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Pernicious Anaemia Society
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UK - changing from hyroxocobalamin to methylcobalamin

I am 72, newly diagnosed and start my course of B12 injections on Wednesday. However, In the UK (Scotland) it is standard practice to use hydroxocobalamin and not methylcobalomin. Since diagnosis I have read extensively about B12 deficiency and the different B12 replacements and it seemed to me that methylcobalamin would be the best choice since it would also help with my arthritis and diabetes. I would be grateful for any comments or advice and getting a GP to change his mind about which replacement to use. Or indeed any advice at all.

1 Reply

In 90- 95% of the patients hydroxocobalamin is fine and the correct treatment. Methyl injections are not licensed as official medication. Only a small number of patients require methyl.

From a haematologist, a B12 expert: " Research shows, and that is also our clinical experience, that hydroxocobalamin i.m. (or deep s.c.) injections are the most proven superior treatment in B12 deficiency, certainly with neurological and psychological symptoms. Hydroxocobalamin facilitates both pathways (conversion to methylcobalamin and adenosylcobalamin) and it works in a more natural way. There are pathways in the complex metabolism/conversion to active forms that we (& the clinical chemists who we work with) do not know yet and which we therefore deliberately do not want to skip.

The comment “it skips the conversion process and helps directly in the active form” we think of as an unscientific approach – to put it mildly. In addition, hydroxocobalamin is an anti-dote of (cyanide) toxins, which is partly due to its complex molecular structure."

Please also have a look at the Pinned Posts on the home page of this forum, for more info.


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