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Pernicious Anaemia Society
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Hydroxy change to methyl - thoughts?

Struggling with the very stingy hydroxycobalamin (from Intravita) and wondering if I should change to Methylcobalamin. Will it be as effective? I don;t mind if its more expensive but the stinging is so awful that Im not sure that I can continue with the hydroxy. The B12d charity suggested the hydroxy but if the methyl will work as well and not be so stingy then Im going to order that. Please tell me your thoughts? Thanks, Gill

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Have you had hydroxocobalamin injections from your Dr and had the same issues with stinging on injection? Are you absolutely sure it's the hydroxocobalamin itself or the other components of the ampules that are causing the issue? Have you tried any of the imported hydroxocobalamin? I use Rotexmedica (purchase from Goldpharma) and find it virtually pain-free (obviously stabbing yourself with a needle is always going to be sharp so never totally pain-free). I also tried methyl sublingual before injecting and I just got terrible headaches. Hope that helps

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Thank you, I think its the 'salt and vinegar' that's the problem as I am feeling better.

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All injectable B12 will contain sodium chloride and acetic acid (salt and vinegar) or a chemical equivalent thereof.

Salt (saline) is required with most injectables to make it isoosmotic with body fluids. If you don't have salt in the stuff that gets injected then you will cause the cells in the site of injection to burst.

B12 injections will also require a small amount of additional chemical to ensure that the correct pH is maintained. If the pH is wrong then the injection may be uncomfortable.

Without 'salt and vinegar' one or both of these may happen. Either could cause the injection to be painful.

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and thank you for this which makes sense. Maybe it doesnt have salt and vinegar in and that's why its not listed, though I think if its required for injection then can;t see it not being included. Thanks,

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The hydroxy I've used does not have any preservatives in so this sounds like its why its so painful and this reply from you makes sense of that for me, so thank you.

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Would it not be better, easier, safer and cheaper to try hydroxocobalamin from a reputable German company...

versandapo.de/en/substance/...

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I think I'm going to do that, have you used this and not found it really stingy? Its a very good price too, thank you.

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I buy the Rotexmedia, 100 ampoules at a time. I inject twice a week and never have any pain of any description.

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thank you, I'm going to order some of that now. Much appreciate your input. Gill

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Hi fbirder, will I need different needles / syringes to the ones I am using for hydroxi 1mg/2ml do you know as the Rotexmedia are 1mg/1ml? Thank you, I havent got my head around the different needle sizing!

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Same needles will be fine. If you're using 2 ml syringes then they should be OK.

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thank you.

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It is impossible to say which form of B12 will suite which individual best - it may be that methyl works better for you or it may be that it is a lot worse - the only way to know is to try.

On the stinging - people have had considerable problems with methyl stinging - becouse of the other incredients in the brand - so it may not resolve that problem.

Although there is a lot of hype about methyl being better there doesn't seem to be any hard scientific evidence to back this up - and the arguments tend to rely on two rather dubious assumptions - a) that the B12 molecule goes from gut to being used in the cell without any changes (infact it is recombined and separated from several other proteins in between and b) its the form used in cells - but actually there are two forms used in cells - methyl and adenosyl - for different processes so if you have a problem converting methyl to adenosyl (which is possible) then it isn't going to be a cure all ... whereas there haven't to my knowledge been any cases of people who can't convert both cyano and hydroxo to both methyl and adenosyl.

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Thank you, that is helpful, I will try the hydroxy from Germany. Many thanks to everyone too, Gill

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I find the hydroxo to be quite stingy - it's the same whether I inject the ampoules I bought from Germany, or the practice nurse injects the NHS version. When I inject at home, I now use cyano. I know some people have said they don't find them as good, or to last as long, but for me the effect seems to be the same, and they 'ouch' less as they go in. Bonus is that the cyano is much cheaper too!

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Hi spacey1, thanks for that - is it really really painfully stingy? Ive ordered some of the German ones now so do hope they're better. The stinging in the ones Ive got is so painful that its almost unbearable - are the ones you have this bad?

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No, it's not unbearable, but definitely 'ouchy' - I can feel every last drop of the hydroxo going in. Personally, the cyano suits better, as I just have the micro-ouch of the needle going in, then it's fine. I still have the hydroxo at the doctor's (they don't know I self-inject), and I don't dread it. I just know that the nurse hurts me a bit more than I do!

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I've just found that the hydroxy I've been using is not diluted with any preservatives and that might be why its so painful.

i don't think Im being a wimp and wouldn't mind it being a tad painful I think but this is too much - I even had to take it out half done and change the needle and do the other half on the other leg this time!

Thanks for this its really helpful to compare.

x

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