vitamin b-12 shots

[Anonymous]

Hi all,

Can you please give recommendations on a dr. that understands vitamin b-12 deficiency and is able to give out prescriptions for shots? Thanks. Fairfax or dc.

[Anonymous]

Any doctor can prescribe vitamin B12 shots. Many are unwilling to, however.

There is a history here. In the first few decades of the second half of the last century, after the dangers of B12 deficiency became known, doctors would diagnose patients as having a possible B12 deficiency clinically, as cheap tests were not available. Pills were not available as they are today so B12 was given by injection.

Legions of patients came in monthly for their injections. Then insurance began to take over medicine and coding for particular conditions was required as well as some back up for treatment. B12 tests became cheaper and it was found that a number of patients getting the injections did not actually have a B12 deficiency, so no coding, no shots. Giving B12 injections started to become associated with quackery. As did, very mistakenly, the very idea that a source of a person's problems could be a B12 deficiency--the normal lab levels were set (and continue to be set) at levels that are entirely too low.

In the meantime, the vitamin industry grew and it became possible to take Vitamin B12 in pill form. A few studies were done showing that pill supplementation was as effective as injections, so giving injections deeply fell out of favor with some as the aura of quackery around them deepened.

However, many of those in the medical community who have studied B12 feel the studies showing pills are just as effective are not very robust and involve very particular sets of patients (older people) whose cause of B12 deficiency is the decrease of stomach acid that occurs naturally with age. They do not believe that the experience of those patients should be compared to those with, say, pernicious anemia, for whom injections are they feel are likely the quickest and surest way to restore health to the patient.

So what you will find is that the majority of doctors without a lot of knowledge of B12 will need a lot of convincing even to test for B12, or if they are willing, go strictly by the lab values, which are set too low. And they will be willing to do only pills to avoid a practice they were taught borders on quackery. Those who will give B12 shots do so either because of the nature of their practice seeing a fair amount of serious B12 deficiency and from experience having seen injections work faster and better than pills or those who are more than willing to do things that make patients happy. Some weight loss clinics, for example, are pretty liberal with B12 injections.

Perhaps the surest way to get B12 injections is to go to a naturopath or a doctor that practices integrative or functional medicine. You will have a hard time finding more conventional doctors--they are out there, but they don't advertise the fact for the reasons stated above.

If you do get shots, see if you can convince them to give you hydroxocolbalamin rather than cyanocolbalamin.

[Anonymous]

Thanks for that very detailed response. I have learned about this doctor cultural problem and it is very frustrating. I have a B12 deficiency that is right at the low end of the "normal" range, but I'm having severe neurological symptoms (numbness, severe dizziness, confusion, mini-"seizures") that track perfectly with B12 deficiency and pernicious anemia. Lots of material on the net says that you must have injections in order to replenish muscle stores and eliminate the neurological symptoms. Have been taking pills for a month but no reduction of symptoms.

My GP has no clue about any of this and is refusing to give me injections. They are perfectly safe, and I am FRUSTRATED that she won't even try since I'm having such serious symptoms.

If anyone knows of ANY doctor that is knowledgeable and experienced with B12 deficiency and/or pernicious anemia in the DC area, please share. Thank you!!

[Anonymous]

I'm sorry you are going through this, op. I know my dad got b-12 shots from his kidney specialist. This was in ny, though, so I don't have a specific rec for you, but perhaps that specialty is more open to it? Maybe check ratemds.com and see if anyone has written anything there on it? Good luck to you. I struggled to get my thyroid properly treated, so I empathize with you.

[Anonymous]

OP: thank you. I was recently diagnosed with hashimotos but since then the dr. has said my levels are normal. I'm switching to the name brand though as i've read on other message boards that the generic may cause side effects like the dizzies. The neuro symptoms my endo says is not thyroid related. Trying to figure this out.

[Anonymous]

Dr. Mustafa Moody in the District will do B12 shots.

http://www.drmoodymustafa.com/nuco.html

OP, I am with you on feeling the shots are surer. There are some doctors--conventional ones--who also have more confidence in the shots.