The more we learn about methylation and MTHFR we realize how important B12 is. I am going to discuss the different types of B12 as it relates to methylation, absorption and genetics and which type might benefit you.
There are four types of Vitamin B12, Cyanocobalamin, Methylcobalamin, Adenosylcobalamin and Hydroxocobalamin
The first, Cyanocobalamin is not very good and we recommend never using it. It is synthetic or a man made form of B12. It takes the body more steps to convert it to a useable form of Hydroxyl B12. Cyanocobalamin is commonly found in energy drinks.
Methylcobalamin is an active form of B12, which helps with the metabolism. It is basically cobalt attached to a methyl group. It is beneficial in methylation because it activates an enzyme called methionine synthase. This helps the myelin sheath of nerves as well as it helps to make red blood cells. Methionine synthase also plays a very important role in converting Homocysteine into methionine. This helps reduce the amount of Homocysteine in the body, which can at high levels cause cardiovascular as well and neurological damage.
Methionine is also utilized through the MAT enzyme to convert it to SAMe. It is the body’s major methyl donor, which is very significant for the breakdown of neurotransmitters (COMT) and breaking down histamines (HNMT).
The best dietary sources of B12 are animal products such as Meat, Poultry, Fish and Eggs. It is very common for people to be deficient in B12. Primarily because of the complex process that is required to absorb it, methylate it and assimilate it. For B12 to work properly it much combine with methylfolate as part of the methylation process to make methionine synthase.  Individuals with the MTHFR gene are already functioning at a 20-50% reduction in converting folate to methyl folate.
Some other causes of B12 deficiency are: Vegan Diets, Antacids, Bariatric surgeries, Alcohol and Pernicious Anemia.
The lab tests MCV and MCH if elevated suggest a B12 or Folate deficiency.
Too much of methyl B12 can cause megaloblastic anemia. A condition where you have high amount of red blood cells, hemoglobin and hematocrit in your CBC blood lab tests.
Adensosylcobalamin is the mitochondrial form of B12. It is great for energy and can be utilized for a person that is experiencing fatigue throughout the day. It can also be successful for the individual that exercises and experiences more muscle aches and fatigue following exercise.
Methylmalonic Acid is the gold standard test, to see if the patient is deficient in Adensosylcobalamin. A high methylmalonic acid suggests B12 adenosyl deficiency.
Hydroxocobalamin is most beneficial to lower Nitric Oxide levels. If there is an abundant amount of nitric oxide in the body this creates too much ROS, reactive oxygen species. It is not uncommon to see elevated nitric oxide levels with chronic fatigue and autoimmune issues. To complicate matters are the eNOS and SOD snps. Generally, supplementing with SOD and Hydroxycobalamin are beneficial to lower the ROS and the nitric oxide levels.
Dependent on various SNP (single nuclear polymorphisms) at the COMT and VDR certain combinations can prove effective as outlined by Dr. Amy Yasko. I have followed her formula with success in my Functional Medicine/Genetic Coaching.
COMT & VDR B12 Types well tolerated
All three types of B12
All 3 types with less methyl B12
Hydroxy and Adenosyl B12
Hydroxy B12
I recommend Pure Encapsulations Adenosyl/Hydroxy B12 liquid.
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