Methylcobalamin is an active form of vitamin B12 and has been used as a therapeutic adjuvant to treat multiple chronic conditions. In fact, methylcobalamin modulates the synthesis of methionine and S-adenosylmethionine. It has been a part of diabetic neuropathy treatment with positive results and can alleviate the pain sensation.
Daily intake of methylcobalamin is necessary because the human body is not able to synthesize it. Therefore methylcobalamin is considered essential. Besides, it is the only form of vitamin B12 that can cross the blood-brain barrier without transformation.
Neurological benefits of methylcobalamin
The methyl groups donated by methylcobalamin stimulated serotonin production, which in turn enhances mood and exerts protection against excitotoxins.
Converts homocysteine to methionine and reduces the risk of vascular diseases, arterial sclerosis, and strokes. Also, 5-methyltetrahydrofolate is an important element to eliminate homocysteine. Vitamin supplements reduce the chances of building homocysteine associated with stress.
Without methylcobalamin, myelin could not be formed.
Methylcobalamin produces S-adenosylmethionine. This compound promotes mitochondrial energy. This promotes better use of fats and carbohydrates in the metabolic process and makes them available for energy production.
Therapeutic applications of methylcobalamin:
The supplementation of methylcobalamin to treat a multitude of clinical conditions has been extensively reported. Indeed, its use to ameliorate diabetic neuropathy has been recognized, as well as its beneficial effects on rheumatoid arthritis and dementia. The exertion of these benefits relies on methylcobalamin’s capacity to regenerate the injured nerves, as it promotes cell growth and replication linked to proper neuronal functioning.
Nevertheless, methylcobalamin supplementation has been linked to reduced pain sensation caused by diabetic neuropathy, lower back pain, and neuralgia.
Diabetic peripheral neuropathy
The prevalence of diabetic peripheral neuropathy (DPN) is around 30-50%, and it is considered the most common chronic complication of diabetes. DPN commonly presents with pain and symmetrical polyneuropathy. It can easily develop with pain, sensory or motor disorders, and numbness.
DPN’s diagnosis is commonly made by reviewing clinical symptoms, a physical test, and the patient’s medical history. Nonetheless, the medical test may include an examination of:
- Overall muscle strength and tone
- Tendon reflexes
- Sensitivity to touch and vibration
Specific tests to help diagnose diabetic neuropathy:
- Filament test. Your doctor will brush a soft nylon fiber (monofilament) over areas of your skin to test your sensitivity to touch.
- Sensory testing. This non-invasive test is used to tell how your nerves respond to vibration and changes in temperature.
- Nerve conduction testing. This test measures how quickly the nerves in your arms and legs conduct electrical signals. It’s often used to diagnose carpal tunnel syndrome.
- Muscle response testing. Called electromyography, this test is often done with nerve conduction studies. It measures electrical discharges produced in your muscles.
- Autonomic testing. Special tests may determine how your blood pressure changes while you are in different positions and whether you sweat normally.
An association between the prolonged treatment with metformin and a deficiency of vitamin B12 in diabetic patients has been reported, leading to a higher prevalence of methylcobalamin deficiency.
Vitamin B12, methylcobalamin with and without other vitamins and microelements have been supplemented to measure pain sensation and regenerate nerve function improvements. Nevertheless, the underlying reason to perform these large cohort studies is to reduce the secondary effects of tricyclic antidepressants and opioid or opioid-like analgesics. It is also fair to mention that while these medications may aid the pain sensation, there is no myelin production or motor nerve fiber regeneration linked to these drugs. Therefore, the treatment or supplementation of methylcobalamin can treat the condition’s root cause and decrease pain sensation.
A study aimed to review the effectiveness of vit B12 on DPN, that included 4 relevant qualified articles showed interesting results. In one of the studies, nerve conduction velocity improved significantly after the intervention. All of the studies reported a decrease in pain symptomatology and better scores in the testing assessments compared to the control groups.
To conclude on a high note, several supplements are being tested and studied to be part of the medical treatment of DPN. They are all being compared to the beneficial effects conferred by methylcobalamin. In fact, methylcobalamin has been approved by the China Food and Drug Administration for treating peripheral neuropathy and is recommended in the Chinese guideline for type 2 diabetes.
Pharmacokinetics and Dosage
Methylcobalamin’s intake can be administered orally, in the form of a nasal spray (9% bioavailability), muscular injection, or parenterally. This compound needs to be bind to an intrinsic factor, which is made in the stomach, and later it is absorbed by the distal ileum. Furthermore, methylcobalamin gets bound and distributed to every cell by Transcobalamine II. It could be stored in the liver in an amount of 300-500 micrograms, and then it is eliminated via bile.
|Stress relief||500 mcg/day|
|Acute cases of neuropathy||1500mcg/day|
|Age-related brain decay||1mg/day|
|Vegetarian diet-related vit B12 deficiency||100mg/day|
|Basic nerve support||3mg/day|
Cauliflower is all the rage right now, and it is clear to see. Nutritionally speaking is a great source of glucosinolates- linked to preventing cancer, vitamin K, and vitamin C. If you are trying to cut some carbs and keep your glucose in check, try this cauliflower rice!
Cook time: 15-20 minutes
- 1 head of cauliflower, roughly chopped into medium-sized pieces
- 4 tablespoon extra virgin olive oil
- 1 teaspoon salt
Place the cauliflower into a food processor and pulse until the texture resembles rice.
Heat the oil in a large skillet.
Add the cauliflower and salt, or use garlic to bring up the flavor.
Stir and cook evenly in the pan (about 8-12 minutes). Serve hot and with your favorite meal. -Ana Paola Rodríguez Arciniega
Gupta, J. K., and Qureshi Shaiba Sana. “Potential benefits of methylcobalamin: A review.” Austin J Pharmacol Ther 3.3 (2015): 1076.
Jayabalan, Bhavani, and Lian Leng Low. “Vitamin B supplementation for diabetic peripheral neuropathy.” Singapore medical journal 57.2 (2016): 55.
Jia, Hai-yan, Hao-ming Tian, and Dong Wei. “Effects of Methylcobalamin on diabetic peripheral neuropathy: a systematic review.” Chinese J Evid Based Med 5 (2005): 609-618.
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Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, CTG*
Licensed in Texas & New Mexico