Know your Ingredients: Which Vitamin B-12 is Best?

The Problem with Vitamin B-12

Most vitamin B-12 has an obvious problem. One that I noticed years ago before I even went to naturopathic medical school. Most vitamin B-12 on the market is in the form of cyanocobalamin. As a teenager, I said wait is there cyanide in the cereal? Cyanocobalamin is not the form of vitamin B-12 found in nature. So for years, I avoided cyanocobalamin, always checking labels to make sure it wasn’t present. Now I’m a responsible adult and naturopathic physician so just for this article I looked up the toxicity of cyanocobalamin. Sure enough there were a lot of side effects listed due mostly to allergic reactions. Unfortunately, that is what happens when you introduce foreign molecules into the body. The molecule cyanocobalamin itself is not toxic but once the cyanide is displaced from the cobalamin who knows what happens. I can not assume that molecule of cyanide is not a burden for any of my patient’s bodies. I then looked up the toxicity for the 3 forms of vitamin B-12 actually used inside of the body. I did not find any side effects from methylcobalamin, hydroxocobalamin, or adenosylcobalamin in PubMed. But, I learned that hydroxocobalamin is used to treat cyanide poisoning. As you can see from the picture below cyanocobalamin has to go through steps to be converted to a usable form. Genetically not everyone can transform cyanocobalamin to the other forms and other nutrients are needed for those steps to take place. 

Cyanocobalamin, Methylcobalamin, Hydroxocobalamin, Adenosylcobalamin

Methylcobalamin, Hydroxocobalamin, and Adenosylcobalamin

Methylcobalamin, hydroxocobalamin, and adenosylcobalamin all are forms of vitamin B-12 used by your body. As usual I’m not going to go into detail about what conditions they are used for or how they work. What I do want to discuss briefly is where in the body each form is used. Keep in mind all 3 forms are used to help people that are vitamin B-12 deficient but within the body each form has specific differences. Methylcobalamin is the form you would find in most supplements. It works with Folate to support your methylation cycle. I’ve written a blog called, Methylation Polymorphisms are more Complicated than MTHFR. While methylcobalamin is used in methylation managment. As mentioned earlier hydroxocobalamin is used when people have cyanide toxicity. Adenosylcobalamin is used as a free radical scavenger in the mitochondria to decrease oxidative stress. Keep in mind that these different forms can convert from one to the other as needed as long as there’s goog nutritional status. Otherwise if you only supplement with one and are deficient of other nutrients then you may have reduced levels of hydroxocobalamin or adenosylcobalamin. At the vert least make sure you are not taking cyanocobalamin in your supplements. 

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