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Sun, Mar. 13th, 2005, 02:56 pm
How to do your own Vitamin B-12 IM injections

Wondering how to do your own B-12 injections? Here's simple instructions that I typed up for someone else.


This is NOT medical advice!! My instructions aim to make this simple, but you should have your doctor or nurse show you how, too. Nothing's a substitute for in-person lessons, though this might help you remember how to do it later. Also, it goes without saying that injectable B12 and needles are both Rx items, and you shouldn't give your friends or anybody else B12 injections even if they have a prescription for the vitamin!

If your doctor refuses to prescribe the vitamin for you because your levels are "fine" (anywhere between 200-600 is often mistakenly considered acceptable), you can get vitamins elsewhere. Email me to ask for the information you need.



1. Get your supplies ready. You'll need the liquid vitamin (cyanocobalamin injection, USP, 1000 mcg/ml for IM or SC use only) and 1 or 3 ml, 25 gauge 1" needle. If you're a serious germ freak, rubbing alcohol and a cotton ball are nice. I do it after a shower, so I feel plenty clean. LOL I prefer the 3 ml/cc syringes because they are bigger and sturdier, but they gave me 1 cc syringes last time and they will work. (1 ml=1 cc)

2. Take the syringe out of the package. Make sure the needle's securely fastened to the syringe (if it's one of the screw-on kinds, as most of them are, this is important). Take the cap off the needle. Draw the syringe plunger back so that you have just over 1 cc of air in the syringe. Holding the bottle and the syringe upside-down, push the needle through the rubber stopper of the vitamin bottle and inject the air into the liquid vitamin.

3. Still holding the needle and bottle upside-down, pull the plunger back to pull about 0.5 cc of the vitamin in to the syringe. Tap the syringe a few times to get any air bubbles to rise to the top. Push those air bubbles back into the bottle of the vitamin before continuing to withdraw the vitamin solution. Eventually, you will have 1 cc of vitamin and no air in the syringe.

4. Bare your thigh (or your bottom) and make sure your skin is clean. Use rubbing alcohol if you like to use something to clean the skin; if you do, let it air-dry before proceeding.

5. Select a muscular part of the thigh (or the bum) as the injection site. Push the needle through the skin slowly (you don't need to "jab" it as that causes the most discomfort and can bend the needle!) With the 1" needles, you want to push the needle in until the syringe is almost touching your skin. Pull back on the plunger a little bit. If the plunger will pull back and/or you suddenly have blood in the needle, you have hit a blood vessel and you should withdraw the needle about 1/8" before injecting the vitamin. If you can't pull the plunger back, that's good, so push the plunger in gently until the plunger touches the bottom of the syringe. I find slow is better, but some people can push the plunger in quite quickly with no discomfort. I wait two seconds before removing the needle so that the vitamin doesn't 'leak' back out of the injection site, but if it does, you can wipe it off with a tissue. Again, if you are a germ freak, you can put a band-aid on the injection site, but in the time it would take me to unwrap a band-aid, I would lose the injection site, so I think a band-aid is mostly "mental medicine" in this case. :-)
6. Recap the needle carefully and then take the used needles back to any pharmacy or doctor for safe disposal. In many places, it's illegal to put used needles into the trash because it's dangerous for the garbage collectors.


That's it. Store the vitamin in a dark place at controlled room temperature. DON'T reuse needles! The vitamin is so cheap that you can discard the vial and get a new one every 90 days, even though it contains enough vitamin for 30 injections.

Hope this helps. BE BRAVE! It's really not a big deal once you take a deep breath and pierce the skin the first time with that needle. When you do it yourself, you can control the pace so that it doesn't hurt... too slow, and I'm just drawing it out and it makes me nervous, and too fast, and you are jabbing the muscle which can make it spasm. Maybe one shot in 20 I get a small bruise from nicking a blood vessel with the needle; this is absolutely no big deal. It's impossible (according to the literature) to OD on vitamin B-12 because you urinate out any excess. When injected intramuscularly, it reaches the bloodstream within 5 minutes and you store all of it that your body is going to store in the liver within the first four hours after an injection.

Some people find that they get a "rush" from the injections; anecdotal evidence suggests that this is more common when blood serum levels are below 1000. For this reason, many people prefer to do the injections in the morning.

Mon, May. 23rd, 2005 12:25 am (UTC)
(Anonymous): Thank you!

I really appreciate you taking the time to write up these instructions. I've putting off doing my b12 injections because, until now, it just seemed too daunting. Now -- I think I can. I think I can. I think I can.

