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Comment by notamy | Hacker News Reader

> The paradoxical B12 deficiency might have a relation with the inactive form being supplemented.

Yup, not everyone can convert cyanocobalamin or hydroxocobalamin to adenosyl-/methylcobalamin. Especially in severe cases, anecdotally I’ve seen people not make progress with the standard cyanocobalamin injections, but then make huge progress with methylcobalamin injections. Unfortunately, methylcobalamin is often not preferred in injectable form due to very quick degradation into hydroxocobalamin upon exposure to light.

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Taking methylcobalamin B12 supplements essentially fixed my memory problems. Early on I tried out the cyanocobalamin type and got absolutely nothing from it.

If I stop taking the supplements for a few weeks, the memory problems come back. If I start again, a week later my memory is excellent. It’s well worth the minor effort.

What kind of memory problems, could you expand? I wonder if I fall on this bucket. I had graying hairs as soon as I finished high school (~19). One of my major problems with studying was an inability to retain stuff in university, which is weird because through middle school a single read was sufficient for me to retain stuff.

Mostly noun recall. I can mentally picture and describe thing or person X, but when I'm having the problem it could possibly take me 30 minutes to figure out the name of X without looking it up.

When I don't sleep enough I definitely have that, but it's not a thing that occurrs otherwise. Thank you!

Subligual methylcobalamin works just as well as the shots and you can buy it anywhere.

Also, get a Methylmalonic Acid Test with you B12 levels. An MMA test is more useful because it is an enz=yme which uses B12, so when the active form of B12 is low, so will MMA in most cases.

> Subligual methylcobalamin works just as well as the shots

It does not. The cobalamin molecules are quite large and don’t penetrate the sublingual mucosa very well. On top of that, the proteins in saliva that bind to B12s will cause any bound B12 to not absorb sublingually, instead having to wait to make it through the digestive system for intestinal uptake.

Sublingual is still certainly a better option than oral pills, but the injections are preferable in severe cases for a reason.

> The cobalamin molecules are quite large and don’t penetrate the sublingual mucosa very well.

Absolute nonsense.

Did you even bother to look for one paper on the subject? Here are a few:

https://www.scielo.org.mx/scielo.php?pid=S0034-8376202000060...

https://pubmed.ncbi.nlm.nih.gov/34871525/

https://www.proquest.com/openview/e9a25963dbc92150e420a3a847...

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