Cyanocobalamin

[jillc39]

does anyone know about this form of B12 injections?

[wedgewood]

I believe that this was the kind of B12 that was used in the UK for many years. It was found that Hydroxocobalamin was better, and that is what the NHS uses now.I believe that Cyanocobalamin is still used in the USA. It is also what is used in supplements and cereals etc. It is much cheaper than Hydroxo or Methyl/

[fbirder]

It used to be used in the UK, but is now only available from the NHS as 50 ug tablets, for people whose deficiency is diet-related.

It is still used in the US for injections.

It is more stable than hydroxocobalamin but it requires more frequent administration. Like hydroxocobalamin, cyanocobalamin is easily converted to the active forms of B12 in the body - for the vast majority of people.

Some idiot web sites warn that cyanocobalamin releases cyanide and should, therefore, be avoided. This is true, but irrelevant. 1000 ug of cyanocobalamin will release 20 ug of cyanide. This is the same amount as found in 10 ml of prune juice (a normal glass of prune juice would be 5 to 10 times that much).

Our very own @clivealive has been injecting cyanocobalamin once a month for 45 years and is, in his own words, still clivealive!

[jillc39 in reply to fbirder]

thank you both so much for helpful replies.

[Gambit62 Administrator in reply to fbirder]

it's not clear that hydroxo definitely needs to be administered more frequently than cyanocobalamin - it will vary from person to person.

The studies in 1960s that showed that on average people retain hydroxo twice as long as cyano also showed such a significant variation with enough people retaining hydroxo longer than cyano for it to be clear that you couldn't really say that people would only need hydroxo every two months rather than cyano every month ... however, that appear to be conveniently overlooked.

When hydroxo was first introduced in the UK it was administered monthly.

People with Leber's Hereditary Optic Neuropathy have a particular sensitivity to cyanide and to the cyanide content of cyano-cobalamin molecule - despite the fact that it is extremely tightly associated and can't cause cyanide poisoning. People with this condition should NOT be treated with cyanocobalamin as it brings a very high risk of blindness. They will also have been warned not to smoke because of the risk from very small amounts of cyanide found in tobacco from the processing. They can be treated with hydroxocobalamin. However, one issue that seems to crop up in the states is that, because of the prevalance of cyanocobalamin - guidance is often expressed as 'should not be treated with cobalamin'.

Interestingly I remember a smoker who was a member of this forum reporting that they found cyanocobalamin much more effective than hydroxocobalamin ... and suspected it was to do with the hydroxo dealing with the small amounts of cyanide they had from smoking ...

[sirlam in reply to fbirder]

Quick question - I have just received some cyano to try. Does it need to be kept in the fridge?

I keep the hydroxy in a wardrobe.

Thank you!!

[fbirder in reply to sirlam]

One of the reasons for cyano's popularity in the US is that it's supposed to be more stable than hydroxo.

So I'd keep it in the same wardrobe.

[sirlam in reply to fbirder]

Thank you. Phew!! Now to see if I get on with it...

[sirlam in reply to fbirder]

Just noticed it is 3mg/2ml. I normally have 1mg/1ml. 3 seems a lot so have taken half and will keep the other half for later use. In the dark. In the syringe. Will that keep OK?!! Thank you for your help

[fbirder in reply to sirlam]

It should be OK. I'd use a new needle, however - just in case it's been contaminated.

[sirlam in reply to fbirder]

Yes - I thought of that. Thank you!

Am I right in assuming that 1mg of hydroxy is the same as 1mg of cyano ?!!! I realise if I take too much I shall just pee it out but am loathe to waste it.

[fbirder in reply to sirlam]

Yes, they are almost perfectly equivalent 1mg = 1 mg.

[fbirder]

it's not clear that hydroxo definitely needs to be administered more frequently than cyanocobalamin - it will vary from person to person.

Which is why I said that cyano requires more frequent administration.

[jillc39]

can I mix and match.... some hydro from gp and top up with cyano....

[fbirder in reply to jillc39]

No reason at al why you shouldn't take both.

[pvanderaa]

I take cyano which is standard in the USA. Initial dose is 1 ml / month.

More frequent injection is 1 ml / week.

[sweetsusie in reply to pvanderaa]

Did your doctor start you off on once-a-month Vit B12 shots? That's what mine did, & I was wondering if this is correct?

[pvanderaa in reply to sweetsusie]

Yes. But I noticed fairly quickly that it didn't last. I use a log book to record all my symptoms as well as my food and drink and meds. And was able to show my GP that the monthly interval was not sufficient . It took a few months and I finally was Abe to convince him that I really needed weekly injections. I self inject 1/2 the rubber stoppered vial on Monday morning and the second half on Thursday morning. This has stabilized the ups and downs. As I think I get the most benefit with the least loss.

That said, if I have a particularly stressful week, some symptoms do return early. So the duration that the B12 last is inversely related to the level of stress.

[sweetsusie in reply to pvanderaa]

I wish I could get once-a-week injections, but I live in the US and it costs me $20.00 a visit to get the shots, so I guess I'll just have to be satisfied with the once-a-month. Ridiculous medical costs here..thank you for the response!

[pvanderaa in reply to sweetsusie]

I too live in the USA, with insurance the 4 vials per month cost $4.

I self inject and a box of 100 needles cost $30

[jillc39]

ah thank you pvanderaa - do you have hydro as well?

[pvanderaa in reply to jillc39]

Sorry - my prescription is cyano

[alamagpa]

I inject cyano twice per month. GP argued once per month would suffice. Armed with Martyn's research findings -- that the response to parenteral B-12 treatments vary from one patient to the next -- I argued for weekly and settled for bi-weekly. My advice is to gauge how you feel and assert your rights for the injection schedule best for you.

[sweetnessandlight]

I am currently in Menorca on holiday. This morning I walked into a farmacia and asked for cyanocobalamin. No problem. Just over 2 euros for 5 ampoules. If only it was that easy at home.