Something I can snort.

A up-the-nose B-12 supplement, what fun! Apparently not something I can take blindly, but everything seems to have this notation:

But, for you, my peers:

Nascobal®(Cyanocobalamin, USP) is a synthetic form of vitamin B ₁₂ in a nasal spray.

Nascobal avoids the gastrointestinal tract by delivering vitamin B ₁₂ directly to the bloodstream through blood vessels in the nose. This product is ideally suited for patients with such conditions as Crohn's disease, HIV/AIDS, multiple sclerosis, or pernicious anemia where absorption of B ₁₂ from foods and oral supplements is either poor or does not occur at all.

This product is not indicated for patients with sensitivity to cobalt and/or vitamin B ₁₂ or any component of this medication.

Reasons for prescribing Nascobal:

• Convenient - replaces the need for monthly injections
  
• Consistent - provides smooth and consistent serum B ₁₂ levels demonstrated in a crossover study compared to IM injections (please see prescribing information )
  
• Easy-to-use - self-administered; One dose, One nostril, Once per week
  
• Indication - for the maintenance of B ₁₂ levels in patients with such deficiencies resulting from Crohn's disease, HIV/AIDS, multiple sclerosis, ileal resections, gastric surgeries, and pernicious anemia

Nascobal Nasal Spray is indicated for the maintenance of normal hematologic status in pernicious anemia patients who are in remission following intramuscular vitamin B ₁₂ therapy and who have no nervous system involvement. Nascobal Nasal Spray is also indicated as a supplement for other vitamin B ₁₂ deficiencies, including:

I. Dietary deficiency of vitamin B ₁₂ occurring in strict vegetarians (Isolated vitamin B ₁₂ deficiency is very rare).

II. Malabsorption of vitamin B ₁₂ resulting from structural or functional damage to the stomach, where intrinsic factor is secreted, or to the ileum, where intrinsic factor facilitates vitamin B ₁₂ absorption. These conditions include HIV infection, AIDS, Crohn’s disease, tropical sprue, and nontropical sprue (idiopathic steatorrhea, gluten-induced enteropathy). Folate deficiency in these patients is usually more severe than vitamin B ₁₂ deficiency.

III. Inadequate secretion of intrinsic factor, resulting from lesions that destroy the gastric mucosa (ingestion of corrosives, extensive neoplasia), and a number of conditions associated with a variable degree of gastric atrophy (such as multiple sclerosis, HIV infection, AIDS, certain endocrine disorders, iron deficiency, and subtotal gastrectomy). Total gastrectomy always produces vitamin B ₁₂ deficiency. Structural lesions leading to vitamin B ₁₂ deficiency include regional ileitis, ileal resections, malignancies, etc.

IV. Competition for vitamin B ₁₂ by intestinal parasites or bacteria. The fish tapeworm (Diphyllobothrium latum) absorbs huge quantities of vitamin B ₁₂ and infested patients often have associated gastric atrophy. The blind loop syndrome may produce deficiency of vitamin B ₁₂ or folate.

V. Inadequate utilization of vitamin B ₁₂. This may occur if antimetabolites for the vitamin are employed in the treatment of neoplasia.

• Pregnancy Category C: Animal reproduction studies have not been conducted with vitamin B ₁₂. It is also not known whether vitamin B ₁₂ can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Adequate and well-controlled studies have not been done in pregnant women. However, vitamin B ₁₂ is an essential vitamin and requirements are increased during pregnancy. Amounts of vitamin B ₁₂ that are recommended by the Food and Nutrition Board, National Academy of Science - National Research Council for pregnant women should be consumed during pregnancy.