Homocysteine
Homocysteine is a small molecule that is fermented into methionine by a B12-dependent enzyme, and when the B12 concentration drops below the optimum (hence the enzyme is not activated), the homocysteine concentration increases. Supplementation of B12 at 100-500mcg correlates with a decrease in homocysteine concentrations, while 10mcg has no effect, despite the fact that many studies that have used B-complex with B12 have used dosages of less than 10mcg.
Inflammation and Immunology
Virology
It was found that the liver is a reservoir of B12 and many liver diseases are accompanied by a decrease in the concentration of B12, which may elude diagnostic control, because. B12 concentration in the liver is not related to plasma concentration. Vitamin B12 also plays a role in hepatitis C virus replication (inhibits translation on the inner surface of the ribosome without a concentration-dependent effect on the cap-dependent mechanism) and is thought to have protective properties. In patients with hepatitis C who received standard therapy (pegylated interferon a, with ribaverin) or the same therapy but supplemented with B12 (5000mcg IM every four weeks) for 48 weeks, the following effect was observed: the group that received B12, showed higher results of early (21%) and sustained (34%) viral response. High doses of B12 may somehow have a protective effect against hepatitis C in people who are already infected, and B12 is able to reduce viral replication in a dose-dependent manner (only hepatitis C virus was considered). In the same study, when considering the hepatitis C virus and the effect of inhibiting its replication, swine flu and encephalomyelitis viruses were also considered, which were not affected by B12. It is likely that B12 is effective against the hepatitis C virus, but not other viruses.
Vitamin B12 and pregnancy
Offspring
Interactions with nutrients
folate
Folic acid is most often used together with B12, because. High doses of folate may mask the symptoms of anemia due to B12 deficiency, which may only exacerbate the manifestations of macrocytic anemia, and not increase the risk of developing cognitive impairment associated with B12 deficiency. Based on the foregoing, B12 supplementation is used to reduce the risk of undiagnosed anemia in B12 deficiency. Folic acid supplementation can mask the manifestations of B12 deficiency anemia, so they are most often taken together, not because they work together, but simply to reduce the risk of undiagnosed macrocytic anemias associated with B12 deficiency. B12 supplementation at doses up to 500mcg has no effect on plasma folate concentrations.
Safety and toxicology
General
High serum concentrations of B12 (hypercobalaminemia, thought to be 950 to 709 pmol/L) cause conditions such as chronic myelogenous leukemia, protomyelocytic leukemia, polycythemia, and also hypereosinophilic syndrome, which is associated with increased production of haptocorrin (an inactive transporter). These diseases are very dangerous and require immediate diagnosis. Exist side effects some serious conditions that increase plasma B12 concentrations, but B12 by itself is not thought to have anything to do with it.
Foods containing vitamin B12
Ultimately, animals must get their vitamin B12, either directly or indirectly, from bacteria, and these bacteria can live in the section of the intestine furthest from where B12 is absorbed. Thus, in the rumen of herbivores, B12 must either come from bacteria or (in the presence of plant fermentation material in the gut) as a result of fecal recirculation.
Vitamin B12 is found in most food products of animal origin, including fish and shellfish, meat (especially liver), poultry, eggs, milk and dairy products. However, the binding capacity of egg yolk and white is noticeably reduced after heat treatment. The NIH (National Institutes of Health) lists a number of animal food sources of vitamin B12.
Animal sources of vitamin B12:
Beef, organ meats and by-products, liver, boiled, fried: 83.1 mcg vitamin B12/100 g
Turkey, all classes, offal, cooked, simmered, offal fat: 33.2
Brunswick pork liver sausage: 20.1
Raw Pacific Oysters: 16.0
Cooked king crab: 11.5
Raw shellfish: 11.3
Slow-cooked chicken offal: 9.4
Cheese: 3.3
Beef (raw fillet): 1.15
Egg (raw, whole chicken eggs): 0.89
Whole cow's milk: 0,45
Raw chicken breasts: 0,20
Other than certain fermented foods, only a few non-animal food sources of biologically active B12 have been identified so far, and none of these have been tested in humans.
Some manufacturers kombucha, such as GT Kombucha, list vitamin B12 as one of the ingredients in their product. One such manufacturer even claims that one package of their product contains 20% of the daily value of vitamin B12, making kombucha a potentially “high” food source of B12. Since kombucha is produced by a symbiosis of yeast and bacteria, the possibility that it contains B12 does not contradict the available data. However, no scientific research confirming this fact, as well as the fact that B12 in kombucha is biologically active B12.
