Ms. Wang, 50, is a stay-at-home wife with an obese body. She was diagnosed with diabetes during a physical examination 5 years ago and found that her fasting blood sugar and postprandial blood sugar were significantly elevated, and the doctor advised her to take metformin regularly to control her sugar. Due to her weak health awareness and no symptoms of physical discomfort, Ms. Wang has not taken it too seriously, not only does she not monitor her blood sugar level on time, but her blood sugar control drugs are often "eat a meal and forget a meal", resulting in her blood sugar control is very unsatisfactory.
Gradually, Ms. Wang gradually felt that many symptoms of discomfort appeared in her body. One year ago, Ms. Wang felt pain and numbness in her limbs like pins and needles, abnormal sensation when touching things with her fingertips, as if she was wearing thick gloves, and her legs often felt weak and weak, and she could not walk for a long time. At the same time, binocular vision also has varying degrees of blurred vision.
Only then did Ms. Wang pay attention to it and hurriedly went to the hospital for treatment.
After listening to Ms. Wang's description, the doctor conducted a blood routine, physical examination and electromyography examination, and found that Ms. Wang's fasting blood glucose reached 8.9mmol/L, and the physical examination found that the sensation of both lower limbs decreased significantly, and the electromyography examination showed a decrease in the amplitude of the action potential, and finally diagnosed her with diabetic peripheral nerve disease.
"You have a complication caused by poor diabetes control and peripheral nerve damage! You have to strictly control your blood sugar!" the doctor said with a serious face as he looked at the results of the examination, and at the same time told Ms. Wang to take methylcobalamin regularly to improve the related symptoms. Ms. Wang realized the seriousness of the problem and agreed.
By the end of the treatment, Ms. Wang's symptoms had indeed improved a lot. Ms. Wang learned on the Internet that methylcobalamin is a type of vitamin B12, so is taking multivitamin tablets containing vitamin B12 have the same effect as taking methylcobalamin? With such questions, Ms. Wang went to the hospital for a follow-up.
After listening to Ms. Wang's question, the doctor shook his head and explained with a smile: "Although they are all members of the vitamin B12 family, only methylcobalamin can be used directly by the human body to improve nerve conduction function, and the efficacy is not as good as methylcobalamin if only B vitamins are taken." ”
Hearing this, Ms. Wang couldn't help but sigh: "It turns out that there is such a big difference, I thought that almost all medicines have the same effect! Fortunately, I consulted you, and there was no blind medication, otherwise the condition would not be under control!"
Methylcobalamin is a common neurotrophic agent that is often used to treat peripheral nerve lesions. As a member of the vitamin B12 family, why can methylcobalamin play a role in repairing damaged nerves, what are the indications for methylcobalamin, and what are the adverse effects of long-term use?
1. The same vitamin B12 family, why can methylcobalamin repair damaged nerves?
Vitamin B12 is often found in the form of coenzyme in the human body, and it has many functions, mainly to protect the myelin sheath of nerves and promote the growth and development of red blood cells. It is available in four active forms, including cyanocobalamin, methylcobalamin, hydroxocobalamin, and adenosylcobalamin.
It is worth noting that methylcobalamin and adenosylcobalamin can directly act on the human body to exert active effects, while cyanocobalamin and hydroxocobalamin need to undergo a series of biological reactions in the body to be converted into directly available methylcobalamin and adenosylcobalamin before they can exert biological activity. In contrast, two drugs, methylcobalamin and adenosylcobalamin, are highly bioavailable and have a faster onset of action.
Although these four drugs have the same efficacy in the treatment of megaloblastic anemia caused by vitamin B12 deficiency, they can be used interchangeably, but there is not much difference.
In the treatment of peripheral neurological diseases, methylcobalamin is easier to absorb into neurons than cyanocobalamin, and plays a better role in promoting neuronal nucleic acid and protein synthesis than cyanocobalamin. Compared with adenosylcobalamin, the human body absorbs adenosylcobalamin much faster than methylcobalamin, and after adenosylcobalamin enters the body, it needs to be converted into methylcobalamin through a series of biochemical reactions, and the therapeutic effect is greatly reduced.
Through comparison, we found that methylcobalamin is highly effective in repairing damaged nerves, which is why Ms. Wang needs to use methylcobalamin instead of other vitamin B12 after suffering from diabetic peripheral nerve disease.
Methylcobalamin is an endogenous coenzyme B12 mainly distributed in the blood and bone marrow, which not only plays a positive role in promoting the regeneration of axons, but also improves nerve excitability, inhibits neurodegeneration, and participates in biochemical reactions related to neural activity, so it is often used to treat peripheral neurological diseases, such as diabetes complicated by neuropathy, polyneuritis, etc., with good efficacy.
It can be seen that although they are all members of the vitamin B12 family, their efficacy and mechanisms are different. However, the seemingly humble methylcobalamin is not only a good hand at repairing nerve damage, it is much less effective than that.
2. Methylcobalamin can also be used to treat these three common diseases
In addition to repairing damaged nerves, methylcobalamin is widely used and has achieved good results in the treatment of megaloblastic anemia, sciatica and herpes zoster.
