From the FDA Drug Label
DOSAGE AND ADMINISTRATION Adult dose is 1 capsule by mouth once daily, preferably with a meal or as directed by a physician. The FDA drug label does not answer the question.
From the Research
Methylcobalamin supplementation during pregnancy is typically recommended at a dose of 500-1000 mcg daily for women with confirmed B12 deficiency, as supported by the most recent and highest quality study available 1.
Importance of Methylcobalamin in Pregnancy
Adequate B12 levels during pregnancy are essential for preventing neural tube defects, supporting fetal brain development, and reducing the risk of pregnancy complications like preterm birth. B12 deficiency during pregnancy can lead to megaloblastic anemia in the mother and potentially cause developmental delays in the baby.
Risk Factors for Deficiency
Women following vegetarian or vegan diets, those with gastrointestinal disorders affecting absorption, or those with pernicious anemia are at higher risk of deficiency and may require higher supplementation doses.
General Supplementation Recommendations
For general pregnancy supplementation in women without deficiency, most prenatal vitamins contain adequate B12 (2.6 mcg daily is the recommended dietary allowance during pregnancy) 1. Methylcobalamin is the active form of B12 and may be better absorbed than cyanocobalamin in some individuals.
Severe Deficiency
If B12 deficiency is severe, your healthcare provider might initially recommend higher doses or injections before transitioning to oral maintenance therapy.
Key Considerations
It is crucial to note that the maternal serum cobalamin concentration during pregnancy is a strong predictor for later maternal and infant cobalamin status, and a concentration >394 pmol/L at week 18 of pregnancy is recommended to secure an optimal infant cobalamin status during the first 6 mo of life 1.
Supplementation Forms
While there are various forms of vitamin B12, including Cyanocobalamin, Methylcobalamin, Adenosylcobalamin, and Hydroxycobalamin, the combination of Methylcobalamin and Adenosylcobalamin was found to be most effective in neutralizing excess folate effects in vitro 2.
Clinical Implications
Given the potential risks associated with B12 deficiency during pregnancy, it is essential to prioritize supplementation, especially in high-risk populations, to ensure optimal maternal and fetal outcomes.