Magnesium and B12 Injections - what to do if your GP refuses to give

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General Comment

Magnesium and B12 injections are so helpful that it is pointless progressing onto other things without trying these first. Below I set out the options that I see as available to anyone to whom I have recommended these injections.

The Options

1. Some GPs are unwilling to prescribe the magnesium and B12 but are prepared to inject them. In this event I can supply the magnesium and B12 (only if you are an existing patient of mine) and the GP's practice nurse should be able to inject.

2. The second possibility is that I teach you to inject yourself (only if you are an existing patient of mine) if the GP refuses to have anything to do with magnesium and B12 injections. This has great advantages because the timing of the magnesium and B12 depends on your clinical symptoms. Some people know exactly how long the injections "last" so that, for example, if they are going through a good phase the effect of the magnesium injection will last longer, whereas if they are going through a bad patch then the effect will last for a shorter time period. Sometimes more benefit is obtained from the B12 than from the magnesium or vice-versa and the injections can be adjusted accordingly. I can teach you how to inject yourself during a consultation, or alternatively you can be taught by a competent local practitioner such as a doctor or nurse. Many of my patients do end up injecting themselves simply because this saves them the effort of travelling down to their GP's surgery on a regular basis and the risk of picking up nasty infections in the waiting room.

3. The third possibility is that you train yourself to self-inject by following a set of extremely clear and well written instructions on giving a subcutaneous injection and published by the Clinical Center of the National Institutes of Health in Giving a subcutaneous injection. Please see below also for a great tip on how to use Blu Tack to help with these injections if using ampoules!

4. If injections are not for you, for whatever reason, I now have a preparation of B12 which delivers 5,000 mcg (i.e. ten times the dose in a ½ ml injection) as a sublingual spray. Even with perfect B12 absorption one can only expect 1% to actually get through the gut wall! So, the idea of the sublingual spray is that some is absorbed under the tongue, the so called "first pass effect" whereby the liver is by-passed. It works well for some people, but many CFSs tell me that the injections are irreplaceable! It costs approx £23 for 60 doses (nearly 3 months supply). It is available from my online shop Shot-O-B12 from Sales at Dr Myhill.

5. Another option in this situation is to try delivering magnesium and B12 through the skin. I have very happy feedback from patients using transdermal preparations of both B12 and magnesium – please see 'Transdermal micronutrients Both of these preparations are available from my online shop -- Transdermal B12 spray and Transdermal magnesium chloride spray

6. The final possibility is to try magnesium by nebuliser. This I have been trying for several years now with reasonably good results in some patients - Magnesium by nebuliser

Tip on drawing B12 from an ampoule

Jane-scott-b12.jpg

Some of my patients obtain B12 in ampoules and loading a syringe from an ampoule (or "vial") can require the dexterity of a Roman centurion - centurions were chosen, in part, for their ability to throw missiles with both hands equally well (Ref - Vegetius. De Re Militari).

One of my patients, Jane Scott, has come up with an ingenious solution - "The Blu Tack Solution". Here is her explanation, in her own words, with a picture to the right. You can see the Blu Tack at the base of the ampoule.

"Loading B12 into your insulin syringe can be a real pain and very tricky.
Especially from the methylcobalamin vials.
All hail the wonders of the humble piece of Blu Tack.....
I no longer require a third hand to hold the vile vial.
My Blu Tack securely holds the B12 vial at whatever angle required to leave my hands free to fill the syringe."

In addition, the surface tension of B12 means that it does not run out when you tip the vial at really quite extreme angles.

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