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What to know about cyanocobalamin?

Cyanocobalamin is the synthetic form of vitamin B12. Our bodies need vitamin B12 to produce red blood cells and keep our nervous system healthy.

Enough vitamin B12 levels allows our body to produce healthy red blood cells that work properly to carry oxygen around our bodies.

We can get vitamin B12 from food or supplements (natural forms or synthetic forms like cyanocobalamin).

A deficiency in vitamin B12 can cause serious symptoms, including nerve damage, neurological problems like depression and memory loss, fatigue, and digestive issues.

Here is the role of Cyanocobalamin which can increase vitamin B12 levels like natural forms to prevent or treat theses serious symptoms.

Cyanocobalamin B12 supplements are available in pharmacies, supermarkets and health food shops. These come as tablets, capsules, mouth sprays and drops. They come in different strengths from 10 to 1,000 micrograms (μg).

Causes of vitamin B12 low levels 

Even though Vitamin B12 is found in many foods, but insufficiency and deficiency are common due to low dietary intake, malabsorption, specific medical conditions, or the use of B12-depleting medications.

These include:

  • pernicious anemia, which makes it hard for your body to absorb vitamin B12
  • low stomach acid due to inflammation of stomach lining (atrophic gastritis) or certain medicines
  • stomach (gastric) surgery
  • inflammation of the intestines because of conditions like Crohn’s disease and coeliac disease
  • an infection in the stomach or intestine.
  • Alcohol misuse or heavy drinking can make it harder for your body to absorb some nutrients or prevent you from eating enough and healthy calories. One sign that you don't have enough B12 may be glossitis, or a swollen, inflamed tongue.
  • taking certain medications that interfere with the absorption of vitamin B12. This includes some heartburn medicines including proton pump inhibitors (PPIs) such as esomeprazole (Nexium), lansoprazole, omeprazole, pantoprazole, and rabeprazole, H2 Blockers such as cimetidine and famotidine; and certain diabetes medicines such as metformin (Glucophage).
  • You can also get vitamin B12 deficiency if you are on a vegan diet (meaning you don't eat any animal products, including meat, milk, eggs, and cheese) or you are a vegetarian who doesn't eat enough eggs or dairy products to meet your vitamin B12 needs.

Cyanocobalamin dosage 

You’ll usually take cyanocobalamin tablets every day to prevent or treat vitamin B12 deficiency. However, you may also need vitamin B12 injections at first to boost your levels.

This may take a few weeks before your vitamin B12 levels and symptoms (such as extreme tiredness or lack of energy) start to improve.

Some people can stop taking cyanocobalamin when their vitamin B12 blood levels are improved according to blood test.

Who can and can't take cyanocobalamin?

Most adults and children aged 2 years and over can take cyanocobalamin.

Tell your doctor before taking cyanocobalamin if you:

  • have ever had an allergic reaction to cyanocobalamin or any other medicines
  • have an allergy to cobalt as cyanocobalamin contains cobalt
  • Some cyanocobalamin tablets may not be suitable for people on a vegan diet.

How and when to take cyanocobalamin?

The amount of cyanocobalamin you need to take depends on vitamin B12 levels in your blood and the causes of low levels. Your doctor or pharmacist will advise you on what dose to take.

The usual doses of cyanocobalamin for:

  • diet-related deficiency: 50 micrograms to 150 micrograms, once daily
  • vitamin B12 deficiency not caused by your diet: one to two 1,000 microgram tablets, once or twice daily – this is usually if you can't take vitamin B12 injections.
  • In children the doses may be lower.
  • Follow the dosage instructions that come with supplements.

How to take cyanocobalamin?

Swallow cyanocobalamin tablets whole with a glass of water and don't chew or crush them on an empty stomach (at least 2 hours after a meal or snack or at least 30 minutes before you eat again).

Follow the instructions that come in the packet.

To see how your cyanocobalamin tablets are working, your doctor will ask you about symptoms such as tiredness and lack of energy. You may also do regular blood tests to check vitamin B12 levels in your blood.

According to vitamin B12 level, your doctor may want to increase or decrease your dose of cyanocobalamin tablets.

How long does cyanocobalamin take to work?

It may take a few weeks before your vitamin B12 levels and symptoms start to improve.

If you have hydroxocobalamin (another form of vitamin B12) injections to boost your vitamin B12 levels at the start of treatment, the cyanocobalamin tablets may start to work within a few days.

If you have stomach or bowel problems or surgery you will not absorb vitamin B12 efficiently from food or low-dose supplements (10 to 100 micrograms), So you will need hydroxocobalamin injections – or high-dose cyanocobalamin tablets (1,000 micrograms) if you can't take injections.

Can you drink alcohol with cyanocobalamin?

Yes, you can drink alcohol with cyanocobalamin as alcohol doesn't affect cyanocobalamin.

However, drinking too much alcohol on a regular basis can cause folate deficiency anemia. This is vitamin B9 deficiency (folic acid) and will lead to symptoms such as tiredness coming back.

What if I take too much cyanocobalamin?

Taking an extra dose of cyanocobalamin tablets is unlikely to harm you.

Pregnancy and breastfeeding and cyanocobalamin

Cyanocobalamin is generally safe to take during pregnancy and breastfeeding.

Cyanocobalamin passes into breast milk, but it’s not harmful to your baby.

If you observe that your baby is not feeding as well as usual, or if you have any other concerns about your baby, talk to your doctor as soon as possible.

Also, cyanocobalamin will not stop any contraception working, including the combined pill and emergency contraception.

However, oral contraceptives can lower vitamin B12 absorption from your cyanocobalamin tablets.

Cyanocobalamin cautions with other medicines

Cyanocobalamin is generally safe to take with other medicines.

Some medicines may lower cyanocobalamin absorption from the tablets or from the food you eat. This will not usually big effect. However, tell your doctor or pharmacist if you are taking any of these medicines:

  • metformin for diabetes
  • antacids like Gaviscon for heartburn
  • H2 blockers like ranitidine , cimetidine, famotidine, nizatidine for heartburn
  • proton pump inhibitors (PPIs) like lansoprazole, omeprazole, pantoprazole or rabeprazole for GERD or heartburn
  • antibiotics such as chloramphenicol and neomycin
  • oral contraceptives such as the combined pill

What foods can you eat to increase the amount of vitamin B12 ?

You can usually help your vitamin B12 levels by increasing the amount of vitamin B12 rich foods. However, this will not help if you have a stomach (gastro-intestinal) problem that means you can't absorb vitamin B12 from your gut.

Foods that are good sources of vitamin B12 include:

  • meat (liver, beef)
  • fish (salmon, tuna, haddock)
  • shellfish (muscles, scallops)
  • dairy foods (milk, yoghurt, cheese)
  • eggs

Some foods have vitamin B12 added (look for "fortified" on the label). These include:

  • breakfast cereals and bread
  • soya foods, non-dairy milks and spreads
  • yeast extract or nutritional yeast flakes

If you have a condition that means you can't absorb enough vitamin B12 from the food you eat, it’s still a good idea to try to eat a healthy, balanced diet with enough vitamins and minerals, including B12.

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