Hydroxocobalamin vs Cyanocobalamin: What’s the Difference?

The name “vitamin B12” refers to a category of cobalt-containing compounds with a macrocyclic tetrapyrrole group connected to a dimethyl benzimidazole nucleotide. Vitamin B12 is converted to two active coenzyme forms in the body:

  • Deoxyadenosylcobalamin
  • Methylcobalamin

Types of Vitamin B12

Vitamin B12 exists in the following four forms:

  1. Hydroxycobalamin
  2. Cyanocobalamin
  3. Methylcobalamin
  4. Adenosylcobalamin

Cyanocobalamin vs Methylcobalamin vs Hydroxocobalamin

What is the difference between cyanocobalamin and hydroxocobalamin?

Vitamin B12 insufficiency is treated and prevented using cyanocobalamin and hydroxocobalamin. Because it binds more strongly to plasma proteins and is thus maintained in the body longer, hydroxocobalamin is the treatment of choice for vitamin B12 insufficiency in the United Kingdom. However, cyanocobalamin is recommended in the United States because hydroxocobalamin may trigger inappropriate immunological responses in some individuals.

Hydroxocobalamin is a type of Vitamin B12 that is extremely bio-available and used to treat patients who have a severe shortage. It can only be obtained with a prescription and is generally given as an intramuscular injection or as an IV drip.

When food sources are broken down, microorganisms in the digestive tract make hydroxocobalamin. It can also be extracted from microorganisms and developed in a lab.

Cyanocobalamin is a synthetic version of Vitamin B12 that the body processes to the active forms Methylcobalamin and Adenosylcobalamin. It has a cyanide molecule in it, which makes it stable in products and the body.

Is hydroxocobalamin supplement the same as methylcobalamin?

Vitamin B12 insufficiency is a frequent nutrient shortage that causes haematological and neurological symptoms. Traditional vitamin B12 formulations for insufficiency have been cyanocobalamin or hydroxocobalamin supplement. The active form of Vitamin B12 is methylcobalamin. Methylcobalamin is by far the most bio-available form of Vitamin B12, meaning it is more easily absorbed by the body. It is naturally occurring and may be found in animal-based foods such as meat, fish, milk, and eggs, making it a staple in many people’s diets. For smokers who are unable to convert cyanocobalamin to methylcobalamin, this is a preferable option.

Benefits of using Vitamin B12

The use of Vitamin B12 helps to prevent

  1. Cardioavascular diseases
  2. Cancer
  3. Dementia
  4. Alzheimer’s disease
hydroxocobalamin supplement

When to use hydroxocobalamin or cyanocobalamine?

Uses of hydroxocobalamin

  • Anemia
  • Cyanide poisoning

Uses of Cyanocobalamin

FDA approved uses of Vitamin B12 include

  1. Pernicious anemia
  2. Impaired absorption of Vitamin B12
  3. Atrophic gastritis
  4. Long-term use of metformin
  5. Helicobacter pylori infection
  6. Malignancy of pancreases
  7. Malignancy of bowel
  8. Helicobacter pylori
  9. Vitamin B12 dietary deficiency

Non-FDA approved uses

  1. Deficiency of folic acid
  2. Smoke inhalation
  3. Cyanide poisoning
  4. Vasoplegia linked to surgery
  5. Vasodilatory shock

Which type of vitamin b12 is best; cyanocobalamin, methylcobalamin, or hydroxocobalamin?

Cobalt is a constituent of vitamin B12, a nutrient required for the production of red blood cells, which helps avoid anemia. The presence of this mineral in meals aids hemoglobin production and iron assimilation from the diet. Vitamin B12 containing cobalt promotes a healthy neurological system, reduces blood pressure, and aids in the synthesis of DNA, choline, and red blood cells. reduces blood pressure and supports a healthy neurological system.

Vitamin B12 supplementation has become more than just a part of our daily routine. According to recent studies, the majority of the world is deficient in B12, making supplementation nearly mandatory. Hydroxocobalamin has a greater affinity for plasma protein and a longer half-life than cyanocobalamin. As a result, hydroxocobalamin lasts longer in the bloodstream, requiring fewer doses. Cyanocobalamin is found in most generic vitamins, however, it may not be as effective or helpful. According to the National Institute of Health, methylcobalamin is the best type of B12 to consume, but a combination of methylcobalamin and adenosylcobalamin is more beneficial.

In the study patients administered oral methylcobalamin at a dosage of 500 mg three times daily exhibited substantial improvements in autonomic and somatic symptoms compared to placebo in a small double-blind, placebo-controlled study of type 1 and 2 diabetes with neuropathy. In a review of many clinical trials including the use of methylcobalamin alone or combination with other B vitamins, cumulative symptomatic improvement of neuropathy was shown to be more substantial than electrophysiological results. Furthermore, individuals with diabetes who took 1500 mcg of methylcobalamin per day for two months had better vibratory sensory thresholds and heart rate variability (an indication of improved autonomic neuropathy).  As per researches, the suggested dose of methylcobalamin or 5-adenosylcobalamin is 500 mcg three times per day or 1500 mcg daily for the greatest bioavailability and absorption.


Comprehensive Medicinal Chemistry III by Samuel Chackalamannil, David Rotella, and Simon E. Ward



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