No Shots Needed: NingXia Nitro, Another MB12 Goodie!

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Everyone knows of my love affair with MB12, I have not met an MB12 I did not like. We’ve done methylcobalamin in various forms-  injection shots, lollipops, lozenges and nasal sprays. What other options can there be? NingXia Nitro by … Continue reading

Methyl B12 – Shots, Lozenges, Lollipops and Nasal Spray

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As you may know, I love love love MB12. Also known as Methylcobalamin and Methyl B12. MB12 therapy was one of the biggest WOWs! in our autism recovery journey. For more information on MB12 and it’s benefits for children with … Continue reading

>MB12 and Pavlova…..

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Bubushka teaching the girls how to make Pavlova

Methyl B12 is definitely one of my most favorite treatments for Autism. You can read about our experience with MB12 here. However, that was written in 2009, since then our experience with MB12 has evolved.

There are many forms of B12 therapy to choose from, different types of B12 can come in oral capsules, nasal sprays, patch and even lollipops. In biomedical treatments, we use the methylated form of B12, also known as methylcobalamin ie. methyl B12 or more commonly known as MB12. Choosing MB12 injection over the other forms were easy for me and my husband. We had learnt enough to know that MB12 shots is our choice for Mei. We couldn’t wait to start MB12.

How you choose to do B12 therapy is based on your child’s unique medical issues as well as other personal reasons. Please discuss with your Biomed doctor and read up more on MB12 therapy. Whether you choose to purchase it in vials, pre-filled syringe, oral, patch, nasal spray or lollipops, please make sure you’re choosing it for the right reasons rather than because your doctor or supplier only carries a certain type thus discouraging you from trying another form because they may not have stock of it and is more concerned about loss of revenue rather than what is best for your child. Take note that MB12 injections are prescription only treatments and can only be ordered by a medical doctor from specialist compounding pharmacies. Discuss with your doctor about the different types of MB12 shots, whether it includes preservatives or not. Some children cannot tolerate the preservatives in MB12, check with your doctor whether he can order preservative-free ones. My girls have no issues with the preservatives though some kids are quite sensitive to it. You may even discuss with your doctor if it’s possible to order MB12 compounded with folinic acid which some parents are already doing. I have not tried this new cocktail (yet!) so I can’t comment on it’s benefits.

Previously, I have never held a needle syringe in my life, and now I’m expected to inject my baby with it? And I have to do it every 3 days? Ironically, I was the one who was begging my doctor a few weeks later to increase the dosage, then to increase the frequency.

Fear of giving injections – many parents when first starting Biomed and hearing about MB12 have strong feelings against giving the shots. Yes, it is extremely nerve-wrecking the first time I had to do the shot. Hubby was holding on to Mei who was screaming and struggling mightily. He thought he had the harder job, whereas I thought he had the easier job.

It took a lot of practicing injecting on an orange before I did it on Mei. We tried on apples and even bananas, but found oranges were more ‘realistic’. We’ve even accidentally injected each other. Mei squirmed so much and never kept still. It was a terrible experience, she screamed on and on and it took us half an hour to calm her down afterwards. The first few shots were awful, but after that it got easier and easier. We found more effective ways to keep her still and the fastest ways to console her. We realize the thought of the injections was scarier to Mei rather than the pain of the injection itself. Mostly because of how we held her in a vice grip, and she could sense our own fears and nervousness.

Mei following Bubushka’s instruction carefully

When done well, the pain would sting like an ant bite and would go away in one minute. We’ve been doing it for nearly 2 years now and we do it every 2 days. Now I just calmly tell her it’s time for her injection, she’ll whine and protest but she will comply. Most times, Mei will bend over for me against the sofa, she will complain and fidget at times, she’ll tell me it hurts but she’ll forget about it a minute later. She hates the cold surgical swab just as much as the injection. When I run out of our preferred needles, it’ll hurt a little bit more. We are more adept at doing it though at times we still botch it up. At times there’s a red mark or a tiny dark bruise afterwards if we injected too deep. Paul and I take turns to give her the injection, both of us have our preferred methods.

We are told to do a shallow subcutaneous injection at 30 degree angle or less into the upper outer quadrant of the buttocks. Say what?? Now, it’s easy as pie. Holding the syringe with my thumb and middle finger, then using my 2nd finger to push the plunger gave me the best control and allows me to do a shallow angle. Many of us have the opportunity to have our doctor to show us how to do the first shot on our child. For some, this may not be possible especially for many of us who consult with overseas doctors and are not able to bring our children to the doctor frequently.

