Vit. B-12 is very poorly utilized in the forms absorbed from the GI tract. I am assuming that her diagnosis of deficiency is based on a blood panel showing some sort of megaloblastic (oversized red cells) anemia.
What tests have been done on her to determine if the causes of the anemia are malabsorption or some problem in development or production of red cells that require additional vitamin B12 above and beyond normal intake? (PM if needed. I know way more than I want to about erythropoeisis or the formation and development of RBCs due to the nature of husband's illness)
Specifically, has a 'Schilling' test been done on her to determine if she actually has a B-12 deficiency anemia able to respond to oral B-12.
husband was on the shots for years. husband had ADHD (inattentive/impulsive), the shots made him bounce off the rafters for about two days after including not sleeping. They did not increase irritability but he was not prone to raging in general. They did make him eat anything that wasn't red hot or nailed down.
The injections are to be given deep IM (intramuscularly) and should be given into a large muscle like the buttocks or frontal thigh. In an adult male they can be administered into the deltoid in the arm/shoulder as well. (or in a well developed muscular female)
While the solution is not viscous and does not 'sting', it is a pretty large volume of fluid and needs to be given deep. A fact of deep IM injections is that they not only hurt at the time but can hurt afterwards as well. Light exercise like walking and gentle stretching help disperse the material and prevent knots and soreness.
The injections should be given in the AM at waking (after breakfast if the victim is prone to passing out from shots). Full tummies help prevent faintness and giving the darned thing in the AM prevents the victim from being up all night.
The BIG thing with any sort of potentially B-12 dependant (or folate dependent) anemia is to make good and darned sure it is just deficiency. Usually it is, but there are a few nasties that can masquerade that you want to catch early.
With husband the shots made him higher than a kite...totally euphoric, bouncing off the walls, yakking my ears off...and starving. He didn't rage or get irritable but he wasn't prone to that normally.
hth
toK (something is rattling around in my head about 'seizure' medication and excessive B-12 that maybe SaraPA has an answer to...since mood stabilizers are usually epilepsy medications...I dunno...Sara...could you pipe in here?)
