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This can create an issue for people with diabetes

This type of interaction is known as a drug-lab interaction, and two common types of medications that interfere with thyroid labs include: Glucocorticoids, dopamine, dobutamine, and octreotide These can lower TSH without indicating true thyroid dysfunction

The mechanism behind this is synergistic rather than additive

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Various blood coagulation factors and regulatory proteins of the coagulation cascade have been implicated in influencing the pathophysiology of central nervous system diseases (Amyotrophic Lateral Sclerosis, Alzheimers disease, Parkinson disease, multiple sclerosis, and ischemic stroke and post-ischemic epilepsy)

We use cyanocobalamin by default, the form of B12 with the longest clinical history, the most extensive research support, and the consistent potency needed for repeated treatments