Hello. I understand wanting a more affordable option for your B12 deficiency. While Neurobion Forte is cheaper, it contains much less vitamin B12 (cyanocobalamin) than MMX B12 (methylcobalamin) and includes vitamin B6. Taking vitamin B6 long-term, even with breaks, can sometimes lead to nerve irritation. Additionally, an on-and-off schedule may not keep your B12 levels stable. I recommend discussing your budget with your doctor. They can suggest an affordable, high-dose generic vitamin B12 supplement that is safe and effective for your specific needs.

An elevated vitamin B12 level of 1400 pg/mL is generally not harmful, as your body typically flushes out any excess. However, since your levels are already quite high, taking additional B-complex supplements like Cobadex or Neurobion may not be necessary right now. Since these were prescribed as part of your osteoporosis care, I gently recommend sharing these lab results with your doctor. They can help determine if you should temporarily pause the supplement or adjust your dose to perfectly suit your body's current needs.

Dealing with persistent IBS-C, poor sleep, and weakness is incredibly draining, especially when your tests are normal. Since Nexito and Prothiaden haven't fully relieved your symptoms, your doctors might consider adjusting your regimen. For anxiety and gut sensitivity, switching to other generic options like selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs), such as duloxetine, can help manage both nerve pain and anxiety. For sleep and bowel habits, optimizing your evening dosulepin (Prothiaden) or adding gut-directed therapies like cognitive behavioral therapy can provide relief. Please consult your psychiatrist and gastroenterologist before making any changes to ensure a safe, coordinated transition.

Yes, you can safely take Neurobion (which contains B vitamins) if you have diabetes. In fact, B vitamins are often helpful for nerve health in diabetic patients. However, please note that Neurobion is not a direct pain reliever for acute muscle or back strains. If your pain is due to muscle tension rather than nerve issues, other treatments may be more effective. I gently recommend discussing your pain with your doctor to find the safest, most effective treatment plan for you.

Medications like Jotter 100 (gabapentin) can take two to four weeks to show their full effect, so ten days is often too early to feel significant relief. Regarding Neurobion Forte, it contains B-complex vitamins, which overlap significantly with your Supradyn multivitamin. Taking both is generally not recommended as it can lead to an unnecessary double-dose of these vitamins. I suggest holding off on Neurobion Forte and speaking with your doctor, who can safely adjust your gabapentin dose or streamline your vitamins to better manage your symptoms.

For safe pain relief, paracetamol is generally the most compatible option with your current medications, including Nexito, Pexep CR, and Prothiaden. Please avoid nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, as they can increase the risk of stomach bleeding when combined with your daily medicines. Since your daytime weakness and pain could also be a side effect of your current regimen or linked to your IBS-C, I highly recommend consulting your prescribing doctor to evaluate your overall treatment plan and ensure you find lasting relief safely.