If you have Crohn’s disease, it probably affects your ileum, and you’ve probably learned that you are at risk of vitamin B12 deficiency. If this is news to you, take a moment to read up. I used to take B12 shots which were effective, but when I leaned that they contained aluminum I sought out a metal-free alternative.
The challenge with B12 is that if your ileum is damaged or removed you simply cannot absorb B12 through diet or vitamin pills and have no choice but to find another delivery method. The lack of sufficient B12 can be problematic and potentially serious if not addressed. Talk to your doctor and read this.
I’ve found a few alternative delivery methods for B12 supplements: injections, nasal spray, sublingual and topical cream. I can’t give you any insider experience with the nasal spray or topical cream, but if you google for “b12 nasal spray”, you’ll find what you need. B12 topical cream is a little harder to find. Google will return many B12 creams for eczema, but I suspect they wouldn’t work as needed. I did find some at Coastal Compounding and you could always speak to your local compounding pharmacy.
My recent experiment in alternative B12 supplementation was to use Pure Encapsulations B12 liquid as a sublingual. I used it for one year as my sole B12 supplement, taking a single 1ml, 1000mcg dose every other day. I recently had my yearly checkup and my blood work showed a B12 level of 439 on a normal scale of 180-914. For context, I’ll tell you that I weigh 170 pounds and consider myself to be moderately active.
Being the eagle-eyed reader that you are, you’ve probably already discovered that Pure Encapsulation B12 liquid contains stevia. You also know that stevia is illegal as a sweetener. But did you know that Elaine allowed it in “miniscule amounts” in supplements? I know that this isn’t ideal, but for me the trade off between aluminum in the shots and stevia in the B12 was acceptable. I have found another B12 liquid that appears to be 100% legal, but at three times the cost of the Pure, I haven’t given it a try.
In her BTVC book, Elaine recommends bringing B12 levels up to a “high normal” (pg 65, eleventh printing). You’ll have to discuss this with your doctor and spend some time with blood work and experimentation to discover what it takes to get you there. If you dig around the web a bit, you will find that the “normal range” for B12 is somewhat subjective as different sources cite different normal ranges. As far as I can tell, no upper limit for B12 has been established due to it’s low risk for toxicity. It appears that excess B12, that is B12 that your body cannot use, is simply excreted. Don’t get crazy with it though.
As always, talk with your doctor before altering your treatment to avoid unintended consequences or complications.