General Information

1. An Introduction to Cobalamin Metabolism, by John Coleman.
2. Enzymes and Vitamins: Understanding the active forms of vitamin B12, by Dr. Greg Kelly
3. The Coenzyme Forms of Vitamin B12: Toward an Understanding of their Therapeutic Potential, by Gregory Kelly, N.D. 57 references.
4. General B12 info from NIH

Four forms:

1. Biologically active, coenzyme forms:
   1. Methylcobalamin (liver, brain, nervous system)
   2. Adenosylcobalamin (liver, hemoglobin manufacture)
2. Chemically synthesized forms
   (must be converted to biologically active form)
   1. Hydroxycobalamin, hydroxocobalamin (also called cobamamide, cobinamide, or dibencozide)
   2. Cyanocobalamin - most common form in supplements

Functions

1. Methyl-B12 Can Improve Alertness and Concentration, by Michael T. Murray.
2. A Shot in Time Saves Mind; Vitamin B12 and Depression, by Syd Baumel.
3. Influences melatonin production [how?] In people with sleep-wake disorder (excessive daytime sleepiness, restless nights, and frequent nighttime awakenings; common in shift workers), taking methylcobalamin (1.5 to 3 mg daily) has often led to improved sleep quality, increased day time alertness and concentration, and improved mood. Much of the benefit appears to be a result of methylcobalamin influencing melatonin secretion.2,3 The low levels of melatonin in the elderly may be a result of low vitamin B12 status.
4. necessary for SAMe
5. [a lot more; I'm still studying this...]

Testing: serum levels do not adequately reflect tissue levels; other ways are...

1. CBC with differential.
2. Elevated blood or urinary methylmalonic acid is often used as an indicator of B12 deficiency.
   1. Normal function:
      1. Propionyl CoA (propionic acid) is mainly converted to succinyl CoA, which is a high-energy thioester(sulfur-containing) bond to Coenzyme A.
         1. Succinyl CoA is further metabolized to produce energy (in the Krebs/citric acid cycle) or is involved in porphyrin synthesis.
         2. A small amount of Propionyl CoA is converted to methylmalonyl CoA,
            • This process requires Biotin and Cobalamin (vitamin B12).
            • "When methylmalonyl CoA builds up to an abnormal level, an enzyme that converts it to methylmalonic acid becomes active." (from the Methylmalonic acid entry in The Medline-Plus Medical Ecylopedia.)
   2. However, there is some controversy over its use as an indicator of B12 deficiency
      1. Pro: see Norman Clinical Lab's presentation, especially the
         1. MMA test is the choice over other vitamin B12 tests
         2. References
      2. Con: see Methylmalonic Acid and Clinical Practice, by Ciriaco Aguirre and Guillermo Barreiro, on the AMA's Archives of Internal Medicine.
3. High plasma homocysteine indicates likely B12 deficiency

Supplementation:

1. Dosage
   1. James South recommends 0.1 mg -1 mg per day
   2. On the AMALGAM email list, Ray Saarela describes his concerns that too much may methylate the mercury in his system: "here is an abstract where it was found that B12 and C vitamin, and combination B12 and C vitamin all increase in-vivo methylation of mercury, and raised brain methyl-mercury levels. Folate was found to produce only increase in peripheral methyl-mercury levels." He has had some good experience with B12, however, and considering problems with deficiencies, has decided to supplement cautiously. (Date= Sat, 25 Jul 1998 01:29:21 -0700; Subject = Re: SAMe indications) (see directions for access to the AMALGAM list)
   3. On the AMALGAM list, Herman Rutner mentions that the Intrinsic Factor in the stomach at any one time in the stomach at any one time "has a binding capacity of only about 8 microgram. Any excess B12 passes through the intestines as free B12 and is available for enzymatic methylations and uptake by the intestinal flora." (Date = Tue, 10 Aug 1999 00:37:00 -0500; Subject = Re: To B12 or not to B12 plus neural therapy) (see directions for access). He refers the reader for more information to Coleman.
2. Oral is ineffective, instead use
   1. sublingual
   2. injection
3. Formulations
   1. Ray Saarela relates his experience with various kinds of B12 supplementation on the AMALGAM list : "cyanocobalamin shots which I do not prefer ( twitch twitch ... ), hydroxycobalamin shots ( European ), no effects, no negatives, Coabamet-10 shots ( meth-coba ) [ie methylcobalamin - chc] sometimes some twitches, but also, sometimes possible mild increase in energy...."(Subject= Re: College Pharmacy methyl-B12; Date= Sun, 5 Jul 1998 14:39:05 -0700) (see directions for access)
4. [fix this!]Oral supplementation only gets around 1% to the blood. Preferable is...
   Intramuscular injection (Hubbuch will teach me and supply me, the next time I get down to see her)
   sublingual supplements (except most have flavoring I’d better be cautious about)
   Ray Saarela on the AMALGAM email list* says he has problems if he takes high doses, and says "Abstracts exist on medline that state that B12 and C vitamin in combination can and does increase brain methyl-mercury content, so one wants to seek optimal levels, not too low or too high" — archived message is Item #17482 dated 31 Aug 1998 22:31; Subject "Re: Dentist looking for information on Vitamin B12 and mercury toxicity" [find medline abstracts]
   For a discussion of the reasons for a high dosage, and description of the ingredients of various brands of intramuscular preparations, see Vitamin B12 - metals disturb transport! by Monica Kauppi, Heavy Metals Bulletin 2(3):8-10 December 1995, available at <http://www.goodshape.net/MoreB-12.html> .
   Further problem: possibility of increasing methyl mercury by supplementing B12 [need further research]
   Only test is of cerebrospinal fluid, which can be painful, and the measurement is tricky. See Kauppi. However I’m interested in taking some and watching my reaction, think that will be definitive anyway
   

My experience

For more information