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Pernicious Anaemia Society
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B12 - methylcobalamin vs cyanocobalamin

Hi guys,

I ordered the B12 for my wife from Amazon DE (great service btw, ordered last Saturday, arrived Thursday morning). Her loading injections were the methylcobalamin type and I inadvertently bought the cyanocobalamin formula. She's concerned that there may be some differences in the way the 2 types work which wouldn't benefit her recovery. Are there any drawbacks to using this formula after the loading ones? Does anyone have any negative experiences or advice from using both?

Many thanks for any advice offered!

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Do not worry . Cynocobalamin works very well indeed . May not stay in the body for so long . But it is effective .Clivealive has used it for years . Best wishes .

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Thanks for that!

Both work the same, I’m on 1 ml cyano (1000 mg/ml) like clivealive, but i’ve had methyl during a trip to saudi when I ran out of cyano. The methy was also 1000mg/ml but came in 0.5 ml doses and I bought a 10x ampoule box over the counter (OTC).

Some people who are really deficient before starting any B12 injections have a pretty strong “reaction” which is really the cells in the body gobbling up the B12 and flooding their blood stream with a lot of metabolic byproducts all at once. With methyl, this reaction is stronger as it is more readily available and reacts faster.

Cyano needs to get converted in the body into methyl to get use so the reaction is slower and more regulated but the conversion.

This type of “reaction” only means that the body needs more B12 or more frequent injections.

Do you keep a logbook of symptoms? Treat the jab as day zero each time and monitor/ record the time since the injection when any of the symptoms show up.

The reaction symptoms are similar to the deficiency symptoms so it gets confusing without a logbook. The ones that come within 72 hours of the injection are “good”. The ones that show up a week or month later are “bad”.

Cyano is typically given on a monthly cycle but I need mine weekly. I split it into 2x 0.5 ml on Monday and Thursday and find that I don’t get the reaction symptoms and the roller coaster ride stops.

I found the methyl gave me a bit more of a boost but didn’t last as long.

Do you supplement with folic acid?

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Hi many thanks for your highly informative response. Yes my wife has just discovered that she’ll benefit from folic acid supplements. She’s self administered twice since the loading injections, her count was incredibly low and she suffers from several neurological symptoms, so we’re on every other day at the moment. Her body tends to react by becoming extremely sleepy (not lethargy or fatigue) and so far this has been consistent so she’ll do it shortly before bed. Thanks again i’ll Pass this info on.

different people respond differently to different types of B12 - they also retain different types of B12 for very different times. On average hydroxo is retained 2x as long as cyano (not sure that there have been comparative studies to methyl). However, there are a significant number of people who will retain cyano longer than hydroxo.

The only instance in which cyano shouldn't be used is in the case of a family history of leber's syndrome - a rare genetic disease that affects men more than it does women - and involves a specific hyper-sensitivity to the cyano element.

Follow symptoms to decide the frequency of treatment.

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Thanks so much for this info

Cyanocobalamin is just as good as, if not better than, methylcobalamin.

ncbi.nlm.nih.gov/pmc/articl...

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I've been on cyanocobamalin for over 46 years and as has been said above you will need to inject (at least) every four weeks or so.

I wish you and your wife well.

Hi!

Can we clone you?!! 😉 There are lots of people who would benefit from a supportive partner - good on you!

I'm wondering what country you live in. Forgive me asking but are you sure you had methylcobalamin loading doses?

In the UK the NHS uses hydroxocobalamin as this is the most widely tolerated and effective form of B12 as Methylcobalamin injectable is less stable, more expensive and can cause horrible headaches.

The cyanocobalamin should be fine but for a few of us with more broken metabolisms it isn't very effective so if you don't get such good results with it be aware that using hydroxocobalamin in future may be better.

The DNA synthesis, nerve function and energy release processes that use B12 also use many different vitamins and minerals so your wife may benefit from taking a broad spectrum multivitamin and mineral supplement plus extra folate, potassium, magnesium and iron, with the last ones coming, where possible, from food and drink.

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Thank you for that! I have to apologise because I got it wrong, you are correct that my wife's loading injections were indeed hydroxocobalamin, NOT methylcobalamin (got my wrist sapped for that one!), we are in the UK.

She has just begun supplementing with everything you've mentioned and will be keeping a symptoms diary. Her initial level before loading was 94 with several neuro symptoms (dizzyness, confusion, pins and needles in the soles of her feet which sometimes prevents her from walking, thinning hair) so we know it's going to be months before we see any significant signs of improvement. Her follow up GP blood test for post loading levels is next week but we've postponed due to her being unable to leave the house, given that we feel we're doing as much as we can right now I feel this can wait.

Interestingly I received this response from Dr Chandy the B12 deficiency charity support group regarding my initial question around cyanocobamalin:

"Please do NOT use Cyanocobalamin at all, NHS do not recommend,

It will have to be hydroxycobalamin or Methyl cobalamin"

Thanks again for all the advice!

The NHS do not recommend anything for injections other than hydroxocobalamin. They do, indeed, recommend cyanocobalamin, but only in tablets for treating a dietary deficiency. clivealive gets cyanocobalamin injections from the NHS.

The B12 deficiency charity often recommend methylcobalamin even though that is not licensed for use in the NHS for anything at all!

I react fantastically well to methylcobalamin and terribly to cyanocobalamin and hydroxycobalamin which both make me 'go downhill' pretty fast. It is very much a case of finding out how your body responds to different B12 preparations. There are different reasons for B12 deficiency and therefore different solutions. Good luck.

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lovinghubby. The conversation in this string - through no fault of your own - has gone way off topic, so apologies for that. I've deleted some responses since they do not contribute to subject of your post.

I'm turning off replying to this post but stress that this is not a reflection on the questions your raised. Apologies to you that this has become necessary.

Sincerely hope that your wife begins to pick up soon and please do post again if you have any more questions or need further support. 😉👍

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Thanks!

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