Japanese fermented black tea, known as "batabata cha", has been found to contain biologically active B12. Unlike kombucha, which is made by fermenting already brewed tea, batabata cha is fermented while still in leaf tea.
Chlorella, a freshwater single-celled algae, has been proposed as a source of vitamin B12, but this has not been proven in animal studies. Algae are believed to acquire B12 through symbiosis with heterotrophic bacteria, in which the bacteria supply B12 in exchange for fixed carbon. Spirulina and dried Asakusa nori (Porphyra Tenera) mainly contain pseudo-vitamin B12 instead of biologically active forms of B12. While dry Asakusa nori (Porphyra tenera) contains mostly pseudo-vitamin B12, fresh seaweed has been reported to contain mostly biologically active forms of B12, but even when fresh the vitamin activity has not been tested in animal enzyme assays.
One group of researchers reported that a fresh red algae known as Susabi-nori (Porphyra yezoensis) has B12 activity in a rat model, implying that the source would also be active in humans. These results have not been confirmed.
B12-fortified foods are also sources of vitamins, although they cannot be considered true food sources of vitamin B12, as this vitamin is added in supplement form from commercial bacterial sources such as cyanocobalamin. Examples of foods fortified with B12 include breakfast cereals, fortified soy foods, fortified energy bars, and fortified nutritional yeast. The Vegan Society of Great Britain, the Vegetarian Resources Committee, and the Physicians' Committee for Responsible Medicine, among others, deny that non-animal food sources of vitamin B12 are reliable and recommend that all vegans not taking dietary supplements eat foods fortified with vitamin B12. Not all of them may have the indicated vitamin activity. B12 supplements added to beverages have been reported in one study to contain varying levels of pseudo-vitamin B12. One report reported that B12 analogs are present in varying amounts in some multivitamins.
There are also non-traditional natural springs vitamin B12, but their use as food sources of vitamin B12 is highly questionable. For example, B12 residues from bacteria present in soil can be found on plants grown in the ground that have not undergone rigorous cleaning procedures. B12 can also be found in lakes if the water is not properly sanitized. Some insects, such as termites, contain B12, which is produced by bacteria in their gut, in a way similar to ruminants. The human gut itself can contain bacteria that produce B12 in small intestine, however, it is not clear whether enough of this vitamin will be produced in this way to meet nutritional requirements.
Vitamin B12 Supplements
Hydroxycobalamin injectable (1000 µg/ml) is a bright red liquid solution that comes in 30 ml brown glass multi-dose vials packaged in paper boxes.
Vitamin B12 is supplied as a supplement to many foods and is also available as vitamin tablets, including multivitamins. Healthy people may take vitamin B12 as a liquid, transdermal patch, nasal spray, or injection, and is available alone or in combination with other supplements. B12 is often found as an ingredient energy drinks and energy drinks, which usually contain several minimum recommended daily allowances of vitamin B12. Vitamin B12 supplements are effective in preventing deficiency, especially in vegetarians, and are often sold as a weight loss supplement. However, there are no scientific studies demonstrating the effectiveness of B12 in weight loss.
Cyanocobalamin is converted to its active form, first hydroxocobalamin, and then to methylcobalamin and adenosylcobalamin in the liver.
The sublingual method, in which B12 is absorbed directly under the tongue, has not been proven necessary or useful, although a number of tablets, pills and even lozenges on the market are designed specifically for sublingual use. A 2003 study found no significant differences in serum levels with oral or sublingual administration of 0.5 mg cobalamin. Sublingual methods are only effective at high doses (0.5 mg). As noted below, such very high oral doses of B12 may be effective as a treatment, even if absorption is gastrointestinal tract gastric atrophy (pernicious anemia) intervenes.
Sometimes injections and patches are used if digestive absorption is impaired, but there is evidence that this mode of administration is not necessary with the availability of current high performance oral supplements (eg, 0.5 to 1 mg or more). Even pernicious anemia can be treated exclusively by the oral route. These supplements contain such large doses of the vitamin that 1 to 5% of high oral doses of free crystalline B12 is absorbed along the entire intestine by passive diffusion.
However, if the patient has congenital disorders in the methyltransfer pathway (cobalamin C disease, combined with methylmalonic aciduria and homocystinuria), treatment with intravenous, intramuscular, or transdermal hydroxocobalamin B12 is necessary.
