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Thyroid patients should use methylcobalamin or adenosylcobalamin because hypothyroidism often impairs the methylation pathways needed to convert cyanocobalamin into its active form

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10.1136/bmj.i4919 [DOI] [PMC free article] [PubMed] [Google Scholar] Sterne J

The same rationale for B12 supplementation applies

It is chemically a true peptide (six amino acids, including two D-amino acid substitutions for stability), so unlike some non-peptide GH secretagogues it is correctly classified in this category

The proportion of patients receiving B12 injections at the correct frequency also increased by 14% (58% to 72%), which resulted in fewer patients receiving unnecessary injections