Could sublingual B12 cause gastritis? Tex? Or anyone?

[carolm]

Last Thursday I took my first sublingual Methyl B12. I took 1/2 tablet as directed. About 3-4 hours later I became chilled and horribly nauseated, to the point I took 25mg meclizine and 8mg Zofran, and still dry heaved for 3 hours. One full tablet contains 1700 mcg DFE from 1000 mcg as Quatrefolic (6s)-5-Methyltetrahydrofolic acid glucosamine salt, and vitamin B12 as Methylcobalamin 5000mcg (which according to the label is 208,333% of the recommended daily value). So I took half of this.

I’m trying to figure out if I had something else going on (a viral thing maybe?) or if this attack of gastritis might have been prompted by the Methyl B 12. It seems that the point of taking it sublingually would be to bypass the stomach to a large degree. I was still washed out and light headed Friday and Saturday, and had to really push the fluids. I was finally hungry Sat night.

Could the sublingual dose cause this? Admittedly my upper GI tract can be dicey... but this was a truly miserable experience, I’d rather not repeat.

I’d appreciate any educated guesses on this or hearing if anyone else has experience with this?

Thanks
Carol

[tex]

Hi Carol,

I've never heard of that type of reaction. I certainly can't blame you for not wanting to go through it again because it sounds as though it was a relatively serious reaction. Did the reaction cause any type of rash or hives or any other anaphylactic symptom? Did you have any tingling or numbness in your face, arms or fingers?

It appears that rather than being an allergic (anaphylactic) reaction, or a neurological reaction, it was strictly a digestive system event (centered on the stomach and/or pyloric valve). I need to think about this some more — it's too late for me to think straight tonight.

Tex

[carolm]

Hi Tex,
I did worry and was on guard for an allergic/ anaphylactic type of reaction when I was in the worst of it but as it turned out, it seemed to be only gastric, and upper GI at that. No D. No hives, rashes, tingling or numbness. When it started it started with chills and I mean I was freezing. It was very much like the reaction I get when I eat soy (except for the chills) but I could not identify anything that would have been soy based that day.

I’ve toyed with the idea of taking a half of the half tablet and seeing what happens, with the idea that if I reacted it would be either less intense or short- lived.

I also have another B complex supplement that has a much smaller amount of B12 and folate, along with niacin and riboflavin among others, so I guess another option is to start with it.

Thank you in advance for your thoughts on this. Never a dull moment living with LC.

Carol

[Gabes-Apg]

I struggled to tolerate any B12, when I was low in things like B6, magnesium etc. took me 6 months of fixing other imbalances before I tolerated active B12. (this applied to lingual, liquid and tablet)
I did ok with methyl B12 injections - they were great albeit they were too expensive. $100 for 8 weeks worth!

[tex]

Carol,

Because you didn't have any allergic or neurological symptoms, I find myself scrutinizing the other ingredients in that mixture (after all, it's not just methtylcobalamin). You know manufacturers are not required to list inactive ingredients on pharmaceutical labels. Most of them do, at least partially, but we have no way of knowing whether or not any label includes a complete listing. Also, folic acid (the synthetic form of folate) has recently been implicated as an in utero cause of allergies in children.

Folic acid is the synthetic form of folate and is often recommended to pregnant women as a way of preventing neural tube defects in their children, like spina bifida. When folic acid is consumed in higher quantities, some of this folic acid is not metabolized and circulates in the blood as “unmetabolized folic acid.”

In a nested case control study performed in the Boston Birth Cohort, scientists found that higher levels of unmetabolized folic acid measured at birth was associated with the development of food allergy.

Folic Acid Exposure in Utero is Associated with Development of Food Allergy

Now this effect has been found to exist only in utero, and it applies only to the synthetic form (folic acid), not to the natural form (folate or methylfolate). I assume you understand the important difference between folate and folic acid. Quatrefolic (6s)-5-Methyltetrahydrofolic acid glucosamine salt is apparently a product of a chemical or manufacturing process and it may be a highly-processed form. But apparently it isn't exactly equivalent to the folate produced by the human body. It has been classified by expert panels to be "generally recognized as safe" ("GRAS") and superior to ordinary folic acid as an additive to food. But you and I both know that does not mean that it is safe for everyone.

I note that the listed side effects of methylfolate are:

insomnia.
muscle and joint pain.
rash.
severe anxiety and irritability.
palpitations.
nausea and vomiting.
headaches, migraines.
decrease in mood, even severe depression and suicidal thoughts.

I have to (at least tentatively) conclude that your reaction may have been due to an inactive ingredient, but was most likely caused by the "folate" ingredient in that product. I would try a plain sublingual methylcobalamin lozenge (without the folate or any other active ingredient, or at least one without Quatrefolic (6s)-5-Methyltetrahydrofolic acid glucosamine salt). Combinations of active ingredients are much more likely to cause problems for us.

As always, remember that this is just my opinion, and these are uncharted waters.

