Methylcobalamin is the active and highly bioavailable form of vitamin B12, supporting proper methylation and effectively replenishing B12 stores, especially in individuals with health conditions that typically impair absorption.

Those with the MTHFR genetic mutation, certain developmental delays in children, and other conditions linked to impaired methylation often find synthetic forms ineffective, making methylcobalamin injections vital.

Methylcobalamin has also been found to prevent age-related macular degeneration by supporting the regeneration of retinal cells and protecting against oxidative damage.

In contrast, cyanocobalamin is the synthetic, least expensive form of vitamin B12 and the only FDA-approved form. It contains a cyanide molecule, which the FDA considers safe for healthy individuals. However, it is contraindicated for those with certain health conditions and is far less effective for individuals with methylation impairments. This is because it requires conversion to the active form of vitamin B12. Additionally, cyanocobalamin will deplete glutathione, which the body uses to detoxify cyanide.

If you have been getting sicker since beginning cyanocobalamin shots, the cyanide may be depleting glutathione.

What about oral supplements?

For many individuals, oral B12 supplements are ineffective due to such underlying conditions as:

Pernicious anemia: People with this condition lack intrinsic factor, a protein required for B12 absorption in the small intestine. Without it, oral B12 can’t be properly absorbed.

Medications and alcohol: Long-term use of certain medications like proton pump inhibitors (PPIs) or metformin, and chronic alcohol use, can interfere with B12 absorption.

Age: In the UK and US, nearly 20% of adults over 60 have B12 deficiency. Additionally, reduced stomach acid production in older adults limits B12 absorption from oral supplements.

Malabsorption disorders and IBD: Crohn’s, celiac, and other gastrointestinal disorders can cause damage to the intestinal lining, preventing the body from absorbing B12 and other nutrients effectively. This often makes oral supplements insufficient.Gastric bypass surgery: This surgery alters the digestive system, reducing the body’s ability to absorb B12 from food and supplements.For these individuals, methylcobalamin B12 injections provide a direct way to bypass the digestive system and restore essential B12 levels.

Why is B12 so important? Is deficiency really dangerous?

Vitamin B12 is crucial for healthy nerve function and red blood cell production. Prolonged B12 deficiency can lead to severe neurological damage, including numbness, tingling, memory problems, and difficulty walking.

Over time, it can cause irreversible nerve damage, cognitive decline, and mental health disorders such as depression.

It can also result in anemia, which leads to fatigue, weakness, and shortness of breath. In extreme cases, untreated deficiency may lead to heart problems and permanent disability. This is why maintaining adequate B12 levels is critical for overall health.

So why on earth is the BOP trying to restrict B12 as methylcobalamin?

The California BOP has not offered any scientific or safety-based explanation for why this widely used and celebrated treatment should be restricted. Their only real argument has been “It does not have a USP monograph,” which is similar to saying it’s not FDA approved. No law requires FDA approval or USP monographs. Most natural medicines aren’t FDA approved.

Countless patients worldwide depend on this treatment, and even the FDA has deemed it safe by adding it to the Category 1 bulks list. The board’s unjustified regulations seem designed to limit patient access to a life-saving treatment. This is blatant overreach. 

We call on the BOP to align with, and not to exceed, scientifically-backed Pharmacopoeia standards like the rest of the United States!

What can you do?

1. Sign and share the petition! change.org/stopthebop
2. Post using #StopTheBOP and share how alternative or compounded meds have contributed to your well-being.
3. Inform your representatives! Templates available at stopthebop.com. Or call Gov. Newsom: 916-445-2851 Can’t find your reps? findyourrep.legislature.ca.gov
4. Attend the board meeting to voice your opposition. The meeting is Nov 6-7 in San Diego. Anyone can join in person or via Webex.  Exercise your 1st amendment right by giving a statement! Plan ahead: stopthebop.com/actnow
5. Donate to the cause:  stopthebop.com/donate

See also:

Fighting to save our lifeline of glutathione, B12, and more.

Crystal A. Frost, PhD, is Southern California leader of Stop The BOP.

Sources

“The Effectiveness of Cobalamin (B12) Treatment for Autism Spectrum Disorder: A Systematic Review and Meta-Analysis” Journal of Personalized Medicine (2021)

“Vit B12 supplement of 500 μg/d for eight weeks does not normalize urinary methyl-malonic acid or other biomarkers of vitamin B12 status in elderly people” J Nutr. (2013)

”Pernicious Anemia: For Patients and Visitors” Penn Medicine (2022)

”How to choose the right B12 for you.” MTHFR Support Australia  (2010-)

“Randomized, Placebo-Controlled Trial of Methyl B12 for Children with Autism.” Journal of Child and Adolescent Psychopharmacology. (2016)

“Association between metformin dose and vitamin B12 deficiency in patients with type 2 diabetes.” Medicine (Baltimore). (2019)

“What is the link between B12 deficiency and Crohn’s disease?” Medical News Today. (2024)

“The Effects of Bariatric Surgery on Vitamin B Status and Mental Health.” Nutrients. (2021)

“Guidelines for the diagnosis and treatment of cobalamin and folate disorders.” British Journal of Haematology. (2014)

“Methylcobalamin vs. Cyanocobalamin: A Dietitian Explains.” Very Well Health. (2024)

“This vitamin deficiency can cause forgetfulness and mimic symptoms of dementia—but it’s reversible.” Fortune Well. (2024)

“The Essential Role of methylcobalamin in eye health..” Vision and Eye Health. (2024)