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Methylcobalamine is effective in peripheral neuropathies

European Journal of Clinical Nutrition volume 69, page 530 (2015)Cite this article

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We read with interest the article published by Thakkar and Billa1 in the European Journal of Clinical Nutrition (2014), providing perspective on ‘Treatment of vitamin B12 deficiency with Methylcobalamine (MeCbl)/Cyancobalamine (Cbl)/Hydroxocobalamin (HCbl), and trying to clear the confusion on which one is appropriate.

In author’s opinion, the role of MeCbl in the functioning of the peripheral nervous system is doubtful, and it is prudent to use Cbl wherever required instead of MeCbl alone to address both the neurological and haematopoietic pathways. Although studies quoted by authors explored the role of B12 (not MeCbl per se) on central nervous system, there is ample of evidence as explained below demonstrating the utility of MeCbl in peripheral neuropathies. We differ with the authors’ view, as it is very well documented that MeCbl is necessary for nervous system maintenance by being crucial and direct donor of methyl groups to the myelin sheath that insulates the axon and for DNA metabolism for nerve regeneration.2, 3 By promoting lecithin (main constituent of myelin sheath lipid) synthesis, MeCbl accelerates the myelination and regeneration of peripheral nerves.4 We would like to also emphasize that MeCbl is one of the two coenzyme forms of vitamin B12. Coenzyme forms bypass several of the enzymatic reactions required for the formation of functional forms of vitamin B12, are retained in body better and increase tissue concentrations of cobalamin better compared with Cbl.5 Cbl ultimately needs to be converted to MeCbl, the biologically active form of B12.3 There is some evidence as to the conversion of MeCbl to adenosylcobalamine intracellularly. This might compensate for the adenosylcobalamine function in the body.6

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References

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Authors and Affiliations

  1. Emcure Pharmaceuticals Ltd, Rajiv Gandhi IT Park, MIDC, Hinjawadi, Pune, India

    S U Naik & D V Sonawane

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  1. S U Naik
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  2. D V Sonawane
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Correspondence to D V Sonawane.

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Naik, S., Sonawane, D. Methylcobalamine is effective in peripheral neuropathies. Eur J Clin Nutr 69, 530 (2015). https://doi.org/10.1038/ejcn.2014.281

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