B12 Injections and Iron Tablets

Let’s talk firstly about the diagnosis that can lead us to think B12 injections and Iron tablets are needed. The condition that springs to mind is  “Anaemia” It’s a word that evokes feelings of fatigue, weakness, and a general sense of being unwell. But what lies beneath this common diagnosed ailment, and what type of anaemia is usually diagnosed?

Types of Anemia:

• There are many different types of anemia, each with its own cause. Common types are:
  • Iron-deficiency anaemia   
  • Vitamin-deficiency anemia (B12 and folate)   
  • Aplastic anemia
  • Hemolytic anemia   
  • Sickle cell anaemia

So,  the culprits for these are deficiencies in key nutrients: iron, vitamin B12 (cobalamin), and folate (vitamin B9). Simple to fix you would think, tablets or injections and extra spinach right!

No!

Let’s delve into the good, the bad, and the ugly, focusing on B12 injections and iron tablets as these are usually the treatment given.

The Good: Essential Roles and Vital Functions

• Folate (Vitamin B9):
  • This water-soluble vitamin is a powerhouse for DNA synthesis and cell division, crucial for red blood cell production. Think of it as the architect of cellular growth.
  • Found naturally in leafy greens, citrus fruits, and legumes, and also available as folic acid in supplements and fortified foods.
• Vitamin B12 (Cobalamin):
  • Working in harmony with folate, B12 is another vital player in red blood cell formation and, crucially, nerve function. It’s the conductor of the nervous system.
  • Primarily sourced from animal products like meat, fish, eggs, and dairy, nutritional yeast.
• Iron:
  • Iron is the backbone of haemoglobin, the protein in red blood cells that carries oxygen throughout the body. Without enough iron, your body’s tissues and organs don’t get the oxygen they need.
  • Found in foods such as red meat, spinach, and legumes.

The Bad: Absorption Challenges and Deficiency Risks

Here’s where things get complicated. Simply consuming these nutrients isn’t always enough. You think if you are taking the tablets, eating your body weight in greens and foods high in b12 or  having the injections you should be feeling great in no time right! all deficiencies taken care of thank you very much let’s get the energy back.

NO!

• B12 Absorption Issues: The Intrinsic Factor
  • B12 absorption is complex. It requires this intrinsic factor, a protein produced in the stomach, to bind with B12 and facilitate its absorption in the small intestine.
  • Conditions like pernicious anaemia (an autoimmune disorder attacking intrinsic factor-producing cells), atrophic gastritis (thinning of the stomach lining), and certain medications can disrupt this process.
  • Many people, especially as they get older will not absorb the cyanocobalamin form of B12 from supplements.
  • This is why Hydroxycobalamin and Methylcobalamin are more readily absorbed, and often administered via intramuscular injection.
  • Injecting B12 intravenously can lead to a significant loss of the vitamin through urine.
  • Injection sites include: the middle of your thigh, the meaty area of your hip, the upper arm area, the buttocks, and the fleshy part of your abdomen. This is better than IV.
  • Here is a breakdown of what forms are used in injections…
    • Cyanocobalamin:
      • This is a synthetic form of B12. While it’s effective in raising B12 levels, it requires the body to convert it to the active forms, methylcobalamin and adenosylcobalamin.   
      • For individuals with impaired conversion processes (due to genetic factors or other health conditions), cyanocobalamin may not be as effective as the already active forms.
      • Therefore for people with absorption issues, or people with MTHFR gene mutations, this form is not the best.
    • Hydroxocobalamin:
      • This is a naturally occurring form of B12 that is readily converted to the active coenzymes.
      • It tends to stay in the body longer than cyanocobalamin, providing sustained B12 levels.   
      • This is often the preferred form for initial treatment of B12 deficiency.   
    • Methylcobalamin:
      • This is the active form of B12 that is directly involved in many metabolic processes, particularly in the nervous system.
      • It’s considered highly bioavailable and is often used for long-term maintenance of B12 levels.

        Therefore, while cyanocobalamin injections can raise B12 levels, they might not be the optimal choice for everyone, especially those with absorption problems or certain genetic variation

• Folate Absorption Challenges:
  • While generally well-absorbed, certain medications (like methotrexate) and digestive disorders (like coeliac disease) can interfere with folate uptake.
  • MTHFR gene variations can hinder the conversion of folic acid to its active form, 5-MTHF.
• Iron Tablet Issues:
  • Iron tablets can cause gastrointestinal distress, including constipation, nausea, and stomach cramps.
  • Iron absorption is highly dependent on a healthy gut. If your gut is compromised, the iron may pass through your system without being absorbed, rendering the tablets useless.
  • Some medications and foods can inhibit iron absorption.
• Masking B12 Deficiency:
  • High doses of folic acid can mask a B12 deficiency, which is a serious concern. Untreated B12 deficiency can lead to irreversible nerve damage.

The Ugly: Complications and the Need for Accurate Diagnosis

• Nerve Damage from Untreated B12 Deficiency:
  • This is the most significant risk. The neurological consequences of prolonged B12 deficiency can be devastating.
• The Importance of Blood Tests:
  • Accurate diagnosis through blood tests is essential to determine the underlying cause of anaemia and to ensure appropriate treatment.
• Iron Overload:
  • Taking too much iron can lead to iron overload, a condition that can damage organs.
• Gut Health Matters:
  • If your gut is not healthy, then supplements and even food will not be absorbed correctly.

What You Can Do: Taking Control of Your Nutrient Health

• Eat a Balanced Diet:
  • Prioritise iron-rich foods (red meat, spinach, legumes), folate-rich foods (leafy greens, citrus fruits), and B12-rich foods (meat, dairy, fish, nutritional yeast).
• Consider Supplements:
  • If you suspect a deficiency or have absorption issues, DM ME FOR HELP
  • For B12, we can discuss the best form for you, and if injections are needed.
• Get Regular Checkups:
  • Routine blood tests can detect anaemia and identify underlying causes.
• Gut Health:
  • Take care of your gut health, by eating a healthy diet, and if needed taking probiotics. DM FOR THE RIGHT ONES.

Anaemia is a multifaceted condition. By understanding the roles of iron, folate, and B12, and by recognising potential absorption challenges, you can take proactive steps toward maintaining healthy red blood cell production and overall well-being.