You can find many uTube videos on how to give Mb12 injections, from doctors giving you full length explanation to parent’s videos of how they administer the shot to their child. If you are new to MB12, remember that practice makes perfect. Some parents take their children to their local doctor regularly to have the shot administered. Personally, the time and hassle of loading up the kids, get them in the car and drag them kicking and screaming to the Doctor’s clinic because they know they’re gonna get an injection is too much of a hassle. Personally, I’d rather inject them myself at home. However, this is a personal choice, ultimately it really doesn’t matter who administers the shot, as long as it is done well and consistently. In certain Asian countries, you can only do MB12 injections at the hospital or clinic, local health regulations do not allow parents to do it themselves.

Previously, MB12 was hard to obtain in Malaysia, we had to go specially to Singapore or via our other biomed doctors to get it. But now you can order MB12 shots with our Malaysian biomed doctors, please contact them directly if you do not have a biomed doctor already and are interested in trying MB12.

Some parents are very opposed to doing injections because of the needle and pain factor, but I look at it this way – if my child was diagnosed with diabetes and required frequent insulin injections, the same thing applies. It is something that as a parent I have to overcome my fears for the sake of my child. The first couple of months is hard, but soon you’ll be injecting like a pro. Pretty soon your new Biomed friends will be begging YOU to do the injection for their child:-) Nonetheless, whether you choose MB12 shots is a personal choice depending on many factors. The ability to do the injections, our own fears, the horrific struggling by our children, parents who travel often and cannot or should not entrust the caregiver with administering shots and many other factors to consider. You will find which forms of B12 is best for your child.

The finished Pavlova – contains eggs and cream

Many children’s Organic Acid Test (OATs) result usually show high levels of B12. A frequent question is why do we still need to do Mb12 shots when the B12 levels are so high? Many Biomed books and web articles will give you a detailed scientific explanation, however this is mine in layman’s Mummy’s terms-

From my understanding, many kids have high levels of B12 in the OATs, but the issue in some kids in Autism is that they are not able to convert it into the methylated form. That is why we still have to give MB12 shots, because it is the methylated form of B12, not plain B12. All the B12 derived from food sources in our children  are not being converted and utilized properly, just going round and round but it’s not really doing the job it should be doing. It’s a biochemistry issue that many of our kids have. MB12 in Autism is a methyl donor, an important component in the methylation cycle.

So yes I would do the MB12 shots regardless of the high levels reported in the OATs, especially if you see improvement. Even if you don’t notice obvious improvements, take note if there is regression when you stop. Always remember, test results are only a guideline. However it is the improvements or regressions that you observe that is the true measure of whether a treatment is effective or not.

Some parents find MB12 injections show no improvements or changes in their child even after a few months, these children are usually referred to as non-responders. In my limited experience, it usually came down to a few reasons;
1. Dosage- perhaps the dosage is too low? Discuss with your Biomed doctor on this. One of the beauties of using vials is that you have the flexibility to change the dosage. I recommend consulting with a doctor before you increase the dosage yourself.
2. Timing- many parents choose to do the injection at night when the child is sleeping, thus making the injection easier. In my opinion, the main benefits would have worn out by the morning. I prefer to inject in the morning, this way I can observe the benefits immediately.
3. Oxidative stress- some children are non-responders to MB12. It is now believed that it is due to high oxidative stress for some children. For these kids, perhaps it’s best to stop MB12 for a while and concentrate on lowering the oxidative stress first. Perhaps later on, MB12 will show significant benefits. Please discuss this with your doctor.

So in some kids, the MB12 will not give you the WOW! results we hear about. Until you lower the oxidative stress, the improvements on MB12 will be limited. Just because for now Mb12 doesn’t give you the amazing results you hope for, doesn’t mean it may not happen when you reintroduce it at a later date, when the body is prepared and ready for it. Mei had very high oxidative stress initially, we worked on it for a few months before we introduced MB12 and we saw immediate improvements.

We did MB12 injections on Min Min too, however unlike her sister, Min Min was a non-responder. We tried different protocols, worked on her super high oxidative stress levels and her other issues and reintroduced MB12 again several times. We did not observe any positive improvements nor any regressions, so eventually we decided to stop and conclude that MB12 is not an important part of her treatment.

“Protocol matters!” – Dr Neubrander, World Autism Congress Hong Kong, May 2010.

