Post Punk Kitchen Forum

I went to the doctor today to get some blood work done because my limbs feel heavy all the time, I have no energy and I get severely out of breath climbing the stairs. I figured I'm probably deficient in something, so off I went.
He gave me a B12 shot and I'll get my test results back on Saturday.
He told me that there is no point whatsoever in taking a B12 supplement in pill form, is that true? I have been taking a B12 5000 since I've been feeling under the weather, and I knew it was hard to get your B12 in pill form, but I didn't think it was *impossible*. He said I should be getting monthly B12 shots... I'm not sure I can afford that so frequently.
Also, he told me I should be eating a teaspoon of sunflower paste every couple of days for the tyrosine. He said it is hard to get on a vegan diet. I never even knew that was something I should be concerned about... I googled it and there seems to be plenty of vegan sources for it... I am confused.

That is ridiculous advice on both counts. There are numerous studies showing that oral supplementation reverses b-12 deficiency unless you have major absorption issues.

Tyrosine can be found in soy products, whole grains, fruits such as avocados and bananas, beans and nuts such as almond, lima beans, sesame seeds and pumpkin seeds. But that doesn't even matter because tyrosine's not even an essential amino acid. It's created from phenylalynine. I would look for a new doctor or at least get a comprehensive blood workup, get a copy of the numbers for your own research and take any advice he gives you based on them with a grain of salt.

the b12 thing isn't true. It's EASIER to get absorbed from a shot, but not impossible unless you have pernicious anemia, which would mean you weren't able to absorb any b12 through your digestive tract, but i doubt that's true.

as for tyrosine, your body makes tyrosine from phenylalanine another amino acid, so it's not even considered one of the essential amino acids that we need to get from our diet. also, you can get tyrosine from plant sources of protein (http://en.wikipedia.org/wiki/Tyrosine) so yeah, your doctor doesn't really know that much about nutrition. also, it seems irresponsible of him to assume you're deficient in b12 before getting your blood work back.

ask for a copy of your lab results when you get them just so you can see for yourself what's really going on.

::vegimator, Jinx!::

Ha! I owe you a coke.

My own advice would be that you should make sure your b-12, d and iron numbers are good and that you're eating enough protein and total calories.

Also, and I'll shut up now, but 1/4 block of tofu has 428 mg of tyrosine and 622 of phenylalanine. A teaspoon of sunflower butter (is that different from paste?) has 31 mg of tyrosine and 54 mg of phenylalanine.

Ok good, that is pretty much what I figured, and I will make sure I get a copy of my results so I can Google myself silly when I get home.
I'm all "Hmm, I've been vegan 7 or 8 years, and I know about B12, but I never knew about the tyrosine thing" and he said it was strange I'd never heard about it, and that a vegan diet is perfectly healthy as long as those two things are supplemented.
My thinking was that if I'm deficient in B12 then a shot followed by my 5000mg supplements should do the trick.
I eat quite a lot of all the things that are supposed to be good sources of tyrosine, so I won't waste my time hunting down sunflower paste (or butter!)
Thanks guys!

I find that many doctors don't have current nutrition information. I don't mean nutrition information as it relates to a vegan diet. I mean overall.

Sunflower seed butter is delicious. You should hunt it down (Trader Joe's and Target have it) just for enjoyment. Anyway, good luck with your health and wacky sounding Dr. And, we are so lucky to have so many knowledgeable people such as ijsustdiedinside and vegimator on the ppk!

I agree with everyone, especially this.



If you feel you have a deficiency in your diet, seeing your doctor is an okay idea, but seeing a Registered Dietitian is an even better idea. I'm not sure how health insurance works with an RD, but perhaps you can get a referral from your doctor. http://www.eatright.org/ will point you in the direction of a local RD! There's a button on the top.

Did the doc mention you may be anemic due to iron deficiency? That could be a cause of the symptoms. It may not be diet related either.

I actually don't have health insurance, so this is out of pocket, I don't think I could afford a dietitian, but I admit I haven't actually looked into it.
He did mention anemia, and said my blood didn't look anemic, but we'd see when the results came back.

That sounds strange. Why did the doctor mention tyrosine of all things?

Have you had a virus recently?

I just happened to have a lecture on B12 deficiency anemia tonight and my teacher mentioned that there are some studies showing that b12 injections aren't absorbed better than oral supplements (providing you don't have an absorption issue)

Huh... interesting. I don't think I have an absorption issue... how would I know? Would it just be a case of it being really hard to get my levels to where they should be?

I haven't had any viruses recently, but am in ED recovery... I'd say it's been about a year now, so I'm sure I'm deficient in a lot of stuff.

just wait till you get your test results back. it may not be b12 at all.

Yes, try not to worry about it, it just pickles your brain. If you're lacking in anything the blood tests should pick it up. The breathing can just be down to how tired you're feeling, I get out of puff just talking on my tireder (is that a word?!) days.

I just asked about viruses because some people can feel washed out with post viral fatigue, it would just mean rest & vitamins but as you haven't had one in a while it probably doesn't apply.

Hopefully they get you feeling bright eyed & bushy tailed in no time! xxx

Okay, with B12 - when you can't see the half-moons at the base of your fingernail, that indicates a deficiency right? I've used a liquid B12 under the tongue, and after a while added a B Complex but it seems to be taking a long time. I'm not getting a white dot now though, and a couple of the "moons" have reappeared (under the cuticle if I push it way back), but the left pinkie nail is stubbornly pink tip to cuticle. I wonder if I'm just throwing supplements at the problem without really affecting it. I'm not especially tired or anything....

Or is this a dr. question? Probably, but any insight or experience would be welcomed.

B12 isn't a thing to fork around with, if you think you may be deficient get a blood test.

I don't have half-moons on several of my fingers and my B12 is fine.

Nope, that's a crazy rumor from the "natural healing" world. Not everyone has visible lunula and it doesn't mean anything. http://en.wikipedia.org/wiki/Lunula_%28anatomy%29

Results are in! I am apparently anemic, which explains the heavy limbs and breathlessness. Also, I'm deficient in some other stuff.
These are the things that are 'out of range' on the printout he gave me.

Vitamin D (25 hydroxy) My level is 9 and 'reference range' is 30-100
Hemoglobin: Mine is 9.2 and rr is 11.4-15
Hematocrit: Mine is 31.7 and rr is 34-45
MCV: Mine is 76 and rr is 78-102
MCH: Mine is 22.1 and rr is 27-31
MCHC: Mine is 29 and rr is 1-37

He has me taking Vitamin B1 (100mg) folic acid (1mg) iron (18mg) and a multi vitamin. He said it should take about 3 months to get me back where I should be.

And your b12 was fine? I wonder why he's having you take the B vitamins.

I'm glad you got you found out about the anemia!

He didn't just, you know, look at your blood, right? He put it the machine, right?

I don't actually see anything about B12 on the printout, unless it's called something else... but I am taking B1, not B12.... maybe it's to help with absorption of something else?
I don't know why I'm not taking D though, although it is in the multi vitamin, so maybe that's enough.
I am glad about the anemia thing too, and also relieved that it's easily fixable!




He also sniffed it and rubbed it on his gums.

Okay, so it was on the up-and-up.

I would definitely look into D supplementation and/or a vitamin D sunlamp. 9 is really low.