Tex

[carolm]

Wow, thank you both for sharing so much information. I had planned on doing more research on my own but spent most of my weekend trying to get rehydrated, rested and back on my feet (and trying not to brood about this set back). I had looked up side effects of B12 but I did not know about the processing of Quatrefolic (6s) 5- Methyltetrahydrofolic acid glucosamine salt. I appreciate you filling me in on that one, Tex.
The bottle does say it’s free of gluten, soy, yeast, etc. I like your suggestion of trying just a B12 lozenge without the other ingredients. That would sort that out.

And as Gabes noted from her own experience, there are other areas that I also need to get in order too. I’ve taken DHEA and CoQ10 before and had no issues with them. Same with Omega 3s, as long as other ingredients are not a problem. But I’m only adding them one at a time.

So I’m back to the drawing board but armed with better information.
Thanks again, I greatly appreciate your help.
Carol

[tex]

Carol,

I know nothing about how the "Quatrefolic . . ." is made. That bothers me a lot. I could be onto something or I could be

Tex

[tex]

Here's what's said about it:

In contrast to folic acid, a synthetic form of folate, 5-MTHF is one of the forms of folate found naturally in foods. ... 5-MTHF provides one milligram of (6S)-5-methyltetrahydrofolic acid (in the form of a vegetarian glucosamine salt) from a very pure, patented form called Quatrefolic®.

It has to be a synthetic product, or it could not be patented, right? No truly naturally-occurring item or process can be patented.

Tex

[carolm]

I agree with your logic. I’ll do more looking tonight and be sure to pass on what I find.

Thanks- Carol

[Marcia K]

Hi, Carol. I hope you are feeling better by now. This is such a horrid disease...enough said there. The day before we left for GA I felt horrible. I didn't know what was causing it but I felt so badly that I went to bed at 8:30 p.m. and I have never done that in my adult life. The next day I was fine. I attribute it to stress from the work week and then getting ready for the trip and not knowing what I would eat, etc. Stress always does me in. No one understands this disease unless they have it. Take care!

[persevere]

For consideration. Too much methyl-anything can cause problems (as above) for those with certain MTHFR genes /snps that can't process properly. It's called methyl trapping. You can get too much.
Dr.Ben Lynch has done a lot of work on this topic.
Here is a link:
https://www.mthfrsupport.com.au/practit ... ate-myths/

[carolm]

Hi again-
Tex I’ve read up on Quatrefolic and at first I mistakeningly thought it was their process that they had patented but based on what I read today I think it’s the concentrated glucosamine salt that results from their process that they’ve patented. I’m afraid I’m not savvy enough in this area to be 100% sure that’s the case. At any rate I think I’ll avoid taking it. I can find an alternative for what I need. I greatly appreciate your help while I’m trying to figure this all out.

Hi Marcia- you are right. No one else gets it like those of us living with this. We have challenges in all directions. I am ‘back to normal’ but it took until Sunday before I was really feeling okay.

Hi persevere- thank you for the link. I glanced at the info and I look forward to digging in deeper when I have a few minutes where I can focus on it. Dealing with MTHFR is new to me.

This week I’m only brave enough to increase my Vit D3. :)

Thanks all.

[persevere]

Good luck. MTHFR is very confusing stuff. Not a linear thing. On B12, only form that doesn't distress me is adenosylcobalamin, the most active form. Some hydroxy-.
No methyl cobalamine for me. It seems anti-intuitive that methyl donor supplements don't help the methylation process for some. sigh.
It's quite a journey.

[carolm]

Thanks Persevere,
I’ll take note that adenosylcobalamin may be an option for me. I’ll look it over.

Best wishes
Carol

[carolm]

Hey Tex- there is an inactive ingredient in the Methyl B12 and the DHEA I bought called isomalt. Both products are made by OrthoMolecular. Here’s what I’m finding on isomalt:

“Like most sugar alcohols, it carries a risk of gastric distress, including flatulence and diarrhea, when consumed in large quantities (above about 20-30 g per day).[1] Isomalt may prove upsetting to the intestinal tract because it is incompletely absorbed in the small intestine, and when polyols pass into the large intestine, they can cause osmotically induced diarrhea[3] and stimulate the gut flora, causing flatulence.[1] As with other dietary fibers, regular consumption of isomalt can lead to desensitisation, decreasing the risk of intestinal upset.[1] Isomalt can be blended with high-intensity sweeteners such as sucralose, giving a mixture that has the same sweetness as sugar.”

It’s hard to imagine I would have such a strong reaction to this ingredient but I can’t rule it out either, yet. Unfortunately it’s in the DHEA too so I’m looking for another brand of DHEA. The other inactive ingredients in the Methyl B12 are natural cane sugar, croscarmellose sodium, potassium bicarbonate, natural cherry flavor, sodium stearyl fumarate, stearic acid, citric acid, silicon dioxide, and billberry fruit extract.

Anyway, just another possibility I thought I throw out there.

Take care-
Carol