Common questions about cyanocobalamin - Brand name: Orobalin

Cyanocobalamin is a manufactured version of vitamin B12. It works by increasing the levels of vitamin B12 in your blood.

You need vitamin B12 to stay healthy. It's used to make red blood cells and keep your nervous system healthy.

Having enough vitamin B12 allows your body to make red blood cells that work properly to carry oxygen around your body.

If you've been diagnosed with low vitamin B12 levels, taking cyanocobalamin helps reduce symptoms such as tiredness and lack of energy or being short of breath.

Vitamin B12 supplements will only improve symptoms such as tiredness and lack of energy if they're caused by low vitamin B12 levels.

It may take a few weeks before your vitamin B12 levels and symptoms (such as extreme tiredness or lack of energy) start to improve.

If you have hydroxocobalamin injections to boost your vitamin B12 levels at the start of treatment, the cyanocobalamin tablets may start to work within a few days.

You can buy vitamin B12 supplements containing cyanocobalamin as tablets (including chewable, slow-release, and tablets that dissolve under your tongue), capsules, mouth sprays, and drops.

There is no noticeable difference in the amount of vitamin B12 that your body can absorb or use from the different types, so no supplement is more effective than the others.

If you have low vitamin B12 levels caused by stomach or bowel problems or surgery, you will not absorb enough vitamin B12 from food or low-dose supplements (10 micrograms to 100 micrograms). You will need hydroxocobalamin injections, or high-dose cyanocobalamin tablets (1,000 micrograms) if you cannot have injections.

If you stop taking prescribed cyanocobalamin tablets, your vitamin B12 levels may start to go down.

If your levels get too low, you may start to get symptoms such as tiredness again.

This may take days, weeks or months to happen because it depends on:

• what your vitamin B12 levels are
• how long you've been taking cyanocobalamin
• how much vitamin B12 you get from your diet

Talk to your doctor or pharmacist if you want to stop taking cyanocobalamin or are bothered by side effects.

Cyanocobalamin will not stop any type of contraception working, including the combined pill and emergency contraception.

Yes, you can drink alcohol with cyanocobalamin. Alcohol does not affect how this medicine works.

However, drinking too much alcohol regularly can cause folate deficiency anaemia. This is a lack of vitamin B9 (folic acid) and will lead to symptoms such as tiredness coming back.

Cyanocobalamin does not usually affect your ability to drive or ride a bike.

You can eat and drink as normal while taking cyanocobalamin. However, it's best to take cyanocobalamin on an empty stomach, at least 30 minutes before meals or 2 hours after eating.

You can usually help your vitamin B12 levels by increasing the amount of certain foods you eat. However, this will not help if you have a stomach (gastro-intestinal) problem that means you cannot absorb vitamin B12 from your gut.

If you eat meat, fish, eggs, milk and dairy foods you should get enough vitamin B12 from your diet.

Foods that are good sources of vitamin B12 include:

• meat (such as liver and beef)
• fish (such as salmon, tuna and haddock)
• shellfish (such as mussels and scallops)
• dairy foods (such as milk, yoghurt and cheese)
• eggs

Some foods have vitamin B12 added (look for "fortified" on the label). These include:

• breakfast cereals and bread
• soya foods, non-dairy milks and spreads
• yeast extract or nutritional yeast flakes

If you have a condition that means you cannot absorb enough vitamin B12 from the food you eat, it's still a good idea to try to eat a healthy, balanced diet with enough vitamins and minerals, including B12.