Morris MS, et al. Folate and vitamin B-12 status in relation to anemia, macrocytosis, and cognitive impairment in older Americans in the age of folic acid fortification. Am J Clinic Nutr. (2007)
Composition and form of release
1 ml solution for injection contains cyanocobalamin (vitamin B 12) 200 or 500 mcg; in ampoules of 1 ml, in a cardboard box 10 pcs.
pharmachologic effect
pharmachologic effect- stimulating cellular metabolism, hematopoietic.Participates in the transfer of methyl fragments, the formation of choline, methionine, creatine, nucleic acids, maturation of erythrocytes, promotes the accumulation of compounds containing sulfhydryl groups in erythrocytes.
Indications for Cyanocobalamin (Vitamin B12)
Anemia (Addison-Birmer, alimentary macrocytic, iron deficiency, posthemorrhagic, aplastic, caused by toxic substances and drugs), cirrhosis of the liver, hepatitis, myelosis, polyneuritis, sciatica, trigeminal neuralgia, amyotrophic lateral sclerosis, cerebral palsy, multiple sclerosis, disease Down, skin diseases, injuries of peripheral nerves.
Contraindications
Thromboembolism, angina pectoris.
Side effects
Excitation, pain in the heart, tachycardia, allergic reactions.
Interaction
Incompatible (in one syringe) with thiamine bromide, riboflavin.
Dosage and administration
P / c, in / m, in / in and intralumbally.
With Addison-Birmer anemia - 100-200 mcg every other day; with Addison-Birmer anemia with symptoms of funicular myelosis and with macrocytic anemia with disorders nervous system- 500 mcg or more per injection (during the first week, daily, and then - at intervals between injections of up to 5-7 days). Simultaneously appoint folic acid. During remission, in the absence of funicular myelosis phenomena, 100 mcg is administered for maintenance therapy 2 times a month, and in the presence of neurological phenomena, 200-400 mcg 2-4 times a month.
With iron deficiency and posthemorrhagic anemia - 30-100 mcg 2-3 times a week; with aplastic anemia (especially in children) - 100 mcg until the onset of clinical and hematological improvement; with alimentary anemia in children at an early age and in premature babies - 30 mcg / day for 15 days.
In diseases of the central nervous system and neurological diseases with pain syndrome, they are administered in increasing doses from 200 to 500 mcg per injection, and when the condition improves, 100 mcg / day; course - up to 2 weeks.
With traumatic lesions of peripheral nerves - 200-400 mcg every other day for 40-45 days.
For hepatitis and cirrhosis of the liver - 30-60 mcg per day or 100 mcg every other day for 25-40 days.
With dystrophies in young children, Down's disease and cerebral palsy - 15-30 mcg every other day.
With funicular myelosis, amyotrophic lateral sclerosis, multiple sclerosis, sometimes 15-30 mcg is injected into the spinal canal (gradually increasing the dose to 200-250 mcg).
Precautionary measures
With angina pectoris, it should be used with caution and in smaller doses.
Storage conditions of the drug Cyanocobalamin (Vitamin B12)
In a place protected from light.Keep out of the reach of children.
Shelf life of the drug Cyanocobalamin (Vitamin B12)
2 years.Do not use after the expiry date stated on the packaging.
Synonyms of nosological groups
| Category ICD-10 | Synonyms of diseases according to ICD-10 |
|---|---|
| D50 Iron-deficiency anemia | Anemia due to impaired hemoglobin synthesis and iron metabolism |
| Iron deficiency anemia | |
| iron deficiency anemia | |
| Lack of iron in food | |
| D50.0 Iron deficiency anemia secondary to blood loss (chronic) | Anemia posthemorrhagic |
| Anemia in chronic blood loss | |
| Posthemorrhagic anemia | |
| Chronic blood loss in the gastrointestinal tract | |
| D51 Vitamin B 12 - deficiency anemia | Vitamin B 12 deficiency anemia |
| Anemia pernicious | |
| Macrocytic vitamin B12 deficiency anemia | |
| D52 Folate deficiency anemia | Anemia folate deficiency |
| Iron/folate deficiency anemia | |
| macrocytic anemia | |
| D64 Other anemias | anemia |
| Anemia | |
| Anemia due to erythropoietin deficiency | |
| Anemia in disorders of erythrocyte metabolism | |
| autoimmune anemia | |
| Idiopathic anemia | |
| Erythroid hypoplastic anemia | |
| Erythrocyte anemia | |
| E53 Deficiency of other B vitamins | |
| Hypovitaminosis B | |
| Additional source of B vitamins | |
