Advice please on different forms b12

[sbadd]

Hi there just finished my last loading dose 4 weeks ago was on the cyno shots, still quite tired and have heaviness in legs arms etc, have read that cyno not really recommend for smokers which i am, suffered terrible side effects on the cyno injections, would i be better trying the methyl type as not due for another shot for 2 months now, but dreading it as just starting to recoup after last ones, any advice please

[Gambit62 Administrator]

where are you based?

If your doctor is using cyanocobalamin then you should be on monthly maintenance doses - 3 monthly is used in the UK for hydroxocobalamin because in theory it is retained longer than cyano (though that's subject to a lot of individual variation). On average cyano is only retained for 1 month. Suggest you double check with your doctor on the form of B12 and frequency of maintenance doses.

If you can source hydroxo I would suggest trying that. Its more stable than methyl.

Not sure about cyano not being recommended for smokers - not aware of smoking as a contra-indication. Some smokers actually find that cyano works better for them because - theory of one was that the hydroxo was actually being used up to clear trace amounts of cyanide from their blood (cyanide is used in the processing of tobacco).

[sbadd in reply to Gambit62]

Thankyou for the advice im in Australia so i will check with my doctor im just concerned because only symptons i had prior to finding out low b12 was tiredness and the odd muscle twitch, other has happened since injections.

[Martin_12]

I'm also in Australia. As far as I know standard treatment for B12 deficiency here is hydroxocobalamin. You should ask if there is a specific reason you were given cyanocobalamin. The only adverse effect of hydroxocobalamin (compared with cyanocobalamin) I know of is a slightly higher risk of developing an allergy to it. Hydroxocobalamin for injection is available over the counter here at about $8-16 for 3 ampoules). I buy it from a local pharmacy and either one of my daughters (both nurses) or a nearby bulk billing GP injects it.

I think Methycobalamin is available here but I think it is more expensive. It has to be kept refrigerated and is less stable than hydroxocobalamin. According to Sally Pachalok, who is well known on this forum, hydroxocobalamin is the preferred form for use in smokers.

pharmacytimes.com/publicati...

[sbadd in reply to Martin_12]

Thankyou i was unaware of the different forms of b12 to start with so purchased from pharmacy they gave me the cyno, wasn't told about any other options, nurse then did injections at my local gp, also my ampules were kept at surgery but were not refrigerated, they were just stored in drawer, mmmm

[sbadd in reply to sbadd]

Sorry just realised you meant methyl form to be refrigerated