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Choose methylcobalamin if: You have confirmed MTHFR mutations Elevated homocysteine levels Neurological or mood symptoms You tolerate methylated supplements well Choose hydroxocobalamin if: Sensitive to methyl-B12 (anxiety, insomnia) Histamine intolerance or MCAS Need gentle, balanced B12 support Want detoxification benefits Choose adenosylcobalamin if: Chronic fatigue is your primary concern Mitochondrial dysfunction Want to combine with methyl-B12 for comprehensive support Consider combination formulas: Many practitioners recommend combining forms: Methyl-B12 + Adeno-B12 (methylation + energy) Hydroxy-B12 + Adeno-B12 (gentle + energy) All three forms for comprehensive support The bottom line: For MTHFR mutations, methylcobalamin is typically most effective for supporting methylation and lowering homocysteine

Initially described as an ADP-ribosyl cyclase, CD38 cyclizes nicotinamide adenine dinucleotide (NAD) to cADPR

Relative risk and absolute risk look very different

It is metabolized in the liver and it is excreted in the urine, bile and secretions