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Pernicious Anaemia Society
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Methyl For SI ??

I think I read somewhere that this is a less painful injection??

I also think it might work better for the person who needs it as they've shown as having a gene mutation that means they can't process B12 as well, plus they need more than normal to stay well. We've hit a brick wall with doctors & as I already SI myself it makes sense. Also needles, I use needles I get from the drug exchange, which are nice and fine, but I wonder if you can buy even finer, less painful ones

The person this is for is very pain sensitive, so looking to SI as pain free as possible

Thank you

8 Replies

Methylcobalamin is not as good as hydroxocobalamin. It is more difficult to source, more expensive and less stable.

The gene mutation you're referring to is carried by about 9% of the population and affects production of methylfolate. Many people with that mutation function perectly well. Some may find that they feel better if they supplement with methylfolate. They have no need to take methylcobalamin.

I didn't find methylcobalamin any less painful the one time I tried it.


Thank you for your reply. Interesting that one of those gene mutations is so common

I was hoping it would be less painful as I've seen that said about Methyl many a time. Hydroxocobalamin is excruciatingly painful for her & she just can't SI with it as a result & we need to go that route as she's getting worse again & we've hit a brick wall with her doctors

My daughter doesn't have the MTFTH gene mutation but another one & the blurb with it suggests she would fair better with Methyl, so I figured it worth trying for both reasons. I have Hydroxo here already & though I'm happy enough with it, it's just no good for her


I have used both , and found absolutely no pain with either. I now only use Hydroxo and use a large long needle to extract , because whilst extracting it is possible to blunt the end of the needle, which could make injecting painful. To inject into my thigh , I change to a shorter 1" needle with 25 gauge ( very thin). I inject very slowly , and never have any pain .


Thank you. I do use Hydroxo for SI myself & do find it okay if warmed to skin temperature. I don't bother swapping needles though as I've not had a problem with blunting needles.

Unfortunately my daughters experience wasn't the same, not the needles going in, but the Hydroxo itself really burned her, she was in tears & I don't want to go through that again, so really want to try Methyl


Do you know if the hydroxocobalamin was warmed before it was injecting - injecting anything cold can cause a lot of stinging. Hydroxo is often kept in the fridge (doesn't need to be kept that cold) and there is often no realisation of just how much pain can be caused by injecting it cold.

B12d.org recently had a supply of methyl that they had to stop using because people found it stung a lot - think it was one of the preservatives/excipients that was causing the problem so it may be worth looking at other types of hydroxo with different preservatives if the problem isn't injecting cold.

Which form of B12 suits which person varies a lot - methyl does work better for some but it is far from universal and the exact reasons are far from clear ... and for some methyl actually seem to cause problems with anxiety and sensitivity to pain.


The B12d problem occurred because the methylcobalamin wasn't buffered properly.

Hydroxocobalamin from Germany will have been prepared by a reputable source, with repeatable, tested formulations.


Thank you for the replies. Food for thought, I really don't want to,waste money on something that might be worse, so,maybe we need to try again with the Hydroxo. I spotted an auto itect gadget discussed somewhere today & it sounded really good. Maybe that might be better to try first.

Thank you for your help everyone 😊


Hi rockinHippy, I use the auto-injector, it is really easy to use and holds the syringe securely, it has a safety lock so you don't accidently inject until ready a window area so you can see what you are doing and a light. You press button and needle goes straight in (not painful - better than when nurse does it), you then press plunger very very slowly and then I find it totally painless. As someone else said, warm up the ampoule beforehand, it really does work. I have needle phobia and couldn't do it without the auto-injector. The link is here: unionmedico.com/product/sup...


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