Reddit mentions of NOW Supplements, Methyl B-12 (Methylcobalamin) 1,000 mcg, Nervous System Health*, 100 Lozenges

In other words, there's a universal narrative that vegetables are icky so I'ma just eat potato chips all day and say being vegan is hard. Although the vegan B12 deficiency is true, especially for raw foodists, it is spurious to say that one deficiency overrides the gamut of health problems associated with animal products. Especially since bacteria produce B12, so it is super easy to find a vegan supplement for it, and fairly cheap.

The AMA is fine with a vegan diet through all stages of life, including pregnancy and early childhood (there are citations at http://www.vrg.org/nutrition/veganpregnancy.htm).

B12 can be produced without the involvement of animals (via bacterial synthesis) (http://www.amazon.com/Foods-Methyl-B-12-1000mcg-Lozenges/dp/B001F0R7VE/ref=sr_1_2?ie=UTF8&qid=1335661746&sr=8-2).

But to each his/her own.

Here's the recommendations for B12 for a normal person.

> Eat two servings per day of foods fortified with at least 2 to 3.5 mcg of vitamin B12 each. You’ll need to eat these servings at least 4 hours apart to allow for optimal absorption.
Take a daily supplement providing 25 to 100 mcg of vitamin B12
Take a supplement providing 1,000 mcg of vitamin B12 twice per week. This is for cyanocobalamin.

> For those who prefer to take methylcobalamin, it’s likely that 1,500 mcg per day would meet needs. But again, it’s difficult to make specific recommendations about this.

Some brands: Deva, Doctor's Best, Now Foods have good reviews.

Methyl and Cyano are different forms of B12 and both are fine. Vegans use both; for which one is better, I have no idea. They have slightly different dosage recommendations. BUT since you're low, I would take any of the brands I listed daily. Go again in 3 months to see if your levels have changed. I get B12 from a 1000mcg cyanocobalamin 3/week, and eat fortified foods like nutritional yeast and soy milk.

I'm in a similar situation - UC since 2000, had a flareup last fall, and never fully recovered my energy even though the flareup was controlled. Even though my bowel movements went back to normal, I was sleeping 12+ hours per night, and randomly falling asleep on the couch in the afternoon - and I was disoriented whenever my SO tried to wake me up.

Over the past few months, I've tried everything. I've been back and forth to my GI and primary care doctor, and also met with a rheumatologist, sleep medicine doctor, and a dietician. I was even sent for a sleep study, because they were worried that I might have narcolepsy (I don't)!

Of everything that I tried, these are the things that worked. I made each change one at a time, and each one improved my energy a little bit. I now feel almost completely back to normal:

1. Increased my Humira dose from every two weeks to every week. The theory was that I still had some residual inflammation making me fatigued, even though my other symptoms were gone. This improved my bowel symptoms more than I thought they could possibly be improved, so I guess there was some truth to that.
   
   
2. Cut back on my caffeine intake. I realized that I was trapped in a cycle of feeling exhausted, drinking more coffee, having restless sleep (even though I was sleeping the day away!), and feeling more exhausted. I stopped drinking coffee, which was incredibly rough at first - but I think I'm sleeping better now. I only allow myself one cup of black tea in the morning.
   
   
3. Re-read the side-effect profile for all of my medications, to see if anything I was taking could be causing drowsiness. I had been on an antihistamine nasal spray for years, and didn't think it was bothering me - but when I asked my allergy doctor about it, he said that drowsiness was a "very rare" side effect, and maybe I was more prone to it because of my underlying UC-related fatigue. He switched me to a steroid spray instead, and my drowsiness is gone - no more falling asleep on the couch! The fatigue remains, but it's more manageable now because I can now force myself to stay awake, even though I feel like crap!
   
   
4. Started taking a B12 supplement (this is in addition to my daily multivitamin). I bought the type that contains methylcobalamin, which is the easiest-to-absorb form of B12. It's a cherry-flavored lozenge that you dissolve under your tongue. However, if you have CD in your ileum, it might be physically impossible for you to absorb enough B12. Ask your doctor about B12 injections!
   
   
5. Increased my Vitamin D dose to 3000 IU/day (this is also in addition to my daily multivitamin). A few years ago (in a period of remission), I was extremely fatigued, and having difficulty getting out of bed in the morning. I was diagnosed with a vitamin D insufficiency - my blood level was 24ng/ml. I started taking supplements (2000 IU/day), and when the level got up to 56ng/ml, I felt awesome! I decided to stay at that dose indefinitely. With this last flareup, my vitamin D level dropped back down to 41, despite no change in my supplements. I'm now slowly increasing my dose, and my doctor is sending me for blood work periodically to make sure I stay in a healthy range (currently at 3000 IU, and might increase to 4000 IU after my next blood test).
   
   For some background on the vitamin D dosing:
   
   A lot of researchers are now suggesting that the currently accepted "normal" range for blood tests is too low, and actually represents the minimum level we should aim for - and that the current recommendations for dietary intake are too low to even get us to that minimum! There's also a link between vitamin D deficiency and IBD, though there's no definitive answer as to which comes first (there's a brief discussion, with a few citations, here.
   
   From what I've read, and what I've discussed with my GI and primary care doctor, it's a good idea to increase to whatever dose you need to get your blood levels between 50 and 100ng/ml - there are some tips here for how to do so. (Although the dosages might seem high, they're safe - many doctors prescribe 50,000 IU per week for patients with severe deficiencies!)
   

Pretty much any brand, but this one is what I get.

I'm grateful for the shared knowledge! Aaaand now I want to throw my B-complex into the trash!

>Sublingual methylcobalamin is supposed to be better.

The person in the article said sublingual doesn't work, because B12 is "a very lage molecule", and only small molecules pass sublingualy, but that sublingual ends up working because it gets swallowed. So, would sublingual still be better than a Methylcobalamin version like this?

If topical is even better, does this product look good? What's DMSO? I couldn't tell if it was included or would need to be purchased separately.

yep, we take ours every day, i try not to take more than that, but they're really tasty. http://www.amazon.com/Foods-Methyl-B-12-1000mcg-Lozenges/dp/B001F0R7VE