Alright so I hate having to post about this because other than this one pesky vitamin, I've had no issues. See, I take the vitamin patches. I take the multivitamin with has 1000mcg of B12 already in it. On top of that I take the B12 patch, which has another 1000mcg in it. In July for my year bloodwork, my tests came back to where my B12 was super close to being deficient. I'll post an image of my results below for each test. After those results, my PCP started having me come in to get an additional B12 shot every month. I've had 3 months of that. Then, as you can see, results from the other day come in. While it's gone up a bit, she's still concerned enough that it's on the lower end to have me still come in every 2 months for a shot. Here's my thing... with my supplements, that's 33,334% of the daily value. On top of the foods I eat, and THEN the shot every month. It almost seems like my body isn't absorbing the vitamin. What the crap? I already sent my PCP a message asking clarifying questions and expressing my concern to her wondering if anything else could be contributing to this, so I'll see Monday her response.

My question is, has anyone else dealt with an issue with their B12 post-op? I know thyroid issues or anemia can cause/effect it, was this the case for you? Or was it something else?

My results:

Ok, I read a very interesting website that talked about how we absorb B-12.

Essentially, our recommended daily intake is 3.5mcg. Most foods that are good sources of B-12 have this amount in one or two servings.

There are two methods the body utilizes to digest/absorb B-12. One is the normal way, where "intrinsic factor" (a chemical created in the stomach) attaches to B-12, and ushers the B-12 out of the small intestine, into the blood stream.

The second way is a "passive system", which doesn't require intrinsic factor. B-12 just slips out into the bloodstream by itself. BUT, this passive system is VERY inefficient, and so only 1/100th of the B-12 makes it into the blood.

We sleevers, we had the portion of the stomach removed that makes intrinsic factor. So the first method doesn't work anymore. The second method works, but look at the numbers. If a serving of B-12 food has 3.5mcg, but you only absorb 100th of it, then you'd have to eat 100 servings of that food to meet your daily goal.

Excess B-12 is stored in the liver, and if your liver is full, it can provide your B-12 needs for 5 or 10 years. Since your blood work is showing dropping levels, it may mean your liver isn't full anymore, so the supplements become more important.

There is no proof the patch works, so don't count that in your figuring out how much B-12 your body is getting. Your pill has 1000mcg, so you are absorbing about 10mcg a day. But, that's statistically, and we don't know if the particular supplement you take is as easily absorbed as the ones used in the studies. So it's possible, you aren't even getting 10mcg.

The shot, however, is the surefire way that you are getting this supplement, since it bypasses the digestive system completely. If your liver is running low, it could take a while before the shot fills it back up enough to reflect in a much higher number in your blood. Since your blood value did go up, the shot is definitely doing its job.

http://www.b12-vitamin.com/intrinsic-factor/

Here's the website:

Instead of taking B12 in pill or patch form try sublingual B12; better absorption post-WLS.

@Berry78 thank you. I do know Stacy and a few other patients of our surgeons actually tested out the patches for months and they did as they claimed. My multivitamin is the patch one as well. I don't do well with taking pills daily, so the patches have been a saving grace. Aside frim my B12, everything else has been perfect since surgery. I'll definitely take a look at that site.

@MarinaGirl I don't understand how that's any different than a pill?

The skin is designed to be a barrier to chemicals from the environment. Not to absorb stuff. The mouth IS absorbant since it's a mucus membrane.

There is some question whether sublingual actually gets absorbed in the mouth, or in the intestine once swallowed. Either way, oral administration is important.

Think about it, if we could absorb b-12 through the skin, we could just go play in the dirt and get our quota.

But that begs the question about my absorption of the other vitamins. I'm definitely not saying that you're wrong because you're right that the patches aren't a FDA approved vitamin. I'd just be super confused as to how I'm deficient in one and not others if they weren't doing something you know? Like I had to stop the biotin patches and switch to a pill because the vitamin a in the biotin patch caused me to have too high of levels.

OP, you can can also try the nasal sprays. It enters the bloodstream directly. Good luck!

The vit A in the patch is beta carotene, right?

"Eating excessive amounts of foods with beta carotene, such as carrots, can cause a person's skin to turn yellow-orange but it does not cause vitamin A toxicity. The body does not convert beta carotene to vitamin A when there is sufficient vitamin A present."

https://labtestsonline.org/understanding/analytes/vitamin-a/tab/test/

Look somewhere else for your excess Vit. A. Liver, cod liver oil, multivitamin, etc.

Ok, I got curious. Turns out my broad denouncement as to the efficacy of patch vitamins was hasty.

So far I have turned up a study that shows vit. D IS effectively absorbed through the skin. Vitamin A (retinol) can as well. These are both fat-soluble vitamins, which probably has an impact.

If your patch Vitamin A is retinol, then that makes sense...beta carotene still doesn't convince me.

Is there a lotion, sunscreen, or something else you are using that has retinyl or retinol?... assuming you don't eat liver every week....

6 hours ago, Berry78 said:

Ok, I got curious. Turns out my broad denouncement as to the efficacy of patch Vitamins was hasty.

So far I have turned up a study that shows vit. D IS effectively absorbed through the skin. Vitamin A (retinol) can as well. These are both fat-soluble vitamins, which probably has an impact.

If your patch Vitamin A is retinol, then that makes sense...beta carotene still doesn't convince me.

Is there a lotion, sunscreen, or something else you are using that has retinyl or retinol?... assuming you don't eat liver every week....

I just want to point out that you get vitamin D from the sun. So our bodys are tailored to absorb it through the skin (well technically your body makes it from the sun, but im not gonna pretend that im very knowledgable)

Id agree about being weary about vitamin patches though, theres no way theyre remotely as efficient as people like to imagine. Regardless I think sublingual or via a shot are the best ways to get vitamin B

I did find a study for vit. B-12. They said it isn't well absorbed through today's patches, but they used some micro needles to put the tiniest of holes into the skin, and that allowed the B-12 to get absorbed.

So unless they start using micro needles, patches aren't the best way to receive B-12.