To prevent diabetic neuropathy, can methylcobalamin and vitamin B12 replace each other?

I met a patient who was a diabetic and wanted to use vitamin B12 tablets to prevent neuropathy. But he went to several pharmacies and couldn't buy any medicine. The only similar medicine was methylcobalamin. He was not sure, so he asked Huazi if vitamin B12 and methylcobalamin were the same medicine, and whether they could replace each other.

Huazi told him that vitamin B12 and methylcobalamin belong to the same class of drugs. Although they are not exactly the same, their pharmacological effects are basically the same and they can replace each other.

1. What is the use of vitamin B12? The main function of vitamin B12 in the human body is to promote the development and maturation of red blood cells. If it is deficient, it will lead to megaloblastic anemia. Vitamin B12 can also increase the metabolism of neuronal cells, promote the synthesis of nucleic acids and proteins, and maintain the healthy operation of the nervous system. When the nervous system is diseased, such as neuritis, diabetic neuropathy and other diseases, supplementing vitamin B12 has an auxiliary therapeutic effect.

Vitamin B12 is also a coenzyme in the human body, which can increase the utilization of folic acid by human cells and promote the metabolism of carbohydrates, fats and proteins.

2. Vitamin B12 is a "big family" In pharmaceutical chemistry, vitamin B12 refers to a class of chemical substances with similar structures. These chemical substances all contain a cobalamin ring structure. More than 20 kinds of them have been discovered, but the four family members related to the human body are mainly cyanocobalamin, hydroxocobalamin, adenosylcobalamin and methylcobalamin. It is ranked 12th in the naming order of vitamins, and now it is customary to call the first discovered cyanocobalamin vitamin B12.

The human body cannot produce vitamin B12 and can only be supplemented exogenously. Oral vitamin B12 cannot be absorbed directly and needs to be combined with the intrinsic factor secreted by the gastric parietal cells before it can be absorbed into the blood. Vitamin B12 itself is not biologically active and needs to be converted into methylcobalamin and adenosylcobalamin in the human body to exert its biological activity.

3. Vitamin B12 and methylcobalamin can replace each other. Foods containing vitamin B12 are mainly found in meat, such as pork, beef, lamb, chicken, as well as fish, clams, dairy products and eggs, while vegetables, fruits and other plants almost do not contain vitamin B12. Therefore, people who eat meat normally will not be deficient in vitamin B12.

However, the absorption of vitamin B12 depends on the combination with intrinsic factor, so people with indigestion may have reduced absorption of vitamin B12. People with unbalanced nutrition, such as strict vegans, may also be deficient in vitamin B12. Patients with liver disease and enzyme deficiency may have insufficient ability to convert vitamin B12, leading to the occurrence of disease.

Therefore, for those who are deficient in vitamin B12, they can directly supplement with biologically active methylcobalamin or adenosylcobalamin, which is more effective than taking vitamin B12. Both methylcobalamin and adenosylcobalamin can be used for neuropathy and megaloblastic anemia, but there are slight differences between the two.

Methylcobalamin can enter nerve organelles and repair nerve cells, while adenosylcobalamin needs to be converted into methylcobalamin to work. Adenosylcobalamin can enter the cell mitochondria and directly participate in the synthesis of hemoglobin to improve anemia. So compared with the two, methylcobalamin is more suitable for the treatment of neuropathy, and adenosylcobalamin is more suitable for anemia.

To summarize, vitamin B12 is a prodrug. After entering the human body, it needs to be converted into methylcobalamin to exert biological activity. Methylcobalamin is more effective in treating the nervous system, and is as effective as vitamin B12 in treating megaloblastic anemia. However, the absorption of vitamin B12 depends on the secretion of intrinsic factor, so when used, methylcobalamin is more convenient than vitamin B12, and the two can replace each other. Drugs must be used under the guidance of a doctor. If you have any doubts about the use of the drug, consult a doctor or pharmacist. I am pharmacist Huazi. Welcome to follow me and share more health knowledge.