This topic is about managing chronic vitamin B-12 deficiency and low platelet count for someone living with a permanent ileostomy. The person has been dealing with these issues for quite some time and is looking for effective solutions, especially since the cost of their current B-12 injections has increased significantly. They are also experiencing challenges with their healthcare providers and are seeking advice on how to improve their situation.

Here are some helpful suggestions and insights shared by others:

1. Consider trying high-dose oral B-12 tablets. Some people have successfully maintained normal B-12 levels using inexpensive over-the-counter tablets taken every 1 to 3 days. A bottle of 100 tablets costs around $25.

2. Chewable or gummy formulations of B-12 and vitamin D might be beneficial. These can help with absorption issues and are easier to swallow. One person even found their B-12 levels became so high that their doctor advised them to reduce the dosage.

3. Use activated methylcobalamin (methyl-B-12) at a dose of 1000 micrograms daily until your levels normalize, then switch to a maintenance schedule.

4. For platelet count issues:
- There is no definitive at-home solution, as platelet levels can fluctuate for unknown reasons.
- If platelet levels become dangerously low, a platelet transfusion might be necessary.
- Some foods are believed to support platelet production, though no specific foods were mentioned.
- It's important to insist that your doctors investigate and explain persistent low platelet counts rather than accepting vague answers.

5. Turmeric gummies were mentioned by someone for pain relief related to having an ostomy, although this is not directly related to B-12 or platelet issues.

6. If you are experiencing long wait times and poor communication with your healthcare providers, consider escalating your complaints, seeking alternative providers, or requesting direct messaging or portal access to specialists.