Q. Dear Terry, “I take Metformin for my diabetes and I read it can decrease levels of certain B vitamins, like B12. What are the best forms of these B vitamins to supplement with?” — Loren B., Olathe, KS
A. Dear Loren, Numerous prescription medications can interfere with our body’s ability to use B vitamins. I highly encourage you to discuss any supplementation with your healthcare practitioner, as they may have additional insight.
Vitamin B12 has many roles and is necessary for many body processes: creating neurotransmitters (our brain’s chemical messengers), supporting mood, boosting our immune system, protecting our nervous system, increasing energy levels, and is important for the health of our hair, skin, and nails.
When it comes to B vitamins, especially vitamin B12, using the bioactive or human form is very important.
There are two main forms of vitamin B12 that you will find on the shelf: cyanocobalamin and methylcobalamin. Cyanocobalamin tends to be cheaper because it is synthetic. This form also needs to go through additional steps in the body to become the active form – methylcobalamin. Methylcobalamin is the form that we use in our bodies and is crucial for optimal health.
The conversion of cyanocobalamin to methylcobalamin is very ineffective and it is estimated that anywhere from 30-50% of the population struggles with the conversion of cyanocobalamin to methylcobalamin.
Therefore, I highly recommend supplementing with vitamin B12 in its bioactive human form of methylcobalamin. Vitamin B12 is often combined with B6 and folic acid – their human forms being pyridoxal-5-phosphate and L-methylfolate, respectively. These forms don’t require conversion by the liver, so they can go to work immediately to increase energy levels, boost mood and optimize metabolism. I would take these B vitamins once or twice per day.
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