| Source of B Vitamin | |
| Increased need for B vitamins | |
| E53.8.0* Vitamin B deficiency c | Hypovitaminosis B c |
| Iron and folic acid deficiency during pregnancy | |
| folic acid deficiency | |
| Additional source of folic acid during pregnancy | |
| folic acid deficiency | |
| Increased need for folic acid | |
| Folinium hypovitaminosis | |
| E53.8.1* Vitamin B12 deficiency | Secondary vitamin B-complex deficiency |
| Hypovitaminosis B 12 | |
| Cyanocobalamin deficiency | |
| Combined iron-folate-B12-deficiency anemia | |
| G12.2 Motor neuron disease | Amyotrophic lateral sclerosis |
| amyotrophic lateral sclerosis | |
| Motor neuron diseases | |
| Low Gehrig's disease | |
| Bulbar paralysis | |
| paralysis bulbar | |
| Primary lateral sclerosis | |
| Progressive bulbar palsy | |
| Progressive pseudobulbar palsy | |
| Amyotrophic lateral sclerosis | |
| Amyotrophic lateral sclerosis | |
| Primary lateral sclerosis | |
| Tropical spastic paraparesis | |
| charcot disease | |
| G35 Multiple sclerosis | Secondary progressive multiple sclerosis |
| Disseminated sclerosis | |
| multiple sclerosis | |
| Exacerbation of multiple sclerosis | |
| relapsing multiple sclerosis | |
| Mixed forms of multiple sclerosis | |
| G54.1 Disorders of the lumbosacral plexus | Neuralgia of radicular origin |
| Pathology of the spine | |
| sciatica | |
| Sciatica lumbosacral | |
| Radiculoneuritis | |
| G80 Infantile cerebral palsy | Infantile cerebral palsy |
| Cerebral paralysis | |
| G95.9 Disease of spinal cord, unspecified | Congenital diseases of the spinal cord |
| Degenerative disease of the spinal cord | |
| Myelopathy funicular | |
| Acquired disease of the spinal cord | |
| spinal spastic syndrome | |
| K73 Chronic hepatitis, not elsewhere classified | autoimmune hepatitis |
| Hepatitis autoimmune | |
| chronic hepatitis | |
| liver infection | |
| Chronic hepatitis with signs of cholestasis | |
| Chronic active hepatitis | |
| Chronic hepatitis aggressive | |
| chronic infectious hepatitis | |
| Chronic persistent hepatitis | |
| Chronic reactive hepatitis | |
| Chronic inflammatory liver disease | |
| K74 Fibrosis and cirrhosis of the liver | Inflammatory liver diseases |
| Cystic fibrosis of the liver | |
| Edema-ascitic syndrome in liver cirrhosis | |
| Precirrhotic state | |
| Cirrhosis of the liver with portal hypertension | |
| Cirrhosis of the liver with ascites | |
| Cirrhosis of the liver with ascites and edema | |
| Cirrhosis of the liver with portal hypertension | |
| Cirrhosis of the liver with portal hypertension and edematous-ascitic syndrome | |
| Cirrhosis of the liver with symptoms of portal hypertension | |
| Cirrhotic ascites | |
| Cirrhotic and precirrhotic state | |
| M79.2 Neuralgia and neuritis, unspecified | Pain syndrome in neuralgia |
| Brachialgia | |
| Occipital and intercostal neuralgia | |
| neuralgia | |
| Neuralgic pains | |
| Neuralgia | |
| Neuralgia of intercostal nerves | |
| Neuralgia of the posterior tibial nerve | |
| Neuritis | |
| Neuritis traumatic | |
| Neuritis | |
| Neurological pain syndromes | |
| Neurological contractures with spasms | |
| Acute neuritis | |
| Peripheral neuritis | |
| Post-traumatic neuralgia | |
| Severe neurological pain | |
| Chronic neuritis | |
| Essential neuralgia | |
| Q90 Down syndrome | Mosaicism in patients with Down syndrome |
| Mongolism | |
| Monkey hand fold | |
| Trisomy 21 | |
| Trisomy G | |
| R68.8 Other specified general symptoms and signs | Toxemia |
Vitamin B12 (cobalamin or cyanocobalamin) is a vitamin that contains cobalt and cyano groups necessary for the body. The main benefit of this vitamin is hematopoietic function - helping in the development of red blood cells. The beneficial properties of cobalamin in the formation of nerve fibers are also invaluable. Vitamin B12 also has a significant effect on metabolism, the movement of lipids and carbohydrates in the body.
Vitamin B12 is soluble in water, almost does not break down during prolonged heat treatment and in contact with alkalis and acids. Cyanocobalamin is able to accumulate in the liver for further use. Small amounts of vitamin B12 are synthesized by the intestinal microflora. The daily requirement for cobalamin for an adult is 3 mcg. During pregnancy, lactation, and during the period, the amount of vitamin taken can be increased up to 4 times.
