Clinician-prescribed therapies · Personally reviewed by your provider
FoundationalActive vitamin B12
The B12 your body can actually use.*
Methylcobalamin is the only form of B12 the brain can use directly. Subclinical deficiency mimics aging in a way restoration reverses.
Foundational
Methylcobalamin
Active vitamin B12
Tides · Clinician-Prescribed
Quick read
What it is
The active, bioavailable form of Vitamin B12, what the brain and nervous system can use directly, unlike the cyanocobalamin form found in most over-the-counter B12 supplements.
Primary benefit
Sharper mental clarity, more reliable recall, steadier energy, and improved mood. Effects usually appear within 2-4 weeks.
Mechanism
Supports myelin sheath maintenance (the insulation around nerves), red blood cell formation, and methylation, a key biochemical pathway tied to mood and DNA repair.
Who it's for
Adults experiencing brain fog or fatigue, vegetarian or vegan patients (B12 is only naturally bioavailable from animal sources), and anyone with absorption issues.
Read the full science
What Tides prescribesMethylcobalaminActive form. Direct use. Bioavailable.
What's in most OTC supplementsCyanocobalaminSynthetic. Requires conversion. Often skipped when depleted.
What it does
Mental clarity
Brain fog and slow recall map most often to subclinical B12 deficiency, not aging. Restoring the active form clears the fog within weeks for most patients.Sustained energy
B12 sits at the center of one-carbon metabolism, the methylation cycle that supports mood, energy, and neurotransmitter synthesis. Restoring it lifts the whole pathway.Nerve function
Numbness, tingling, or peripheral neuropathy responds to methylcobalamin specifically. The methyl form is the one nerve tissue can metabolize directly.Mood and resilience
Methylation supports serotonin, dopamine, and SAM-e production. Improvements in mood and stress resilience are common at 4 to 8 weeks.
How it works
Methylcobalamin is the active, methylated form of vitamin B12, the only form that crosses the blood-brain barrier and enters one-carbon metabolism directly. Oral B12 absorption is gut-dependent and unreliable past age 40. Injectable methylcobalamin bypasses the absorption ceiling and restores nerve and cognitive function in ways oral supplementation cannot match.
Clinical context
- Typical dose
- 1000 mcg weekly
- Range
- 1000–2000 mcg/week
- Route
- Intramuscular
- Per vial
- 10 mg · ~70 days
- Required labs
- CBC, Comprehensive Metabolic Panel
Who it's for
- Brain fog and mental fatigue
- Age-related cognitive shifts
- Vegetarian or vegan diets
- Numbness, tingling, or peripheral neuropathy
Cautions
- Standard caution profile, no major contraindications
Pairs with
$59/moLASTS ABOUT 10 WEEKS
Methylcobalamin 10,000 mcg vial. Each vial lasts about 10 weeks at the standard 1,000 mcg weekly dose, or about 5 weeks if dosed twice weekly. Pharmacy and clinician fees included.
How the price works
- Unit size
- 10,000 mcg vial
- Prescribed dose
- 1000 mcg weekly
- Frequency
- weekly
- How long one unit lasts
- about 10 weeks per vial
- vials per year
- 8 vials over 12 months
- Per month
- $59
- Per dose
- about $14
What’s included
- Clinician review by Dr. Rachel Deutsch, DNPShe reviews your case and prescribes the protocol. Every 4th refill returns to her for a scheduled check-in, and she can adjust that cadence based on your specific care. Not a bot, not a checkbox.
- Compounding by a licensed US pharmacy503A partnership. Every batch traceable, every ingredient sourced under FDA oversight.
- Temperature-controlled shipping when requiredTemperature-controlled packaging for injectables that need it. Ground shipping for orals and topicals.
- Unlimited messaging with your care teamAsk Rachel anything, any time. Dr. Rachel typically replies within one business day.
- No charge until Rachel approves your orderYour card is authorized at checkout, captured only when Rachel signs off. If she declines, nothing is charged.