What now...

Hi, Pat,
Without the ileum, B12 cannot be absorbed from food. However, the B12 in pill form can be absorbed in the stomach. It is best to take higher dosages because the absorption rate is not efficient. Sublinqual probably gets you more, faster, but pills do work just fine. I was told by my urosurgeon to take a daily vitamin pill that contained B12 after my RC/ileal neobladder surgery. Because my B12 dropped considerably after my surgery, I also take a separate B12 pill to supplement the daily vitamin pill. I know other neobladder patients that have been able to keep their B12 levels high by using the oral pill form. Here is a quote from and a link to an article from the Family Physican Journal that addresses B12 absorption, deficiency, and treatment:
"Because most clinicians are generally unaware that oral vitamin B12 therapy is effective,17 the traditional treatment for B12 deficiency has been intramuscular injections. However, since as early as 1968, oral vitamin B12 has been shown to have an efficacy equal to that of injections in the treatment of pernicious anemia and other B12 deficiency states.9,17-19 "....
"Although the daily requirement of vitamin B12 is approximately 2 mcg, the initial oral replacement dosage consists of a single daily dose of 1,000 to 2,000 mcg (Table 4). This high dose is required because of the variable absorption of oral vitamin B12 in doses of 500 mcg or less.19 This regimen has been shown to be safe, cost-effective, and well tolerated by patients.19"

www.aafp.org/afp/20030301/979.html

Since B12 in pill form is an over-the-counter product, I do know what you mean about the shot form being the only one approved by the FDA.

My best to you,
LindaW

without the ileum the only way to absorb Bl2 is by shot or sublingual and now they apparently have a B l2 patch which absorbs directly into the blood stream....however the only one approved by the FDA is in shot form..........Pat

Hi, Holly,
I am so glad you listened to your husband and got the B12 shot...126 is well below the recommended reading for B12. Anemia caused by low B12 is very serious and can cause irreversible nerve damage if low levels continue for long, so keep your B12 above a 200 reading if you can. I always get a sore tongue whenever my B12 gets low. You might also like knowing that the pill form of B12 is very effective for most people as well as costing less and not as painful as the shot. One of the good thing about the pill form is that it can be absorbed in the stomach instead of like the B12 in food that depends on the small intestine to extract it. Here is a website that gives good, concise info about B12 deficiency:
[ www.webmd.com/a-to-z-guides/vitamin-b12-deficiency-anemia-topic-overview ]
I wish you good results with your bone scan and the treatment plan that you decide upon.
My best to you,
LindaW

Your new warrior name sounds perfect for you. We used to live in Wisconsin but moved to Tucson this year. Could not face any more winters there. My husband had all his Bladder Cancer treatment in Madison until he switched to a urologist at the University Hospital here in Tucson. Also we have daughter that lives in Minnesota.

Holly,
I am crushed you didn't pick "VENUS' means beutiful roman goddess, like APHROTIDE...thats okay, I'm just kidding, I always want to be the QUEEN,,I don't know of what? Your selection is perfect!! Ginger

Holly,
Excellent choice. And I know your Grandma would be so very proud of you, just as so many of us are. When I think of the name Holly, I can't help but think of brave, courageous, caring, kind, enthusiastic, fun, smart, wise, spiritual, outgoing, compassionate, etc....and so much more. No matter what you call yourself, you are a wonderfully strong person and all of us have so much admiration for you....some of our strength is a result of knowing you. Thank you, Holly, for being you! Hugs to you! As always, you are in my daily prayers. Melodie