Re: [ozmidwifery] B12

[Marilyn Kleidon]

Yes, I have often recommended Vit B12 too which was why I was surprised. The Category A rating (no problems shown by controlled studies) is for the oral/sublingual vit B12; the category C rating is for the IM/deep subcutaneous dose which exceeds the daily requirement and also must have no controlled studies done. Doesn't mean it shouldn't be used. This is a critical vitamin and supplements shouldn't be necessary for women with normal absorption of nutrients and unrestricted diets, however malabsorption and /or restriction of animal products can lead to deficiency. Dietary restriction can be overcome by oral supplementation often with fermented soy products (e.g. tempeh) and/or nutritional yeast; if this is insufficient or inadequate then I recommend the sublingual preparation. However if malabsorption is the problem then it wont matter how much vit B12 is eaten nor how much meat the person is ingesting, the levels will remain low as will iron stores and possibly/often anemia will persist. The end result can be significant neurological impairment which is apparently reversible if short term deficiency but may not be with long term deficiency (I cannot find any info on this i.e. a time line etc.). I have 2 vegan daughters, and 1 vegetarian all now for the last 12 to 15 years, all have developed a liking of nutritional yeast: I guess it beats my nagging. There is a "Farm Cookbook" put out by Ina May Gaskin and her cohort at "The Farm" all those years ago, it deals very thoroughly with the dietary supplementation of Vit B12 and the need for it in the diet. The Farm of course was vegan.   marilyn ----- Original Message ----- From: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Thursday, April 01, 2004 7:27 PM Subject: Re: [ozmidwifery] B12 i have often recommended bi2 inj in preg will look into it more jan ----- Original Message ----- From: Marilyn Kleidon To: [EMAIL PROTECTED] Sent: Saturday, April 03, 2004 5:12 AM Subject: Re: [ozmidwifery] B12 Hi Rochelle:   I was surprised to read that Vit B12 administration would be contraindicated in pregnancy. So, I looked it up in the 2003 PDR Nurses drug reference aand found it to be Category A or Category C in doses that exceed the RDA (this is a USA publication so not sure even now how RDA translates). Anyway Category A is interpreted as controlled studies have shown no risk. Category C just means that risk cannot be ruled out usually because "human studies are lacking" and states that potential benefits may justify the potential risks.  Do read the side effects carefully.   An IM preparation would most likely by Category C because of the dosage.   It seems from what you describe that you have some degree of malabsorption of Vit B12. Since this Vitamin is very important for the synthesis of red blood cells and nervous tissue including nucleoprotein and synthesis of myelin for both you, your lactating baby, and your gestating baby I would agree with your GP and advise the IM or deep SC injections. You GP is most likely concerned about the effect on you should you suffer a postpartum haemorrhage or even a moderate blood loss at birth with your low iron stores. You  must weigh the benefits against the risks. However,  discuss this further with your GP if you suffer from allergies (in particular cobalt as this is part of the Vit B12 molecule) as there can be significant allergic reactions ranging from itching to anaphylactic shock. It would be usual for you to remain in the GP's office for half an hour to an hour to safeguard this.   marilyn     ----- Original Message ----- From: Tim & Rochelle To: [EMAIL PROTECTED] Sent: Thursday, April 01, 2004 3:55 PM Subject: [ozmidwifery] B12 Hello,   what do midwives, nurses, naturopaths etc out there think about having vitamin B12 shots at the end of my pregnancy. I have always been told I have a B12 deficiency but have been previously unaware of the actual levels until results almost a year ago showed a reading of around 400 (anything over 250 is normal anything under 170 low and inbetween is well inbetween.) I had bloods taken at 28 week pregnant - now 31 and the results of my B12 came back at 212. My GP has recommended 2 intramuscular shots prior to the birth, which I was fine with until I got the script filled and read the leaflet that says that B12 shots are contraindicated in pregnancy and that B12 does cross the placenta. It says that B12 should not be used to treat anemia in pregnancy. I am not anemic my hemaglobin levels were fine and hadn't dropped much since the start of the pregnancy however my iron store is down to 4. (it was 23 a year ago). For this I am taking floradix and have upped my pregnancy multi and take it in conjunction with ascorbic acid.   I guess I am in need of some direction, Firstly is there an issue with the baby receiving B12 in such a way or at such a level? and Is it really important for me to get my B12 levels up? If so for me or the baby or both? What are the consequences if any of not having the shots? Is anyone familiar with B12 issues?   By the way years ago I had a schillings test which I think concluded that I was unable to efficiently absorb B12 from food sources into the blood.   I am breastfeeding my 3 year old approx once a day.The other thing the leaflet says is, "USE IN LACTATION" Hydroxocobalamin is distributed into breastmilk. Therefore it is not recommended for breastfeeding mothers unless the expected benefits to the mother outweigh any potential risk to the infant.   The prescription is Neo-Cytamen '1000' (Hydroxocobalamin Chloride - Vitamin B12)   I will do some more research and further discuss this with my care providers, but thought someone might have some information or an opinion on this this, all responses will be greatly appreciated.   Cheers Rochelle.