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Because it activates three receptor pathways, the dose-response curve is steeper and the side effect profile is more sensitive to sudden increases

[13] [16] For confirmed deficiency, particularly with neurological symptoms or pernicious anaemia, intramuscular B12 injections (hydroxocobalamin) are the standard NHS treatment

Best Vitamin B12 for Energy: Form, Dose, and the Bigger Picture Choosing the right form For daily energy support, methylcobalamin is the stronger choice

For people with type 2 diabetes who also use insulin or insulin-stimulating medications, the risk of low blood sugar, also called hypoglycemia, can increase, and the dose of those medicines may need to be lowered