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

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[UPDATED JULY 2022]

General Comment

Magnesium and B12 injections are so helpful as both essential for mitochondrial function. Below I set out the options that I see as available to anyone.

The Options

1. Supply -

2a. How much to inject -magnesium?

  • I used to supply 500mg/ml Magnesium Sulphate - Magnesium is essential for mitochondrial function - see The Involvement of Mg2+ in Regulation of Cellular and Mitochondrial Functions
  • So, if you were doing a 0.5ml injection, this supplied 250mg Magnesium Sulphate.
  • By weight Magnesium Sulphate contains about 10% elemental Magnesium.
  • So, each 0.5ml injection delivers about 250mg x 20% = 25mg elemental Magnesium.
  • The German 4mmol product states that it contains 97.22mgs elemental Magnesium per ampoule as per the links above.
  • It is not the total amount of magnesium that is critical.In fact it amazes me that such a tiny amount can make a difference. I think this works because of the concentration gradient across cell membranes. Injected Mg temporarily spikes serum Mg so it gets into cells more easily via ion pumps, kickstarts the mitochondria and the energy so generated drives the ion pumps to bring in more Mg. It is like getting the flywheel of an engine spinning!

2b. How much to inject - B12 - see B12 - rationale for using vitamin B12 in CFS

3. Self injecting is easy and safe. 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.

4. 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!

5. If injections are not for you, for whatever reason, I now have a preparation of B12 which delivers 1200 mcg 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 £14.30 for 48 doses (just over a 2 month supply). It is available from my online shop B12 Oral Spray from Sales at Dr Myhill.

6. 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 from Sales at Dr Myhill and Transdermal magnesium chloride spray from Sales at Dr Myhill

7. The final possibilities are to try magnesium by nebuliser. This I have been trying for several years now with reasonably good results in some patients - see 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). See also The qualities necessary for the centurion

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.
  • 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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