We all started on Dr Neubrander’s dosage and protocol of every 3 days. However, remember that it is always child specific. So, if you start to notice that the benefits or effects or MB12 wears off on the 3rd day, discuss with your doctor about increasing the frequency to every 2 days. With the help of my doctor, I have tried different dosages and frequencies and finally found the optimum protocol that suits my child best. I am blessed with doctors who are open to different protocols and dosage, fully embracing the first thing they learn at biomedical conferences- that there is no one size fits all.

Some side effects may be expected –

Pink Urine – we are all familiar with the pink urine. This is usually the first urine after the shot. If the urine is still pink even after several wee wees in the day, then the dosage may be too high, please consult with your doctor. What if there’s no pink urine? Err….. Ask your doctor:-) In my highly unscientific opinion, either the child is absorbing all the Mb12 well or possibly the dosage is too low. However, the pink urine is not an indication of optimum dosage. Behavioral, cognitive or speech improvements is your guidelines.

You may notice increased hyper activity in some children. Folinic acid will usually help with hyperness on MB12. Some children experience increased mouthing, this is also a common side-effect. MB12 increases sensations and awareness in the mouth and lips. Most parents reports that the side effects will last 6-8 weeks. However, again discuss with your doctor as to the cause of the behaviors or any issues you are concerned about.

I’m hearing more and more parents are doing MB12 shots for themselves, though it’s mostly the husbands doing so. Yes, at times I give Hubby an injection when he feels he needs a boost. He has more energy, feels clear-headed, his mind is sharper, his problem-solving skills are faster and has better concentration. Other fathers report that they feel happier, work seems easier, less stressed and is in a good mood. I know of husbands who request for an MB12 shot from their wives when they have a super-stressful day at work to look forward to. You’ll find that many Daddies are also our guinea pigs when trying out a new syringe. They give us the thumbs up on which needles are good. And give valuable feedback on certain needles which hurts like hell. Thank you to the Warrior Dads who give it up for science:-)

Though MB12 when administered by injections are considered to be the most effective based on parents’ and researchers’ feedback, please remember that one size does not fit all. If you are currently doing oral or patches and you are happy with the progress, then I say go for it. However if you have the chance to try MB12 injections, it’s always good to see if it may or may not improve your child’s condition. We have been doing MB12 shots on Maya for nearly 2 years now. Though we no longer notice much improvement anymore, whenever we miss the shots for up to 1 week, we start to notice some slight regression, mostly in fine motor skills. For now, we are happy to continue with MB12 du
ring this phase of managed recovery.

These photos were taken when we were on holiday in Australia, we never missed giving a shot even when travelling. In case you were wondering, the photos have nothing to do with MB12 directly. The girls’ great-grandmother Bubushka (means grandma in Russian) is teaching the girls how to make a traditional Aussie dessert – Pavlova, a mouth-watering concoction made with egg-white meringue, cream, sugar and summer berries. A couple of years ago, the thought of Mei learning how to do this under the supervision of her Russian great-grandmother wouldn’t have been possible.  But thanks to MB12 as part of our biomedical treatment, we now have these wonderful moments to capture and memories to cherish.

>16 Month Journey

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This is our biomedical journey in the past 16 months – please see below for list of supplements that were added on as the months went by and the steps we took with our little girl.


June 2008 – Maya was diagnosed with mild to moderate Autism at 2 years 8 months. Implemented GFCF diet. Able to make occassional 1 word request within 1 week.

July – December 2008 – started home based ABA at 6 hours a week. Eventually this grew into 18 hours a week maximum by December. GFCF diet was refined over the next 6 months, but still included soy. Maya was able to make occassional 2 word request, less hyper and better mood. No other biomed intervention except GFCF diet.

January 2009 – Hospitalised with Rotavirus. Started center-based ABA for 30 hours per week. Change to rice milk, started Super Nu Thera, probiotics and Cod Liver Oil.

February – March 2009 – consulted with Dr Sundardas, he only required us to do hair analysis. Started calcium, zinc, 3 Billion CFU non-refrigerated probiotic, Nordic Naturals cod liver oil, Efalex, Intestamine, NTC Detox, Zeolite, digestive enzymes, ASD Plex, Super Nu Thera. Implemented the Blood Type Diet as per recommendation. After 2 1/2 months on his protocol and despite my insistence that we do more to address Maya’s unresolved gut issues, Dr S recommended we start on B12 shots instead. So we decided to change to another doctor as I feel that there were gaps in treatment for gut issues. Atec score of 78

April 2009 – consulted with Dr Erwin Kay. Asked us to do OATs, IgG and Comprehensive Stool Test. Dr Erwin accepted the previous hair test result. Revert back to basic GFCF diet, started supplements based on basic gut treatment with prebiotic, multi-species probiotic, lactobaccilus probiotic, melatonin, l-glutamine (for leaky gut, but later had to stop because of bad regression), super nu thera, cod liver oil.


