Being newly diagnosed this year, I'm still learning about Crohn's. I'm now quite comfortable in admitting to myself that I don't know a lot more than I do know, and there is a long learning curve ahead. One issue that has really surprised me is how many differences there are in the severity of Crohn's, some of the symptoms, and the effectiveness of medications. This forum has been invaluable to me in working through quite a number of personal issues on how I relate to this whole situation I now find myself in.
That said, the B12 issue is frustrating -- I understand that my SI is no longer efficient enough to be able to absorb/process B12 from my diet. So I've been taking B12 shots. First weekly, then monthly, now back to weekly. Not a big deal, but it does affect my energy level, and it's back and forth to the doctor. David, your comments about how many shots it might take to restore a normal level are interesting, and would explain the test results I had.
And, of course, life continues with its little practical jokes. My GI has now run out of B12 and it's on back order. So I started taking 1mg orally and it seems to be helping quite a bit. I could have gone to another doctor for a B12 shot, but I sort of welcomed the opportunity to solve this problem without utilizing a doctor.
Sublingual B12 interests me -- how/why would it be more effective than oral B12? Because it's being absorbed into the blood vessels under the tongue? I already have one prescription (Hyoscyamine) that is sublingual, and I know it's an effective way to absorb medication. But if B12 can be absorbed under the tongue, why not in the mouth, or in the esophagus, or in the stomach, or anywhere else? I remember reading about some sort of transport agent that is only produced in the SI that allows the B12 to enter the bloodstream.