What is the benefit of vitamin B12?
The main purpose of vitamin B12 is the normalization of hematopoiesis. In addition, cobalamin has a beneficial effect on fat metabolism in the liver tissues, optimizes the state of the nervous system, metabolic processes in the body, lowers cholesterol and stimulates growth. Cyanocobalamin is involved in the synthesis of DNA molecules, amino acids, affects the processing of fats and carbohydrates.
Cobalamin stimulates cell division, the well-being of those tissues that are most susceptible to intensive division depends on its presence in the body: immune cells, blood and skin cells, as well as cells that make up the upper intestine. Vitamin B12 affects the myelin sheath (covering of nerves), and a lack of the vitamin causes permanent nerve damage.
Cyanocobalamin deficiency:
Cobalamin deficiency is accompanied by the following symptoms:
Cobalamins, or vitamins of the B12 group, are substances indispensable for the human body. These are complex compounds of protein origin, responsible for many of the processes they carry out. Their deficiency leads to the development of serious pathologies, the treatment of which can be delayed for long time. Often, dietary correction is not enough to replenish the elements in the human body, then experts recommend using vitamin B12 tablets. Before using, it is important to get detailed advice from a specialist, study the instructions for use.
Cobalamin Deficiency Symptoms
It is not always easy to understand that the body lacks elements of a certain group of vitamins. It is important to first pay attention to the signals it sends. In the case of vitamin B12 deficiency, symptomatic manifestations such as:
- constant feeling of weakness, lethargy;
- fatigue accompanied by dizziness;
- pain in the area of the tongue;
- pallor of the skin;
- the occurrence of bleeding gums;
- the rapid appearance of bruises at the slightest compression of the skin;
- rapid weight loss;
- violations in the functioning of the digestive tract;
- constipation, diarrhea;
- the occurrence of convulsive conditions;
- irritability, nervousness;
- slowing down the growth of hair, nails, deterioration of their condition.
If you have several symptoms, you should consult a doctor. Only he, after studying the anamnesis, conducting additional studies, can prescribe vitamin B12 tablets.
Instructions for use
Currently, there are several pharmaceutical companies that produce cobalamins in tablet form. Pharmacists in pharmacies often offer complex preparations containing them. However, the main points in the guidelines indicating how to use them are the same.
Beneficial features
Given the fact that the main active ingredient in the tablets are the elements of cobalamins, that is, vitamin B12, their useful properties are:
- normalization of the process of assimilation, oxidation of lipid particles;
- production of essential amino acids;
- normalization of the hematopoietic system;
- participation in the process of creating such shells of nerve endings as myelin;
- reduction in the amount of cholesterol deposits;
- protection of the hepatic system from various harmful factors affecting it from the outside;
- normalization of blood pressure indicators;
- normalization of sleep, wakefulness;
- prevention of the development of depressive disorders;
- prevention of the development of senile dementia, confusion of thinking;
- strengthening the immune system;
- providing anabolic effects;
- normalization of work reproductive system in men and women.
It is important to human body received the required daily norm of cobalamins. So, for adults, it is 2.4 mcg, for newborns - from 0.4 to 0.5 mcg, children under three years old - 0.9 mcg, up to eight - 1.2 mcg, up to thirteen - 1.8 mcg, until reaching adulthood - 2.4 mcg. For pregnant and lactating women, the daily requirement increases to 2.6 and 2.8 mcg, respectively.
Indications for appointment
Most often, hypovitaminosis B12 occurs in people who want to correct the figure with constant diets, refusing food of animal origin. Indications for prescribing the tablet form of the drug are:
- anemia caused by a lack of vitamin B12;
- weakened immunity, expressed in frequent infectious, bacterial diseases;
- violation of the functioning of the hematopoietic system;
- hepatitis;
- cirrhosis of the hepatic system;
- alcohol poisoning;
- polyneuritis;
- radiculitis;
- neuralgia;
- the presence of phantom pain;
- cerebral palsy;
- Down syndrome;
- multiple sclerosis;
- dermatitis;
- neurodermatitis;
- psoriasis;
- pathology of the digestive tract;
- diseases of the renal system.
It is extremely important to use pills with constant physical, mental stress, at times when the body should be as resistant to stress as possible.
Contraindications
Contraindications to the use of this form of substances of group B12 are:
- their individual intolerance;
- blockage of blood vessels in the hematopoietic system, which is acute;
- blood cancer;
- the excess of glandular cells and cells of the erythroid series in the human genetic material.
