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Vitamin B12 There is four types of parenteral Vitamin B12 available: Cyanocobalamin 100 mcg/ml and 1000 mcg/ml best used as IM to prevent rapid loss via kidneys Hydroxycobalamin IM (compounded 1000 mcg/ml or more) known as long acting B12 (binds better to plasma proteins than cyanocobalamin) Methylcobalamin IV (compounded 1000 mcg or more up to 5000 mcg/ml) Adenosylcobalamin IV Common dose is 1000 mcg IM or IV Vitamin B12 as hydroxycobalamin is synthesized exclusively by microorganisms and is found in the liver of animals bound to protein as methylcobalamin = metabolically active form of Vitamin B12 Hydroxycobalamin is a chelator of cyanide and is used in cyanide poisoning Hydroxocobalamin is most generally used for vitamin B12 replacement therapy and is considered the drug of choice for vitamin B12 deficiency by the Martindale Extra Pharmacopoeia (Sweetman, 2002) and the World Health Organization (WHO) Model List of Essential Drugs

Heres what to watch for: Fatigue & Low Energy Brain Fog & Poor Focus Mood Swings & Irritability Numbness or Tingling Slow Metabolism Shortness of Breath & Pale Skin If these symptoms sound familiar, it might be time to consider a vitamin injection Who Needs B12 Energy Shot

Larger doses, if required,could be given

Her comment was that a patient brought these vials in to her office visit and if you look at the vials, they look like they have inkjet-printed labels