I dont take B-12 now, but did years ago as an athlete. B-12 is destroyed by stomach acids, so you need to take a sub-lingual form - there are tablets that you put under your tongue or liquids you can drop there.

A nasal spray form would be really boss, as I dont like dealing with sub-lingual meds or supplements, but I have never seen that for B-12

HI!!

Word of caution, if I may......B-12 can be very dangerous if taken in too great a dose when you are not deficient!! Many people think that the more supplements they take the better they'll do! NOT SO!

My CFS doctor tests me routinely for B-12 and Vit. D. I am not deficient in either....so he will not adivse taking it! Some things, when taken in exessive doses can really hurt us. B-12 levels need to be checked to see if you are deficient before you take it in any form.

Please check with doctor on this one. OK? OK! Know lots of people that have had trouble after starting B-12 when they weren't deficient to begin with......

I get a B-12 shot once a mth but do have my levels checks & my Vit D levels. My D level is good but B12 was way low in the beginning.

I give myself B12 shots in small amounts everyday, with Glutithyone. The B12 is methylcobolamin and hydroxocobalamin 20 ui each, and is much safer then the cynocobalamin, as this converts to cyanide! This has helped a lot with my energy levels.

I forgot to mention, the injections clear up the brain fog, (of course I forgot to mention it, so must still have a little fog...)
Here is an article how the B12 helps CFS:
http://www.drmyhill.co.uk/wiki/B12_-_rationale_for_using_vitamin_B12_in_CFS

One thing to clear up, B12 is not toxic, any extra is just passed in the urine, except for the cynocobolmiin, that can convert to cyanide.
Vitamin B12 has no known toxicity and B12 surplus to requirement is simply passed out in the urine (which may discolour pink). It is theoretically possible to be allergic to B12 but in the thousands of injections that I have sanctioned this has only ever occurred after several injections and caused local itching, redness and swelling (although the commonest cause of redness and swelling is poor injection technique) in a handful of patients. I usually start with 1/2mg (500mcgms) daily by subcutaneous injection, then adjust the frequency according to response - some patients will respond straight away, some need several doses before they see improvement. I would do at least a month of injections before giving up. Many of my patients learn to inject themselves - this means they can be independent of their doctors.

Why such high levels of Vitamin B12?

Vitamin B12 is a key nutrient in CFS. Technically, a patient's B12 level is normal if it is over 208 pg/dL. Studies, however, have shown that people can suffer significant nerve and brain dysfunction from B12 deficiency, even if their levels are as high as 300 pg/dL. In addition, a recent study using the respected Framingham database showed that metabolic signs of B12 deficiency occur even with levels over 500 pg/dL.

Why are the "normal" levels set so low? In part, the normal values were initially set according to what prevents anemia. This is problematic, however, because the brain and nervous system's needs for vitamin B12 are often much higher than those of the bone marrow. Also, the medical establishment has greatly enjoyed poking fun at the old-time and holistic doctors who gave vitamin B12 shots for fatigue. The use of B12 shots, despite "normal" levels, is considered almost a symbol of unscientific, archaic medicine. As noted in an editorial in The New England Journal of Medicine, however, current findings suggest that those old-time doctors may have been right. I suspect, though, that our modern medical establishment will be a little slow to eat crow.

Recent research shows that despite having low normal B12 levels in the blood, CFS patients often have very deficient (and sometimes absent) B12 levels in their brains! This suggests that, because of the metabolic problems present in CFS/FMS, patients may need a very high B12 level in their blood to get adequate levels past the blood-brain barrier and into the brain, where B12 is needed. In addition, vitamin B12 helps to reduce excessive levels of nitric oxide, a neurotransmitter that can be too high in CFS/FMS and that can easily contribute to symptoms. More and more, research studies are supporting what holistic doctors who effectively treat CFS/FMS using B12 shots have said for years!

It is no surprise then, that when their other problems are also treated, many people respond dramatically to B12 injections. If a patient's B12 level is under 540 pg/ml, I treat with a 1-cc (3,000-microgram) injection of hydroxycobalamin (from a compounding pharmacy; e.g. Cape Drug at 410-7573522 or the Apothecary at 800-869-9159 are two excellent ones), one to five times a week, for fifteen injections. These shots are very safe and fairly inexpensive. If a patient feels worse when the injections are stopped, I resume giving the shots, usually every one to five weeks (but as often as three to four times a week in some cases) for an extended period of time. Most people, however, can maintain the benefit after fifteen injections by taking the 500 mcg/day of oral B12 which is present in the Daily Energy Enfusion vitamin powder.

This post just reminded me that I was supposed to go get my labs done and have my B12 checked. I forgot all about it because of the Holidays.

I have only had shots given by the doctor in the past.

I take 500mcg of b-12 dots whenever I remember. You put it under your tongue to dissolve. I've read some theories that it's better absorbed this way than swallowing tablets. There is much written about B12, but I agree, don't go with a crazy high dosage (as a few healthfoodgroupies might suggest).

I get b12 shots from the doctor but haven't had any for a while. I don't feel they make any significant difference in my fatigue.