This topic is about dealing with vitamin B12 deficiency and related neurological symptoms after having an ileostomy. The person sharing their experience is looking for advice on treatment options and wants to know what has worked for others in similar situations.

Here are some helpful insights and advice:

1. People with B12 deficiency often experience symptoms like fatigue, weakness, numbness or tingling in the hands and feet, balance problems, cognitive issues, a swollen tongue, and anemia. Having an ileostomy can increase the risk of B12 deficiency because B12 and other water-soluble vitamins can be lost with high stoma output.

2. If oral tablets are not absorbed well, consider these supplementation options:
- Sublingual B-Complex or B12 drops/lozenges that dissolve under the tongue, allowing absorption through the oral mucosa and bypassing the gut. These are widely available and affordable.
- Liquid B12 taken orally might help if some absorption is still possible. Some people have found grinding tablets into powder or using liquid forms helpful until more bowel was removed.
- Injections of hydroxocobalamin or cyanocobalamin are effective when absorption is very poor. They can quickly raise B12 levels and can be reassessed over time.

3. Regular blood tests, suggested every six months, are important to monitor B12, magnesium, vitamin D, and other micronutrients. A dietitian or gastroenterology team should oversee this.

4. Combine B12 replacement with a good multivitamin, and make sure any tablet form is not visible in the stoma output.

5. As a dietary tip, consider eating a small amount of Marmite daily, as it is rich in B-vitamins.

6. For other nutrients that are poorly absorbed, similar strategies can be used: sublingual vitamin D for bone health and trans-dermal or foot-bath magnesium flakes to maintain magnesium levels without needing IV infusions.