Importance of Diet
For good health, it is important that you eat a balanced and varied diet. Follow carefully any diet program your health care professional may recommend. For your specific dietary vitamin and/or mineral needs, ask your health care professional for a list of appropriate foods. If you think that you are not getting enough vitamins and/or minerals in your diet, you may choose to take a dietary supplement.Vitamin B 12 is found in various foods, including fish, egg yolk, milk, and fermented cheeses. It is not found in any vegetables. Ordinary cooking probably does not destroy the vitamin B 12 in food.
Vitamins alone will not take the place of a good diet and will not provide energy. Your body also needs other substances found in food, such as protein, minerals, carbohydrates, and fat. Vitamins themselves often cannot work without the presence of other foods.
Before Using This Medicine
If you are taking this dietary supplement without a prescription, carefully read and follow any precautions on the label. For vitamin B 12, the following should be considered:
Allergies—Tell your health care professional if you have ever had any unusual or allergic reaction to vitamin B 12. Also, tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.
Pregnancy—It is especially important that you are receiving enough vitamins when you become pregnant and that you continue to receive the right amount of vitamins throughout your pregnancy. Healthy fetal growth and development depend on a steady supply of nutrients from mother to fetus. However, taking large amounts of a dietary supplement in pregnancy may be harmful to the mother and/or fetus and should be avoided.
You may need vitamin B 12 supplements if you are a strict vegetarian (vegan-vegetarian). Too little vitamin B 12 can cause harmful effects such as anemia or nervous system injury.
Breast-feeding—It is especially important that you receive the right amounts of vitamins so that your baby will also get the vitamins needed to grow properly. If you are a strict vegetarian, your baby may not be getting the vitamin B 12 needed. However, taking large amounts of a dietary supplement while breast-feeding may be harmful to the mother and/or baby and should be avoided.
Children—Problems in children have not been reported with intake of normal daily recommended amounts.
Older adults—Problems in older adults have not been reported with intake of normal daily recommended amounts.
Other medicines—Medicines or other dietary supplements
Although certain medicines or dietary supplements should not be used together at all, in other cases they may be used together even if an interaction might occur. In these cases, your health care professional may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking any other dietary supplement or any prescription or nonprescription (over-the-counter [OTC]) medicine.
Other medical problems—The presence of other medical problems may affect the use of vitamin B 12. Make sure you tell your health care professional if you have any other medical problems, especially:
* Leber's disease (an eye disease)—Vitamin B 12 may make this condition worse
Proper Use of This Medicine
Dosing—
If you are taking vitamin B 12 intranasal gel:
* Take it at least one hour before or one hour after hot foods or liquids.
* Check with your doctor for follow-up blood tests every 3 to 6 months.
The amount of vitamin B 12 needed to meet normal daily recommended intakes will be different for different individuals. The following information includes only the average amounts of vitamin B 12.
* For nasal dosage form (intranasal gel):
o To prevent deficiency, you are given this dosage form only if you have received vitamin B 12 by injection into the muscle and are in remission state.
+ Adults—500 mcg (0.5 mg) into the nostrils once a week.
* For oral dosage form (tablets or extended-release tablets):
o To prevent deficiency, the amount taken by mouth is based on normal daily recommended intakes:
+ For the U.S. Adults and teenagers—2 micrograms (mcg) per day.
+ Pregnant females—2.2 mcg per day.
+ Breast-feeding females—2.6 mcg per day.
+ Children 7 to 10 years of age—1.4 mcg per day.
+ Children 4 to 6 years of age—1 mcg per day.
+ Children birth to 3 years of age—0.3 to 0.7 mcg per day.
+ For Canada Adults and teenagers—1 to 2 mcg per day.
+ Pregnant females—2 to 3 mcg per day.
+ Breast-feeding females—1.5 to 2.5 mcg per day.
+ Children 7 to 10 years of age—0.8 to 1 mcg per day.
+ Children 4 to 6 years of age—0.5 mcg per day.
+ Children birth to 3 years of age—0.3 to 0.4 mcg per day.
o To treat deficiency:
+ Adults, teenagers, and children—Treatment dose is determined by prescriber for each individual based on the severity of deficiency.
For patients receiving vitamin B :
* You will have to receive treatment for the rest of your life. You must continue to receive vitamin B 12 even if you feel well, in order to prevent future problems.
Missed dose—
If you miss taking a vitamin for one or more days there is no cause for concern, since it takes some time for your body to become seriously low in vitamins. However, if your health care professional has recommended that you take this vitamin, try to remember to take it as directed.
Storage—
To store this dietary supplement:
* Keep out of the reach of children.
* Store away from heat and direct light.
* Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the dietary supplement to break down.
* Do not keep outdated dietary supplement or those no longer needed. Be sure that any discarded dietary supplement is out of the reach of children.
Side Effects of This Dietary Supplement
Along with its needed effects, a dietary supplement may cause some unwanted effects. Cyanocobalamin or hydroxocobalamin does not usually cause any side effects.
However, check with your health care professional immediately if any of the following side effects occur:
* Rare--soon after receiving injection only
o Skin rash or itching; wheezing
Check with your health care professional as soon as possible if either of the following side effects continues or is bothersome:
* Less common
o Diarrhea; itching of skin