May 09 – added on taurine, digestive enzyme, phenol assist, glutathione lotion, 1 month course of anti-fungal Diflucan, epsom salt bath, n-acetyl cysteine, zinc. Changed to organic food.


June 09 – started 2 week course of Cedax antibiotic, rotate probiotics to Kirkman’s Probio Gold, 2nd course of Fluconazole antifungal, added calcium/magnesium combo, vitamin C, vitamin E, Methyl B12 (every 2 days, adjusted dosage for next 1 month) and Ketaconazole cream for her itchy and flaky feet (2-3 weeks only). Replaced old carpeting and air conditioning in the girls’ bedroom. Removed all dust-collecting and mold-producing items and installed an air purifier.


July 09 – added on Interfase, sodium butyrate, MSM glucosamin cream, AminoPlex (all these 4 based on Dr Westaway’s consult and monitored by Dr Erwin. Eventually had to stop AminoPlex due to regression) more readjustment of dosage for existing supplements. Added Dual Detox and Valtrex anti-viral (eventually we had to give up on Valtrex because we couldn’t get Maya to take it), 2 month course of Nystatin, Candex, increase magnesium, s.boulardii, OSR (upon Dr Westaway’s consult, but product ordered and approved by Dr Erwin). Replaced all non-stick cookware, reduce microwave use and plastics.


August 09- We did additional tests for Essential Fatty Acids, Plasma Amino Acid and kidney and liver function. Changed to Zinc picolinate and Ester C (based on Dr Rina’s consult), change to separate Calcium and magnesium (not combined), magnesium sulfate cream, 2nd course of Cedax antibiotic, another course of Fluconazole (both girls at this time had recurring gastro issues with bacterial infections and colds & flu), change MB12 to daily shots, rotate probiotics to Klaire Labs Therbiotic complete. Only use organic and chemical free cleaning products for household cleaning as well as body care including shampoo and soaps.


September 09 – Added Culturelle and increased probiotics due to last month’s infections, gut issues and antibiotic use. Increase MB12 to 0.05, change from SNT to B6 P-5-P, change to Magnesium glycinate powder, rotate digestive enzyme with Trienza, added ViraStop, SAMe200, Folate Acid, and adjustment of supplements based on new test results. Psychological assesment shows great improvement across the board, Atec scores down to 30 from previous 78 in April 2009.


October 09 – Maya turns 4 years old. Added TMG (upon Dr Anthony Underwood’s consult), readjust MB12 to alternate days, change from Candex to Candidase, increase ViraStop dosage (very little change due to Dr Erwin being away) Replaced all milk bottles to BPA free.


Who knows what next month will bring. It is undeniable that Maya’s progress has been on fast track ever since we had Dr Erwin to guide us, we couldn’t have gotten this far without him.

