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Head-to-head evidence comparison — which supplement is right for you?
Vitamin B12 wins 3 of 3 categories. Both are solid choices — the best pick depends on your specific goals.
Verdict
Mostly mechanism / observational
Top outcomes
Verdict
Probably helps
16 of 23 studies with measurable effects showed benefit.
Top outcomes
20 micrograms once daily by subcutaneous injection (the approved osteoporosis dose; PRESCRIPTION ONLY)
any
Subcutaneous injection (prefilled pen)
500-1000mcg daily for maintenance; higher for deficiency
Morning (may be energizing), With or without food
Methylcobalamin (sublingual)
Over ~18-24 months of daily use
Over ~18-24 months
Detectable by ~3 months
Hours after each dose
2-4 weeks
4-8 weeks
Weeks to months
Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis.
N Engl J Med (2001) · Rct · n=1637
Pivotal Fracture Prevention Trial: 1637 postmenopausal women with prior vertebral fractures randomized to PTH(1-34) 20 or 40 microg/day or placebo, median 21 months
Effects of teriparatide and risedronate on new fractures in post-menopausal women with severe osteoporosis (VERO): a multicentre, double-blind, double-dummy, randomised controlled trial.
Lancet (2018) · Rct · n=1360
Head-to-head double-blind, double-dummy RCT of teriparatide 20 microg/day vs risedronate 35 mg/week in 1360 women with severe osteoporosis over 24 months
Teriparatide or alendronate in glucocorticoid-induced osteoporosis.
N Engl J Med (2007) · Rct · n=428
18-month randomized, double-blind, controlled head-to-head trial in 428 patients with glucocorticoid-induced osteoporosis
Efficacy of different routes of vitamin B12 supplementation for the treatment of patients with vitamin B12 deficiency: A systematic review and network meta-analysis
Irish journal of medical science (2024) · Meta analysis · n=4275
Regarding the hemoglobin level, the pooled effect sizes showed no difference between all routes of administration that could reach statistical significance.
Dosage exploration of combined B-vitamin supplementation in stroke prevention: a meta-analysis and systematic review
The American journal of clinical nutrition (2024) · Meta analysis · n=76664
In areas without and with partial folic acid fortification, combined B-vitamin supplementation significantly reduced the risk of stroke by 34% [RR: 0.66; 95% confidence interval (CI): 0.50, 0.86] and 11% (RR: 0.89; 95% CI: 0.79, 1.00), respectively.
Vitamin Status in Patients with Phenylketonuria: A Systematic Review and Meta-Analysis
International journal of molecular sciences (2024) · Meta analysis · n=770
The effect sizes were expressed as standardised mean differences.
Vitamin B12 has a higher evidence score (7.5/10 vs 7/10) and wins in 3 of 3 categories.
No known interactions between Teriparatide and Vitamin B12 have been documented in our database. However, always consult a healthcare provider before combining supplements.