How is sublingual b12 absorbed

This number accounts Drugs such as antacids and metformin used to treat diabetes Drug Treatment of Diabetes Mellitus Many people with diabetes require drugs to lower blood glucose levels, relieve symptoms, and prevent complications of diabetes. There are two types of diabetes mellitus Type 1, in which the Intrinsic factor may be lacking because abnormal antibodies, produced by an overactive immune system, attack and destroy the stomach cells that produce intrinsic factor—an autoimmune reaction called autoimmune metaplastic atrophic gastritis.

Intrinsic factor may be lacking because the part of the stomach where intrinsic factor is produced was surgically removed. Vitamin B12 deficiency due to lack of intrinsic factor causes a type of anemia called pernicious anemia. Among older people, absorption may be inadequate because stomach acidity is decreased.

However, the vitamin B12 found in vitamin supplements can continue to be well absorbed even in people with decreased stomach acid. Liver disorders Overview of Liver Disease Liver disease can manifest in many different ways. Characteristic manifestations include Jaundice a yellowish discoloration of the skin and whites of the eyes Cholestasis reduction or stoppage Anemia Vitamin Deficiency Anemia Vitamin deficiency anemia results from low or depleted levels of vitamin B12 or folate folic acid.

Consequently, symptoms may be mild even when anemia is severe. If severe, anemia causes shortness of breath, dizziness, and a rapid heart rate. Occasionally, the spleen and liver enlarge. Younger adults who have pernicious anemia due to lack of intrinsic factor are more likely to develop stomach and other gastrointestinal cancers.

In people with nerve damage, the legs are affected earlier and more often than the arms. Tingling is felt in the feet and hands, or sensation in the legs, feet, and hands is lost. Their arms and legs may feel weak. People become less able to tell where their arms and legs are position sense and to feel vibrations. Mild to moderate muscle weakness develops, and reflexes may be lost. Walking becomes difficult. Some people become confused, irritable, and mildly depressed.

Advanced vitamin B12 deficiency may lead to delirium, paranoia thinking that people intend to harm them , and impaired mental function, including dementia. Usually, vitamin B12 deficiency is suspected when routine blood tests detect large red blood cells. Doctors sometimes suspect it when people have typical symptoms of nerve damage, such as tingling or loss of sensation. If the deficiency is suspected, the level of vitamin B12 in the blood is measured. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

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Search for:. References U. Department of Health and Human Services. JAMA network open. Malouf R, Evans JG. Folic acid with or without vitamin B12 for the prevention and treatment of healthy elderly and demented people. Therefore, SL route for treating VB12 deficiency has several advantages, including potentially good adherence to treatment, safety, and low cost 1.

In addition, this route enables the treatment of VB12 deficiency in patients with swallowing disorders or malabsorption syndrome inflammatory intestinal diseases, intestinal surgery, short bowel syndrome, etc.

In recent years, the importance of SL route has been recognized; however, few studies have evaluated this method, especially in children 1 , 13 , In the present study, we aimed to compare SL and IM routes of VB12 administration in children with VB12 deficiency and to compare the efficacy of methylcobalamin and cyanocobalamin therapy in these children.

This retrospective study comprised patients with VB12 deficiency inadequate dietary intake and 3 pernicious anemia aged years, and conducted between January and December We obtained the data from the electronic medical record system and patient files at Parkhayat Hospital. Based on the formulations of VB12, we divided the patients into three treatment groups as IM cyanocobalamin, SL cyanocobalamin, and SL methylcobalamin.

Exclusion criteria were as follows: I patients with chronic diseases that may affect hematologic parameters sideroblastic anemia, thalassemia, aplastic anemia, etc. According to the protocol that is applied in our hospital, the treatment response of VB12 is reevaluated after 4 weeks in every patient. The statistical analyses were performed using SPSS version 21 software. A one-way analysis of variance and Chi-square tests were used to assess comparisons between the treatment groups.

Post hoc analysis was carried out by Tukey test. The independent t-test was used to compare pre-treatment and post-treatment values. The demographic and laboratory characteristics of the study participants are summarized in Table 1. Table 1 The demographic and laboratory characteristics of the study participants.

Figure 1 Serum Vitamin B12 levels of the treatment groups. Out of patients, 76 After the 1 st month of the treatment, the improvement ratios in anemia of the treatment groups IM cyanocobalamin group, SL cyanocobalamin group, and SL methylcobalamin group were detected as 13 In addition, WBC and platelet counts did not change significantly either after VB12 therapy or between the treatment groups. IM injection is a traditional choice of treatment for VB12 deficiency due to inadequate dietary intake, pernicious anemia, gastrectomy, ileal resection, or malabsorption syndrome 17 , However, IM method is associated with some disadvantages, such as pain, high cost, poor adherence to treatment, and bleeding in patients with coagulation disorders Considering these issues, SL route is now being considered for VB12 administration.

SL method enables direct absorption of VB12 under the tongue, bypassing intestinal absorption Moreover, this method has several advantages, for example, it is less costly, results in high patient satisfaction, does not require a hospital visit, is not painful, and does not result in injection-related injury However, few studies have evaluated the efficacy of SL administration of VB12 and compared it with that of IM administration.

Bensky et al. The authors concluded that SL route should be the first-line choice of treatment in patients with VB12 deficiency Sharabi et al. The authors reported that SL route is as effective as the oral route in treating VB12 deficiency In a prospective open-labeled study, Delpre et al.

To the best of our knowledge, this is the first study to compare two treatment methods SL and IM and two cobalamin types cyanocobalamin and methylcobalamin simultaneously in children with VB12 deficiency. Even with sufficient intrinsic factor and good intestinal health, B is very poorly absorbed. For example, about 10 micrograms of a microgram oral supplement -- only 2 percent -- is typically absorbed in healthy people, according to the National Institutes of Health.

Sublingual supplements -- either as tablets or liquid drops -- are meant to be put under your tongue and absorbed through the mucosal membrane that lines your mouth. Substances absorbed under the tongue get into the bloodstream without having to go through the gastrointestinal tract. Sublingual B tablets usually come in or 1,milligram doses. The amount of B your body needs daily is only between 2.