At the beginning of January I made two changes. I switched from cyanocobalamin to hydroxocobalamin, and I switched from 1000mcg daily to 1000mcg every other day.
I sort of think I am doing less well: signs of increased inflammation of the shoulder, hip, and knee; increased brain fog; and generally feeling less well. I am considering switching back to daily, though of course that always raises doctor-related concerns; or, I am thinking of switching from 1000mcg e/o day to 500mcg daily.
I am wondering whether anyone who has changed from 1000mcg daily to 500mcg e/o day has experienced any benefit from that change, and would appreciate any insights, concerns, etc.
Written by
WiscGuy
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I haven’t done this myself , but I heard from someone who has excellent knowledge on the subject , that the usual dose of 1,000 mcg is way over what can be absorbed— So I’m sure you would have equal benefit from a 500 mcg dose . It’s certainly worth a try. Sounds like a good idea .
I would try it myself but am concerned because I have 1.000 mcg ampoules . and I would have to draw up 500 mcg into 2 Syringes and keep one back for a week ( I inject weekly ) I would be concerned that there is danger of contamination in that Syringe being kept for a week . So I’ve not tried it .
I wouldn't keep a syringe drawn up for a week either! The risk is not worth it, but you'd only find out if it went nasty. Use it, and bin the leftover.
The way that B12 is absorbed is more like wedgewood described, for the most part. The body can only absorb so much at a time and you're better off taking the smallest doses you need to stay well, more frequently. Anything extra gets passed out through the urine. By 24-72 hours, nearly all of it from your last injection has been either absorbed by the body or passed through your kidneys and filtered out. My wife suffered from MTHFR caused neuropathy in her legs and was on daily 1000mcg methylcobalamin injections. The pharmacist recommended going to a once weekly 5000mcg injection. It did not work. At the end of 3 days, her symptoms would return. We backed it off to 1000mcg daily and they subsided. We did daily injections for approximately 5 months (she was severely deficient), and she has just now been able to stretch her injections out to 1 injection every 4-6 days. I'm not a medical professional, but what I believe a higher dose did was cause a "spike" in her level and then a crash as her body disposed of any excess that wasn't absorbed. (At the beginning of her 5000mcg injections, urine would be pink, indicating it was too much at once.) Smaller doses, more frequently, caused fewer peaks and valleys in her level. It's been a long road to get where we are now but we've learned a lot!
Most of what we learned is that DRs don't usually know much about the effects of B12 deficiency! We went to neurologists, pelvic floor specialists, different GP's, etc. We did test after test and she was prescribed drug after drug. Nobody wanted to get to the root cause, but only wanted to cover up the symptoms with another pharmaceutical! We finally found a PA who was open minded to trying what we wanted to do; B12.
Just a couple questions: why did you switch? Was the cyanocobalamin not working any longer? Also, have you tried methylcobalamin? My wife did not respond to cyanocobalamin due to her MTHFR gene mutation. Methyl is more expensive and more storage sensitive. It's not as common, but easy enough to find online; in case you have stubborn Healthcare providers. With a telehealth phone call and a couple hundred dollars, you can get a good supply from Olympia Pharmacy. A legit, 503B pharmacy, and a legit prescription from a Dr. Nothing shady! Good luck on your journey!
Until December 2024 I had been injecting cyanocobalamin daily since September 2021. B12 symptoms have improved slowly, even (I think) spinal cord degeneration. I initially went to the doctor because every so often I would be sick in bed for 2 or three days, then those symptoms would suddenly be less. I was diagnosed with B12 deficiency and bounced around with injection frequency until I told the doctor I wanted to return to the frequency that made me feel the best, which was daily. But that pattern ( feel ok for a couple of weeks, then feel crappy for 2-3 days) never resolved. I heard Sally Pacholoc describe, in a recent taped interview and Q & A, why she used hydroxocobalamin rather than cyanocobalamin, and she ended that particular response by saying, "Why would I use the inferior form?" Then I looked up cyanocobalamin in Dr Chandy's book (easy to do because I had downloaded the PDF), and found the part describing why Britain uses hydroxocobalamin rather than cyanocobalamin. So I wanted to try hydroxocobalamin to see whether those periods of feeling crappy would finally resolve. I stupidly decided to reduce frequency at the same time, from daily to e/o day, which muddied the water when it seemed to me that symptoms were becoming exacerbated/reoccurring. So in the next day or two I will tell my doctor that I wish to return to injecting daily.
I haven't tried methyl Cobalamin. It was a big jump for me to go from individual doses to the 30mL bottle. I will (hopefully) return to daily injections, but with hydroxocobalamin, so that I can compare daily cyanocobalamin with daily hydroxocobalamin, and see where that goes. I have a smart doctor now (knock on wood), so hopefully different treatment options will be available to me through the local clinic.
Was there a reason that you and your wife skipped hydroxocobalamin and went right to methylcobalamin?
I hadn't heard of Olympia Pharmacy. Apparently it's in the US.
Hydroxocobalamin isn't as popular here in the states... the only 2 "popular" options are really cyanocobalamin (because it's cheap, stores well, and insurance will pay for it) and methylcobalamin; expensive and must be compounded at a compounding pharmacy and stored in the refrigerator, in the dark. Not 100% positive, (I'm not a doctor or scientist) but everything I've read states that when methylcobalamin "expires" it breaks down into hydroxocobalamin. Yes, Olympia Pharmacy is in Florida; I thought I had read that your bio stated you were from the US; maybe I saw that somewhere else. Good luck in your journey!
I am in Wisconsin. Getting hydroxocobalamin was not difficult, but the only available container is 30 mL bottle, which, for me, is not nearly as convenient to use as the 1000 mcg bottles that cyanocobalamin comes in. But because I had a lot of experience with self-injecting cyanocobalamin, it was not difficult to get adjusted to the 30 mL bottle, though I would still prefer 1000 mcg bottles. (I don't know the jargon, hence "bottles".)
Based on half life curves, you will have a more steady level injecting every day. It may be something you are supersensitive to. Half life of B12 from what I have read is six days, and every time you inject it goes back up, then that injection will fall off according to the half life curve.
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Methylfolate - how much are people taking?
Almost passed out. 
Methylcobalamin injections?
