also - (and I"m sure you know this) - salt combined with fat is a good combo - so if I'm being healthy - guacamole with salt - etc.  Tuna, fish, etc.  I know all the things to do - I think when you've been at this 35 years - at times - you just sort of forget about details and I should be more aware and careful about watching what I eat.  I truly appreciate you connecting with me from across the pond.  This site has been so wonderful for me - I don't use it enough and I need to reach out more to others to help newbies.  You can live a very good life with this pouch - it's not always easy - but it's not awful either.  Mindset is key.  Covid and thrown us all for a loop and just being "heard" about the B-12 - and getting other responses - has made me feel less alone and reminds me - I'm not alone.  Thanks and I send a hug from Dallas, TX

Thanks for your hugs and kind words from Dallas.

It’s normally advised that once in our mid 50’s, we’re to cut our salt intake to reduce the risk of Heart Disease, Stroke & higher blood pressure but as we no longer have a colon, either due to an ileostomy or a J pouch, we don’t absorb salt like those with a healthy colon.

The salt intake I reference to is different from potassium; I don’t know how or why but it’s sodium we require, which is acquired from salt.

We acquire potassium from our diet, normally without trying or even being aware of it and any additional potassium consumed, is expelled in our urine, with our body only using what it needs.

The sodium we require, must be acquired by some kind of bodily function/chemical reaction within the colon, that somehow extracts the sodium from our waste but as we don’t have a colon, we can’t extract the sodium, so we have to increase our salt intake to compensate.

A low magnesium level can also cause fatigue; I also believe low magnesium can give a false potassium level during blood test.

Magnesium levels aren’t normally tested during routine blood test.

I have to say that I take B12 shots every month, and it has been incredibly beneficial for me/my energy levels/ability to keep up at work and home.  For 18 years of pouch life all of my gastros missed it.  My surgeons missed it.  The doc in my team that the rest would probably consider a quack was the one who caught it.  My B12 was at 212.  The range low used to be 200.  My "quack" says anything under 400 should be supplemented.  I bounced the plan off my gastro and surgeon and they were both like "Whoa!  That IS low.  Yes, go ahead and do that."  

If you are clocking in lower than 400 give it a shot.  Worst case scenario, nothing will happen. Best case scenario, your quality of life is dramatically enhanced, as mine was and continues to be.

Before 'lockdown' I had a blood test that suggested I was deficient in B12.  Since my diet is pretty varied I can only put it down to malabsorption, I don't absorb tablets well at all so I bought sublingual B12 supplements on ebay, not sure if they work or not since I haven't had a follow-up blood test yet.

Sos, ask your doc for a prescription for B12 shots.  It probably won't be covered under insurance, but it's not very expensive.  The syringes will be covered.  If you are not comfortable with home injections, you can probably arrange to have them administered at the pharmacy that fills the prescription.  Not absorbing B12 is 100% my issue.  I eat tons of foods that are sources of it, and tried oral supplements forever, to no avail.  Shots is the only thing that works for me, and the difference between deficient and all-good is very noticeable to me now.  

Thanks for all these informative replies!!  They are all really helpful!  Good info and reminders about sodium.  Interesting take on B-12.  Seems like something to consider - maybe I'll give it a shot  ha!  Thanks to all my kind pouch brothers and sisters out there - you are my heroes!

I'm B12 deficient & take injections every 2 months, 2ml of Cianocobalamine. I believe Cipro will spoil the B12 blood test.

Paul

Hey - thanks Paul - good point about Cipro.  I hadn't thought of that  YOu guys are great!