Short Supply of Injectable Vitamin B12 Causes Distress Among Patients

An unidentified walker in Kin Coulee Park, Medicine Hat, AB. (Dr. Noorali Bharwani)" >"When I'm in turmoil, when I can't think, when I'm exhausted and afraid and feeling very, very alone, I go for walks." -Jim Butcher, Storm Front An unidentified walker in Kin Coulee Park, Medicine Hat, AB. (Dr. Noorali Bharwani)
"When I'm in turmoil, when I can't think, when I'm exhausted and afraid and feeling very, very alone, I go for walks." -Jim Butcher, Storm Front
An unidentified walker in Kin Coulee Park, Medicine Hat, AB. (Dr. Noorali Bharwani)

It has been nine months or more, injectable vitamin B12 (Cyanocobalamin) has been in short supply.

The obvious question is: why? According to media report, the drug maker Sandoz Canada had to close a manufacturing plant in Quebec in February 2012, to upgrade it to meet U.S. Food and Drug Administration standards. A second company found it too much to cope with the shortage and increased demand.

Here is the good news. Last week I asked Larry Legare, AHS Provincial Pharmacy Director, South Zone, about the availability of B12 injections. He said, “I have just received notification that Vitamin B12 1000 mcg/ml 1ml amp may be available as early as next month. This is earlier than we anticipated.” He added that there will be very limited stock available initially and stock may become unavailable again until sufficient supplies can be released to meet the current demand.

Legare says for many people with vitamin B12 deficiency, treatment with high-dose oral administration of vitamin B12 (1000–2000 mcg per day) is as effective as injectable (intramuscular or deep subcutaneous) administration. There are many reasons why some patients prefer or need to have monthly injections rather than take pills on a daily bases. I have covered this topic in the past in great detail. For more information visit my website.

It is estimated as many as five per cent of Canadian adults have a vitamin B12 deficiency. It is also reported that 30 per cent of the adults older than 50 may have vitamin B12 deficiency. It is estimated up to 40 per cent of the general population may be deficient in this vitamin. Sometimes figures are irrelevant, it is the people we worry about.

The most common cause is pernicious anemia. It is also common among vegans and people with celiac or Crohn’s diseases. Without vitamin B12, the body has trouble building the red blood cells that carry oxygen and allowing the brain and nervous system to function properly. The result is a feeling of chronic fatigue.

Legare says either oral or injection formulations are effective for treating B12 deficiency. The daily requirement is 2-3mcg. Dosing with intramuscular or deep subcutaneous injections of 100mcg daily for five to 10 days, then 100-200mcg monthly until levels are normalized followed by 100mcg monthly for maintenance.

High oral doses in the range of 1000 to 2000mcg daily are just as effective. It can be used sublingually (2000mcg). The benefit to sublingual vitamin B12 vs. oral is not well defined.

I am sure you have discussed your needs with your doctor. I hope help will be here soon. I wish you all the best. Stay positive (sometimes it is difficult to do that) and keep smiling (that can be difficult too). But don’t give up.

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