I always wonder why the patient has to do the work for the doctor, the latter who gets PAID money. Or better yet, why people like me have to do it for free too, because the doctor is just unmotivated to learn new things! LIke it is sooooo hard to type in methylcobalamin into Google!

The bottom line is that cyanocobalamin is an artificial substance that the body cannot use. It has to be converted to the active form methylcobalamin and this process may fail for some people. This is chemistry, and doctors don't have a good grasp of chemistry either.

Tell your doctor that the RX vitamin Metanx has methyl in it for this reason:
www.metanx.com
Doctors love to see drug reps who give them gifts and spoon feed them information. So he can call the rep from that company and learn all about it.

Here is an article that explains it a little bit:
http://www.doctormurray.com/newsletter/1-11-2003.htm

Methylcobalamin is over the counter when not mixed with high dose folate like the Metanx. No RX is needed for you to buy it and use it yourself.
It is available on many websites...the Jarrow brand is pretty popular here.
I use www.iherb.com

In regards to the patch.... that is way overpriced for getting what you need. I have a long post about this,
if you search this forum for B12 patch you will find that thread.

After providing YOUR doctor with this information, ask him if he will reimburse you for your time, by giving you a
free visit? I can guess what that answer will be.