>B12

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Vitamin B12 therapy is one of the most popular treatments in Autism biomedical intervention. B12 is utilized in almost every cell in the human body, it affects the normal functioning of the nervous system, the detoxification system and other biomedical pathways. Most parents report almost immediate improvements once starting B12 therapy. To read more about the benefits of B12, please refer to the article at this link http://www.talkaboutcuringautism.org/medical/methyl-b12-treatments.htm
You can also watch videos by doctors and parents on how to administer methyl B12 shots. Just do a search on Google or YouTube for Autism B12 Injections and you will find many videos. Your doctor will also teach you how to do the shot, Paul and I also practiced injecting into an apple before we did it for the first time on Maya.
We saw huge gains in maya’s language and cognition and overall behavior. 7-8 word sentences are used frequently. Maya now strings 2-3 sentences together. She easily follows 2 step instructions. She is able to answer questions that she previously could not understand eg. “What did you do at school today?” and “Who did you play with?” . She makes new requests such as “Mummy, can you turn on the lights please”. She asks us questions like “Daddy, what are you doing?” Also, “No, I don’t want to go to school. Let’s go to the zoo!”. Her behavior is more appropriate and we saw improvements in her social skills.
There are many forms of administering B12 – oral, transdermal, nasal or subcutaneous injections. Most of our children have issues with malabsorption, therefor oral types such as capsules and lollipops may not be the best option. Yes, lollipop version of B12 – Stan Kurtz created a lollipop called Revita Pops. You may need to check with the website on where to purchase them. Check out www.revitapop.com
There is also several types of MB12 Nasal Spray, however this may not be well accepted for younger children. Transdermal B12 may take the form of creams or patches.
According to research and parents’ feedback, the most effective form of administering B12 are injections. For injections, the methylated version of B12 is used, thus usually referred to as Methyl B12. It is also known as Methycobalamin. Subcutaneous injections requires thin and short needles, the shots are very shallow, usually on the upper outer quadrant of the buttocks and taken at an angle of 30 degrees or less. Because the shot is given just under the skin, you don’t penetrate it into deep fat tissue or muscle tissue, it doesn’t get into a vein, a nerve or artery.
Depending on your child’s weight, the doctor will usually prescribe 0.03mls per shot. It’s a very tiny amount. Frequency will vary according to doctor and child, usually every 3 days. You have a choice of either getting the B12 in a multiple-dose container or prefilled syringes. Your doctor can order both from a compounding pharmacy. You will need to store methyl B12 in the refrigerator and keep it away from the light.
Multiple-dose container – A single vial may last you 2 months or more depending on your dosage and frequency. It’s more affordable compared to pre-filled syringes. You will need to wrap the vial in aluminum foil in order to protect it from the light. Also, if you find that the dosage recommended by the doctor doesn’t seem to be effective, you can adjust the amount easily. However you will need to purchase your own syringes and fill it up yourself. Dr Erwin Kay sells methyl B12 at SGD$180 per 3ml vial. You can purchase BD Ultra-Fine Insulin Syringe 1/2cc at any pharmacy in Malaysia, a pack of 10 syringes are RM5-10. These needles are the same size ultra-fine, however at 1/2″ it is slightly longer than pre-filled syringes. You just have to exercise more control during the injection to make sure the needle doesn’t go in deeper.
Pre-filled syringes – this reduces the hassle of filling up the syringes yourself every time. It’s very convenient and you know the dosage is correct. However there are 2 drawbacks; firstly it is a lot more expensive – 1 pre-filled syringe may cost SGD$10.00 – SGD$20.00 each. Depending on which compounding pharmacy and the US$ currency exchange. Your DAN doctor can give you the exact figure.
Depending on how often your doctor recommends you to do it, the cost can be very high. Secondly, because it is pre-filled, you may not be able to adjust the amount of B12. The needles are ultra-fine and best of all, the needle length is 1/4″. This is the perfect depth for subcutaneous injections and you are assured that it will never go in too deep.
We have been giving Maya methyl B12 shots for 2 months. For the first 1 month, we did it every other day. Dr Erwin initially prescribed 0.03mls however we did not see any improvements within 1 week. He then advised us to increase the dosage to 0.04mls and we saw amazing improvements within 1 hour! We now give maya methyl B12 injections 0.04mls every day. We did not get pre-filled syringes, instead ours came in a vial.
At SGD$180 a vial, for 0.04mls every day, I calculate our cost to be RM200 per month for B12 therapy including the cost of the B12 3ml vial and syringes. Definitely worth the money and the initial struggles.
Initially it was very hard, Paul would hold Maya tightly and she would be screaming and fighting and wriggling and kicking, whilst I’m trying to inject her at the proper angle, at the proper spot at the shallowest depth possible. Maya would start screaming and struggling the moment I swabbed her bottom with the pre-injection swabs. The injection itself is very quick and I try to find interesting plasters or band-aids. She would then cry for 10 minutes while we comforted her and redirect her.
Eventually, the cries got less and less and for the past 1 month, Paul doesn’t even have to hold her and she doesn’t cry at all anymore. I tell Maya “It’s time for Doctor Mummy” and she’ll bend over the bed willingly and will keep still while I give her the shot. Usually we have a discussion about what plasters she’ll get today, her favorites are the Disney princess ones:-) The whole process takes less than 1 minute.
To save time, I usually fill up to 10 syringes at once and cover the needle with the needle shield. Then I make a little parcel made of aluminium foil. In every piece of foil, I place 1 syringe that I’ve pre-filled to the correct dosage, 1 swab, 1 cotton ball and 1 plaster. And I roll up everything together making sure that the plunger is well protected and not going to be accidently pressed. And everyday I just grab a parcel from the refrigerator so it’s quick and easy. And that’s how I make my own pre-filled pre-prepared B12 shots.
Depending on your child’s underlying medical issues and personal preference, you can talk to your DAN doctor about which forms of B12 are best for your child.