Best Treatment for Vitamin B12 Deficiency: Methylcobalamin or Hydroxocobalamin?


Your body relies on many different vitamins and minerals. These nutrients are vital for keeping you healthy and reducing your risk for developing serious health issues. B vitamins are just a few of the necessary vitamins you need. There are actually several different B vitamins, B1 (thiamine), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B6 (pyridoxine), B7 (biotin), B9 (folate or folic acid), and B12 (cobalamin). They are water-soluble vitamins that play many different roles. Vitamin B12 is essential for the formation and maintenance of red blood cells and DNA. It also plays an important role in brain health and heart health. A deficiency of in this vitamin can cause serious complications. There are a few different treatments for those who don’t get enough B12. But which one is the best?

What Causes a Vitamin B12 Deficiency?

Your body doesn’t actually need all that much Vitamin B12. However, it’s still crucial to ensure that you get enough. There are a few different issues that can cause a B12 deficiency. One of the main causes is malabsorption in the intestine. While most people can get the necessary B12 from foods, malabsorption can prevent your body from extracting or using the B12 it needs.

Certain diseases can contribute to a deficiency. Pernicious anemia is an autoimmune disease in which your own antibodies attack stomach cells. Atrophic gastritis occurs when your stomach doesn’t function well, leading to a buildup of bacteria in the small intestine. Other conditions that may cause a deficiency include celiac disease, Crohn’s disease, and alcoholism.

Individuals who follow a vegetarian or vegan diet are also at risk for a B12 deficiency. This is because, generally speaking, only animal-based foods naturally contain this necessary vitamin. While some vegetables contain B12, the amount they contain is typically not enough to provide you with what you need.

Symptoms of a Vitamin B12 Deficiency

If you don’t consume enough B12, or if your body can’t absorb it properly, you may begin to notice symptoms of a B12 deficiency. These symptoms include tiredness, weakness, shortness of breath, heart palpitations, pale skin, vision problems, mental health problems like depression and memory loss, and nerve problems. If not addressed, a B12 deficiency can lead to anemia, infertility, and a higher risk of neural tube defects during pregnancy.


Methylcobalamin is the active form of vitamin B12. It’s a natural form that’s considered to be one of the best for maximum bioavailability. This is because it doesn’t need to be converted. Instead, it’s ready for your body to use. It’s especially helpful in the methylation process, helping to reduce homocysteine levels in your body by converting homocysteine into methionine. This provides several significant benefits, including helping to prevent cognitive decline, reducing the risk of heart disease, and aiding in the treatment of children with autism. Because methylcobalamin aids in the methylation process, it’s also often thought to be beneficial for those with MTHFR mutations.

There are a few other benefits associated with methylcobalamin as well. Some studies have shown a significantly increased rate of survival in mice with cancer. It has also been shown to aid in the treatment of those with sleep disorders, as it helps with melatonin synthesis. Methylcobalamin can be taken as an oral supplement, sublingually, or through an injection.


Hydroxocobalamin is another natural form of Vitamin B12. It’s one of the most common forms of B12 found in food sources. Like methylcobalamin, it can be taken orally or as a hydroxocobalamin B12 injection. Unlike methylcobalamin, hydroxocobalamin needs to first be converted by the body. When it’s converted, it forms two bioactive coenzymes, methylcobalamin and adenosylcobalamin. Even though it first needs to be converted, it provides many of its own benefits.

One of the biggest benefits of hydroxocobalamin is that is used up much more slowly than other forms of B12. This is because it bonds to the transport molecules and travels in the body longer. As a result, you get a longer-lasting supply of the vitamin. For those who take hydroxocobalamin B12 injections, this means that you need fewer injections overall as compared to other forms of B12 injections.

Hydroxocobalamin can help to block nitric oxide radicals, thus helping to block nitrosative stress. Nitrosative stress is considered to cause a wide variety of different diseases, including atherosclerosis, high blood pressure, neurological diseases, and inflammatory diseases.  By blocking nitric oxide radicals, hydroxocobalamin can help to prevent the development of those complications.

Another major benefit of hydroxocobalamin is that it can help to reduce cyanide in the body. It can be used as a treatment to prevent against cyanide poisoning. It detoxifies the body by binding to cyanide molecules and transforming them into cyanocobalamin.

Which Vitamin B12 is Best?

There is actually no real answer to this question. This is because the best type of B12 depends upon you. It’s often thought that the best form of B12, including treatment for those with MTHFR, is methylcobalamin.  After all, it’s already in its usable form. It seems to make the most sense. While it may work for some, it may not be the best answer for everyone.

While some individuals with a B12 deficiency may benefit best from methylcobalamin, others may benefit from hydroxocobalamin. Methylcobalamin may be the first choice, but you may require hydroxocobalamin B12 injections or oral supplements if you don’t notice any differences after trying methylcobalamin, your bloodwork still shows that you’re deficient, or your homocysteine levels don’t decrease. Every person is unique, and the type of B12 to treat a deficiency is unique to you.

The best treatment for a Vitamin B12 deficiency will depend very much on you. Methyl-Life offers several different types of B12 supplements, including B12 Complete, B-Methylated II, and a methylated multivitamin. If you are interested in learning more about the supplements that we provide or want to make a purchase, contact us today!