You should not take drugs containing cobalamins on your own if you:
- insufficiency of the functioning of the cardiovascular system;
- pregnancy;
- breastfeeding;
- cancer;
- thrombophilia.
How to apply?
Most often, experts recommend using one chewable dragee per day. They are either absorbed by placing under the tongue, or taken with food, chewed. The dosage depends on the patient's condition, as well as on the recommendations of the manufacturing company that produces the prescribed drug. It is important to remember that there are substances and products with which B12 cannot be used. These include:
- vitamins B1, B2, B6, C;
- salt formations of heavy metals;
- antiepileptic drugs;
- coagulant agents.
If the specialist considers it necessary to use both those and those drugs at the same time, it is better to use them, alternating, but not using them within one day. In addition, there are complex preparations, where the dosage of "warring" substances is selected in such a way as not to harm the human body.
Side effects
Side effects when using drugs, where the main active ingredients are cobalamins, are rare. However, they include:
- increased excitability;
- palpitations, pain in the heart area;
- allergy, manifested in the form of urticaria;
- violation of the metabolism of purine substances;
- hypercoagulation.
If these conditions occur, you should immediately refuse to receive funds. It would be useful to visit a doctor, as a person's condition may require the appointment of symptomatic therapy.
Is it possible to have an overdose?
The state of hypervitaminosis B12 usually occurs when:
- constant, uncontrolled use of tablets;
- exceeding the dosage prescribed by the doctor.
Symptoms of an overdose may include:
- itching of the skin;
- pulmonary edema;
- thrombosis of peripheral vessels;
- congestive heart failure.
In extremely rare cases, anaphylactic shock develops. At the first symptoms of the onset of a state of hypervitaminosis, it is worth abandoning the cobalamin-containing agent. Next, you need to get a doctor's consultation, otherwise you can end up in a hospital bed.
Pharmacy preparations
Experts quite rarely prescribe domestic remedies, the intake of which allows you to make up for the lack of vitamin B12. Among foreign drugs, there are several names that differ in certain advantages.
Vitamin B12 from Solgar
American made product. Has a wide range of activities. The recommended dose daily is one tablet, absorbed until completely dissolved. A polymer can contained in a carton is enough for three courses, if one of them is designed for thirty to thirty-one days. It is known that there are no starch- and salt-containing components in the composition of the dragee. Often, the indicated agent is replaced with solutions for injection.
Vitamin B12 from Now Foods
This dietary supplement is made in the USA. It is known that it also contains folic acid, accelerating the absorption of cobalamins by the human body. Pastilles packed in a polymer jar are intended for resorption. Prophylactic dosage - one lollipop per day. The supplement is for adults only. Pregnant and lactating women should use it after a doctor's prescription.
Neurobion
This drug is produced in Germany. It is offered in two forms - injectable and tablet. The tablets contain lactose monohydrate, and therefore people suffering from lactase deficiency should not use them. The main rule of their reception is to use during meals or after it, swallowing whole, without chewing, drinking plenty of water. The tool can be used by children who have reached the age of fifteen years. The prophylactic dose is three tablets per day.
Neurovitan
Contains substances belonging not only to the B12 group. Tablets are produced in Jordan, most often prescribed for various neuralgic pathologies. Can be used in childhood. The dosage for babies from one to three years is from a quarter or half of a dragee, children under seven years old are prescribed one tablet daily, up to fourteen - from one to three dragees per day. Adults may be given up to four gummies daily. The course of admission is thirty days.
Means of domestic production
Among domestic drugs, Cyanocobalamin and Cobamamide are distinguished. They are both available in three strengths and can be used in place of injectable solutions. Designed for both adults and children. It is better to take them half an hour before a meal. The total dosage is from two to six tablets per day, the specialist indicates more accurate. Before taking drugs by children, the tablets are dissolved in boiled water or a weak solution of dextrose.
The injectable form of vitamin B12 contains it in pure form. In tablet dosage forms, the substance is contained along with other compounds. The action and purpose of different dosage forms is different, as well as the rules for their use.
Characteristics of the active substance
Cyanocobalamin (vitamin b12) is a micronutrient actively involved in internal transformation reactions chemical substances. The largest cobalt-containing vitamin molecule, after transformation, is part of vital enzymes. Another name for the vitamin - anti-anemic factor - was assigned to it due to its ability to regulate erythropoiesis.
Varieties
Two vitamers vit B12 differ in spatial orientation. Their names are cyanocobalamin, hydroxycobalamin. Both molecules are varieties of vitamin B12 and are part of drugs.