1. Megaloblastic anemia
Folic acid and vitamin B12 belong to the same family of B vitamins, and they have a positive effect on the synthesis of DNA in the nucleus and the growth and development of red blood cells.
When the body lacks these two substances, it will lead to DNA development defects in the red blood cell nucleus, and the development rate is much slower than that of red blood cell cytoplasm, so that the newly synthesized red blood cells are still in the naïve red blood cell stage with abnormal morphology, and cannot play the normal transport and exchange function of substances, resulting in megaloblastic anemia.
As we mentioned earlier, methylcobalamin is an endogenous vitamin B12 with coenzyme activity. Therefore, taking methylcobalamin can not only promote the synthesis and utilization of folic acid, but also help red blood cells to complete normal growth and development, promote the production of new blood, and is often used to treat megaloblastic anemia.
2. Sciatica
When the nerve root is compressed, the pain will be transmitted along the direction of the sciatic nerve, and patients often have uncomfortable symptoms of numbness and pain in both lower limbs, because sciatica still belongs to the category of peripheral nerve diseases, the use of methylcobalamin promotes neuronal regeneration by repairing abnormal nerve conduction protrusions, improves the excitability of nerve conduction, and plays the role of nutritional nerve, which has a certain alleviating effect on peripheral muscle numbness and other symptoms caused by sciatica.
It is important to note that methylcobalamin does not exert analgesic effects, and patients often need to combine non-steroidal anti-inflammatory drugs such as aspirin and ibuprofen to achieve better efficacy.
3. Herpes zoster
When the body's resistance is weakened, the chickenpox virus "latent in the body" in the body will become active again, moving along the nerve distribution, accompanied by severe nerve pain.
Methylcobalamin can not only promote the regeneration of neurons damaged by the varicella virus, improve nerve function, reduce pain, but also increase the body's resistance to the virus, accelerate the clearance of the virus, and alleviate the symptoms of shingles.
However, although methylcobalamin is good, it can only alleviate the symptoms of herpes zoster and play the role of adjuvant therapy, but cannot completely cure it, so it cannot rely on methylcobalamin alone, and still needs to be combined with antiviral drugs to achieve better treatment purposes.
It can be seen that methylcobalamin has outstanding efficacy and a wide range of use, and many patients will take it as a health care product. However, it is important to note that methylcobalamin, while good, is not suitable for everyone, and long-term use may bring side effects.
3. The doctor reminds that although methylcobalamin is good, it should not be taken regularly
Methylcobalamin is widely used because of its low price and definite efficacy. However, although methylcobalamin is good, it should not be taken regularly, and excessive consumption may lead to adverse reactions such as drug-induced rash, gastrointestinal discomfort, liver and kidney function damage.
In daily life, if the use of methylcobalamin within one month can not improve the symptoms, it is not recommended to continue to use, continue to take not only can not alleviate the condition, it is likely to bring many adverse reactions, the most common is the drug rash, patients often appear red macules all over the body, accompanied by severe itching.
This is due to the mucosal inflammatory reaction caused by the digestion and absorption of the drug and finally the submucosal transport to the skin and mucosa after an overdose of methylcobalamin. In particular, patients who are allergic to methylcobalamin may also be accompanied by systemic symptoms such as dyspnea and shock in severe cases, which can be life-threatening.
Gastrointestinal discomfort is another common adverse reaction of methylcobalamin, a drug containing the heavy metal element "cobalt", which can cause irritation to the mucosa of the gastrointestinal tract when taken for a long time, and may cause loss of appetite, bloating, vomiting and other manifestations.
Especially for children and the elderly with weak immunity, there are no studies to confirm the absolute safety of the drug, and the probability of gastrointestinal reactions is higher. In addition, excessive use may also cause cobalt poisoning, which in severe cases can lead to damage to the nervous system and mental disorders.
Long-term overdose of methylcobalamin can also cause damage to liver and kidney function. This is due to the fact that methylcobalamin is absorbed through the gastrointestinal tract and metabolized by the liver and kidney, and if taken in excess, it will increase the burden of liver and kidney detoxification function and enhance liver and kidney toxicity.
In addition, if people who have been exposed to the heavy metal "mercury" and its compounds for a long time take it without authorization, it will cause mercury to react with methylcobalamin to form toxic "methylmercury", which will precipitate in the human body and cause damage to important organs such as liver and kidneys.
Methylcobalamin is only a methylated vitamin, although it can repair nerve damage and speed up blood production, not only can be used to repair damaged nerves, but also can be used to treat megaloblastic anemia, sciatica and herpes zoster and other diseases, but do not exaggerate its efficacy, as a health care product to take more or more for a long time, so as not to produce adverse reactions, endangering health. Therefore, methylcobalamin can only become a "little guard" to protect health under the premise of reasonable use!
Bibliography:
Medical Information,2019,32(22):39-42.
[2] Wang Jingjun, An Hongchun.Clinical new uses and precautions of methylcobalamin[J].China Community Physician,2008(22):21.