Know the difference between cyanocobalamin, methylcobalamin, adenosylcobalamin, and hydroxocobalamin?
Find out who would benefit from each type of B12 and which one should be thrown away!
Do you know which form of B12 is best to take? Find out! @drbenlynch
Hey, Dr. Ben Lynch here. Four types of B12. You’re confused. Yes. I know. Let’s clarify that confusion right now, shall we? Let’s start with the easy one, cyanocobalamin, garbage can. That simple. Cyanocobalamin is a synthetic form of B12 that you don’t want to be using in your patients. It’s cheap and it’s utilized but its demanding process to convert cyano into methylcobalamin and into ethylcobalamin. So, why take a nutrient that your patient has transformed using other nutrients in order to make it bioavailable and effective? Let’s not do that, right? Cyanocobalamin, garbage can. Stop using it.
Now, methylcobalamin, the kingpin. A lot of people are deficient in methylcobalamin. Why? Antacids. A lot of people are taking antacids. A lot of people are also vegetarians or vegans and they’re not eating the red meat. Methylcobalamin requires very good absorption and digestive system function, right? So , patients who have poor digestion or they’re taking antacids or both, and not eating red meat, or even eating red meat could be deficient in B12. So, you check serum cobalamin, it looks fine. That doesn’t tell you anything. Serum cobalamin is not a good marker. Look at MCV, MCH. MCV and MCH is elevated or borderline high, then you know that they’re B12 or folate deficient or both. Okay, methylcobalamin is very important. It’s ready. It’s ready to work. Methylcobalamin supports methylation, but it needs methylfolate in order to work. So methylfolate and methylcobalamin are in tandem to support methylation. That’s where I’ll stop on methylcobalamin.
Now, methylcobalamin needs also to be carried and it needs to be carried by transcobalamine. There are genetic issues that take your transcobalamin and help carry your methylcobalamin. Glutathione is needed to help that binding be stronger. So if your patient is glutathione deficient, and you’re giving methylcobalamin, and they’re still not getting a good effect, maybe they’re deficient in glutathione. So, support your glutathione levels.
Now, adenosylcobalamin, what’s that? Adenosylcobalamin is the fuel B12. It’s the kick starter. So if you give adenosylcobalamin to a patient who is tired and fatigued or who has exercise induced fatigue that’s too quick, it just doesn’t seem right to you that they run a quarter of a mile and they’re just hurting? Maybe they have a genetic defect or some enzymatic co-factor problem that converts methylcobalamin to adenosylcobalamin. That conversion occurs in the mitochondria, because adenosylcobalamin is a mitochondrial form of B12. So, check for it. And you can check to see if adenosylcobalamin levels are okay. How? You check urinary methylmonic acid which you know about. Oh, that’s what that’s checking. Yes, if you’re low on adenosylcobalamin, the patients’ methylmonic acid levels will be high or pushing high.
Hydroxocobalamin is the third one. It’s a third active form. And hydroxocobalamin is very useful to lower nitric oxide levels. Now another cardiologist thinks, whoa, whoa, nitric oxide is really useful. It is, in the right amounts. Too much causes radical issues in your patient, reactive oxygen species. So, we want to make sure that the nitric oxide levels are where they need to be. And you also need to also support them with glutathione and supraoxide dismutase as well. So, if you give hydroxocobalamin to lower the nitric oxide and your patient does better, that’s a sign that their nitric oxide levels are elevated and you typically see elevated nitric oxide in patients with chronic disease especially autoimmune disease or fibromyalgia or chronic fatigue. These things are known to drop nitric oxide levels and improve. The research is out there. So, those are three four types that you want to be focusing again. Again, cyano garbage can, methylcobalamin supports methylation, adenosylcobalamin supports energy, and hydroxocobalamin supports the reduction of nitric oxide and optimizes the levels. Thank you. I hope that’s useful for you.
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