Deoxyadenosylcobalamide (cobamamide) or methylcobalamin are active forms of the vitamin that exhibit a therapeutic effect and are formed in the human body after the inactive form delivered with the drug enters the liver. There, under the action of enzymes, it is activated.
The bioavailability of the drug depends on the degree of its conversion to the active form. Naturally, if an already active molecule enters the body, the pharmacological effect of the substance begins to manifest itself immediately, and its losses will be minimal.
Role in physiology
Cyanocobalamin affects the human body at the molecular level, providing transformations that affect the functioning of cells, tissues, and organs.
- Reparation of the skin and mucous membranes. A normal level of B12 is necessary for tissues that are quickly updated - the epithelium of the skin and mucous membranes, blood composition. The optimal functioning of these tissues depends on the rate at which their cells divide. It is provided by tetrahydrofolic acid, which is formed from folic acid under the action of reductases - special enzymes. The existence of reductases is impossible without cyanocobalamin.
- function of erythropoiesis. Cinocobalamin stimulates the timely and efficient division of cells from which red blood cells are formed. This ensures the normal form of red blood cells and the qualitative performance of their functions - the attachment and transfer of oxygen to the tissues.
- Transmission of nerve impulses. The work of all nerve cells is based on the myelin coating of nerve fibers. Cobamamide is involved in the formation of the main component of myelin -. Without it, degeneration of nerve fibers will occur, and therefore, demyelinated nerve fibers will not perform their functions - to transmit nerve impulses.
- Participation in fat metabolism. Methionine, formed from homocysteine under the action of cyanocobalamin, is involved in the removal of excess fatty deposits by the liver. This prevents fatty degeneration of the tissues of vital organs such as the liver, kidneys, spleen, and heart.
These effects are essential for the functioning of the body. In addition to them, vitamin B12 is necessary for a number of other enzymatic transformations.
Cyanocobalamin is not synthesized by the intestinal microflora in quantities sufficient for life. The body receives it from the outside, processing animal products. The surplus of the incoming vitamin is accumulated by the body for later use. As a rule, reserves are sufficient for three to four years, provided good nutrition. Chronic deficiency of cyanocobolamin is observed in vegetarians.
Vitamin B12 in ampoules: instructions for use
Pure vitamin B12, produced in ampoules, can be represented by a lyophilisate for the preparation of an injection solution or a ready-made sterile injection solution. Its characteristics are as follows:
- dose - 0.5 or 0.2 mg in one ampoule;
- volume - 1 ml or the amount of lyophilisate intended to dissolve 1 ml of water for injection;
- methods of administration intramuscular, subcutaneous, intravenous, intralumbar;
- features - the finished solution has the appearance of a pink liquid.
Intravenous and intralumbar injections are administered only in a hospital setting. It is important to understand that the methods of administration for different active substances are different:
- hydroxocobalamin– intended for intramuscular and subcutaneous administration;
- cobamamide - intravenous and intramuscular administration;
- cyanocobalamin - all routes of administration.
Pure cyanocobalamin cannot be mixed with other drugs, since its molecule inactivates medicinal substances, in particular vitamins B1 and B6.
Other injectables based on cyanocobalamin
On the modern pharmaceutical market, there are injections with pure cyanocobalamin, as well as complex preparations containing B vitamins. Examples are shown in the table. Combined products contain special substances that prevent the inactivation of vitamins.
Table - Injectable preparations of vitamin B12
When to inject
The metabolic and hematopoietic action of vitamin B12 determines the list of indications for the administration of the drug.
- Anemia. Complex and basic therapy of anemia that occurs against the background of Addison-Birmer syndrome, iron deficiency, blood loss, aplastic processes, ingestion of chemicals.
- Liver diseases. Complex treatment cirrhosis, hepatitis of any cause (etiology), liver failure.
- Pathology of the nervous system. Complex therapy of polyneuritis, neuralgia, injuries of peripheral nerve endings, multiple sclerosis, myelosis, as well as cerebral palsy, autism, Down syndrome.
- With intoxication. With alcoholism, metal intoxication, feverish conditions of infectious etiology, as well as with renal failure, vitamin B12 injections are prescribed.
- For dermatological problems. With psoriasis, photodermatosis, as well as atopic dermatitis, vitamin B12 provides enhanced skin regeneration.
- To prevent deficiency. With oncology of the stomach, intestines, pancreas, with resection of the stomach, vitamin absorption disorders, with Crohn's disease, celiac disease, radiation sickness.
Often, doctors prescribe the external use of "Vitamin B12" in ampoules. For example, children with thrush are recommended to lubricate the mucous membranes with 1 ml of solution mixed with half a Nystatin tablet.
