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Choosing the Right Vitamin B12 Supplement: Methylcobalamin vs. Hydroxocobalamin

Explore the differences between Hydroxocobalamin and Methylcobalamin for Vitamin B12 deficiency, the role of folate in B12 supplements, and potential acne concerns. Consult tailored advice based on blood results and symptoms like tiredness, vision issues, and mouth ulcers.

  • Trying to figure out which B12 vitamins to take. Bloods results. Also acne?

    UK. I'd like to start a B12 (Complex?) vitamin, but I'm not sure which to take.

    I am suffering from some symptoms, the feelings of bugs crawling on my head and legs, slight vision issues, mouth ulcers(sometimes), weak/tired.

    I'm really worried about getting acne as I don't want to ruin my skin and my confidence really.

    Is Hydroxocobalamin or Methylcobalamin the best form to take?

    Should I be taking a vitamin b12 complex with folate or just B12? Any recommendations please?

    Blood test results:

    Serum vitamin B12: 201 ng/L (was 140 last year)

    Serum Ferritin 143 ug/L

    Serum Folate: 3.2ug/L

  • Based on your blood test results and symptoms, here is some information regarding Vitamin B12 supplementation and its forms:

    Vitamin B12 Forms: Hydroxocobalamin vs Methylcobalamin

    • Hydroxocobalamin: Is commonly used for vitamin B12 deficiency treatment and is favored for its longer retention time in the body1. It is often administered through injections, particularly for individuals with severe deficiencies or absorption issues.
    • Methylcobalamin: An active form of vitamin B12 that is increasingly popular in supplements. It is utilized in treating certain neurological issues, though comprehensive controlled trials are lacking2. It may be suitable if taken orally, but evidence suggests that it might not fully replace hydroxocobalamin's effects in all deficiency cases23.

    Vitamin B12 Only vs. B12 Complex with Folate

    • Concerns about mixing folate with B12 supplements arise due to the potential masking of B12 deficiency symptoms by correcting anemia but not addressing neurological damage4. Folate, found in supplements typically as folic acid or methylfolate, can be beneficial but should be monitored to ensure it does not exacerbate symptoms if you are not sufficiently supplemented with B12.
    • For comprehensive support, especially with your folate levels also being on the lower side, consider a B-complex that addresses both B12 and folate deficiencies5.

    Acne Concerns and Vitamin B12

    • Some studies suggest that high doses of certain forms of vitamin B12 can exacerbate acne or other skin conditions6. It's been noted that supplementation of cyanocobalamin and high doses of B6 might aggravate acne7. However, different individuals may react differently, and maintaining balance with other B vitamins is crucial.

    It might be beneficial to discuss with a healthcare provider which form of vitamin B12 would best suit your needs, considering your symptoms, current vitamin levels, and acne concerns. Your provider can advise whether to start with more frequent B12 injections (if considering hydroxocobalamin) or to use oral supplements (methylcobalamin) and adjust based on your response to the treatment.

    Footnotes

    1. NHS website ↩

    2. Ashwin Kamath, "Methylcobalamin in Vitamin B12 Deficiency: To Give or not to Give?", PMC5370327 ↩ ↩2

    3. Cristiana Paul, "Comparative Bioavailability and Utilization of Particular Forms of B12" PMC5312744 ↩

    4. Office of Dietary Supplements - Folate, NIH ↩

    5. Shumin M. Zhang, "Effect of Combined Folic Acid, Vitamin B6, and Vitamin B12 on Cancer Risk", PMC2593624 ↩

    6. Dina H Zamil, "Acne related to dietary supplements", PubMed ↩

    7. Noura Elgharably, "Vitamin B group levels and supplementations in dermatology", PMC10099312 ↩

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