Amy (who has been watching Dumbo with her grandson this week)

Wed, Jun. 8th, 2005 08:15 pm (UTC)
(Anonymous): Sterilizing the bottle

Hi Julia,

While I am not a nurse I have had to give myself injections before. I just wanted to say that you might want to add to your series of steps a step that I was taught by an RN and that's to sterilize the rubber on the bottle. I was taught to wipe the rubber part of the bottle clean with an alcohol swab just before inserting the needle filled with air. This can prevent infection and will ensure that the needle is clean. I am in the process of trying to find somewhere that I can buy the syringes and B-12 w/out my doctors help. I can't get him to write me a script for it so I've got to do it on my own. I am 18 months post-op and at my goal weight. If you know of somewhere online where I can order the supplies I'd appreciate your advice. Thanks so much. :)

Thu, Jun. 9th, 2005 07:51 am (UTC)
opabinia: Re: Sterilizing the bottle

I don't believe in using rubbing alcohol on the rubber stopper; it damages the rubber over time and with a 100 dose bottle, that's not a trivial issue (though I agree it's probably a good idea if you have a 30-dose bottle or smaller).

Look up a day or two (right around March 14th) for information on where to purchase veterinary B vitamins. I've been using them for many months now and have beautiful labs to show for it... as do MANY others. They are made in a human-grade pharmaceutical factory and are perfectly safe. :-)

Sat, Aug. 2nd, 2008 12:24 am (UTC)
reortega: Re: Sterilizing the bottle

Have you found somewhere to purchase vitamin B12?

Thu, Apr. 26th, 2007 01:27 am (UTC)
(Anonymous): B12 shots

I just read your instructions for doing self-injections----it was very helpful and I learned a couple of things that I've not already been doing (tapping the syringe etc). I've always done my shots in my stomach, rather than my thigh. Do you think that's ok? I just grab a "roll" and it's painless.

Thanks!
Paige

Lap RNY/5-22-06

Thu, Apr. 26th, 2007 05:02 pm (UTC)
opabinia: Re: B12 shots

What you're doing is a subcutaneous (SQ) injection instead of an intramuscular (IM) injection. It won't hurt you, but you absorb less of the vitamin that way. IM gives you 90% or better absorption, and SQ will give you 50-85%, depending on the site and what you actually inject into.

This probably won't hurt you; just watch your serum B12 levels. You want them to stay over 800 minimum, preferably over 1000.

Thu, Jul. 19th, 2007 08:22 pm (UTC)
(Anonymous): Re: B12 shots


B12 injections should be given in the muscle not in the stomach tissue. Check with your doctor or public health department if you feel the need to confirm this.

Thu, Jul. 19th, 2007 11:43 pm (UTC)
opabinia: Re: B12 shots

IM (intramuscular) injections are preferred over subcutaneous ones because the rate of uptake is superior (95% vs. 80% or less) and because the quantity of injected fluid is a bit high for the subcutaneous tissues to cope with.

If you are using needles long enough to do IM injections with (1"), you probably are causing yourself more pain that you need to, and you are not absorbing as much of the vitamin.

I'd recommend the following locations suitable for self-administration: thighs, upper rms, and buttocks (you'll need a friend for that).

HTH

Wed, Mar. 25th, 2009 02:39 pm (UTC)
empatheticcrush: Re: B12 shots

I just started injections too, and I was told to alternate between my arms daily for a week. Should I be considering the thigh instead?

Mon, Sep. 14th, 2009 07:22 pm (UTC)
opabinia: Re: B12 shots

Most of us find the thighs are much less painful and are easier as well. The arms can be tricky to do for yourself especially if one hand is very dominant... injecting that arm with the non-dominant hand can be an adventure. :-)

Thighs generally have a nice large surface area, they are easy to alternate between, and there's big muscles there so it's hard to "miss".

HTH

Tue, Sep. 15th, 2009 10:37 pm (UTC)
(Anonymous): The Needles

I really hope everyone remembers too ask the store for a "Bio-Medical Waste" container. They are free, and they cost nothing to drop off again.

Wed, Sep. 16th, 2009 03:54 am (UTC)
opabinia: Re: The Needles

I have never gotten one for free. You always have to pay for them in the US. Some places even charge you for disposal too but most hospitals and many fire stations do not.

Wed, Jan. 26th, 2011 04:50 am (UTC)
disturbedme

I am glad I found this. I was just diagnosed with pernicious anemia and probably have had it for 15 years or longer and never knew. I have to start giving myself B12 IM injections and kind of nervous about it. I am not scared of needles at all, but giving a shot to myself is going to be weird and scary.

I will do the thigh. Do I switch off thighs each week?