Tablets
They are prescribed for the prevention and treatment of vitamin B12 deficiency, as part of the treatment of diseases accompanied by its deficiency. The most commonly prescribed tablets of B vitamins in the treatment of neurological disorders and neuralgia. A significant advantage of tablets is the convenience and safety of use. There is a recipe in Russian and Latin, the specialist will be able to decipher.
The main indications for the use of vitamin B12 tablets:
- neuralgia, neuritis;
- chronic anemia;
- low hemoglobin;
- unbalanced diet;
- psoriasis;
- pain of neurological origin;
- osteochondrosis;
- stomatitis.
Tablet preparations intended for the treatment of diseases with B12 deficiency contain dosages in excess of 240 micrograms per tablet. This ensures sufficient intake of cyanocobalamin. Examples of such medicines:
- "Neurovitan";
- "Neurobion";
- "Neurubin";
- "Milgamma";
- Neurobex.
There are also food supplements with vitamin B12. The most famous are from Nowfoods and Solgar. They are recommended for the prevention of deficient conditions, normalization of protein and lipid metabolism, improvement of endurance and stress resistance of the body. In the elderly, these drugs are used to prevent memory disorders and the development of senile dementia. In addition, the ability of B12 to prevent hair loss has been noted.
Suction features
According to doctors, cyanocobalamin deficiency is associated with disorders of the stomach, and its deficiency is observed mainly in hypoacid gastritis. This is due to a violation of the mechanism of absorption of B12, which occurs in several stages.
- Complex formation. In the acidic environment of the stomach (and only under this condition), cyanocobalamin binds to a protein substance called the Castle factor and forms a complex that penetrates into the small intestine.
- Suction. Through the walls of the small intestine, the formed substance penetrates into the hepatic portal vein, splits and is activated by hepatocytes with the formation of cobamamide.
- Distribution. Together with the bloodstream, B12 is distributed to all organs and tissues, showing therapeutic activity.
- Collection. Again getting into the liver, cyanocobalamin is deposited in the depot, and its excess is excreted along with urine and feces.
Thus, if the acidity of the stomach is disturbed, and the Castle factor is not produced, the body will not be able to absorb and use B12, even if it is adequately supplied with food.
The use of vitamin B12 tablets helps to cope with violations of the vitamin absorption mechanism. By using its doses, significantly exceeding the recommended daily rates, the deficiency is eliminated even in the complete absence of the Castle factor. The main condition is regular ingestion of large doses of the substance.
What is important to consider. How and in what cases they can be used
Application of any dosage form cyanocobalamin requires preliminary diagnosis for the presence of its deficiency or diagnostic confirmation of indications for use. Only after that the doctor prescribes the recommended drug, selects its dosage and mode of application.
- For children. B12 is necessary for normal growth, development, metabolic processes, but it is impossible to independently select the dosage for children. Even external use baby must be agreed with the pediatrician.
- For pregnant. If a pregnant woman has symptoms of cyanocobalamin deficiency, the doctor may prescribe her to take its tablet form. vitamin B12 during pregnancy is prescribed only taking into account potential benefit and risk, since there is evidence of a possible negative impact an excess of substance on the fetus. To prevent deficiency, it is possible to use injections or tablets with B12 at the stage of pregnancy planning.
- For nursing. During lactation, the use of any drugs is undesirable. Doctors recommend making up for the lack of cyanocobalamin by eating foods rich in it.
In some cases, the drug can have a negative effect. Therefore, it is especially important to consider its contraindications and side effects.
- Contraindications. Cyanocobolamin can not be used for individual intolerance, thrombosis, as well as for erythrocytosis. Diseases such as angina pectoris, benign or malignant neoplasms require careful use.
- Side effects. Long-term use of high doses of canocobalamin leads to the formation of purine deposits in the joints, as well as to an increase in blood clotting. Reviews about taking vitamin B12 indicate a rare occurrence of such effects as increased excitability of the central nervous system and tachycardia. Allergic reaction, manifested by urticaria, may indicate sensitivity not to the active substance, but to other ingredients in the preparation.
- Overdose. Subject to therapeutic doses, an overdose of cyanocobalamin is not observed.
Vitamin 12b affects many processes occurring inside the body. Dosages for admission and courses of treatment may vary depending on the clinical picture of the disease. Taking multivitamins containing B12 does not need to be coordinated with a doctor. Taking therapeutic drugs, as well as injections, require a mandatory medical prescription. The price is not high, you can look on the Internet on pharmacy sites.