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Hydroxocobalamin is a storage form of B12 which can be easily converted to the active forms of B12 (methyl and adenosylcobalamin) as needed. Hydroxy B12 helps to form healthy red blood cells, and metabolize carbohydrates, fats and proteins.


  • Nutrients: Vitamin B12 Deficiency, Malabsorption, Pernicious Anemia
  • Energy: Metabolism of Carbs, Fats and Proteins
  • RBC: Formation of red blood cells (RBC)
  • Cyanide toxicity

Feature Ingredients

  • Methylcobalamin: is involved in methylation, RBC formation, neurotransmitter and DNA synthesis, and homocysteine recycling, which is important for heart health.
  • Adenosylcobalamin: is important for energy production and to maintain a healthy nervous system.
  • Hydroxocobalamin: acts as a precursor to both the above forms (providing long lasting reserves of B12) and has independent detoxifying actions.

Unmethylated vitamin B12 for sensitive bodies

  • Supports the detoxification pathways
  • Involved in the energy production process
  • Assists the brain and nervous system

Vitamin B12 is essential for the health of the brain and nervous system, forming red blood cells and DNA, and is also an important part of the crucial biological pathways known as methylation cycles. However, deficiencies are quite common, particularly among vegetarians, adults over age 50, people with malabsorption or gastrointestinal disorders such as Celiac, Crohn’s, Colitis, IBS and those with pernicious anemia. A deficiency can be profoundly detrimental to overall health. Some of the signs of vitamin B12 deficiency include megaloblastic anemia, fatigue, cognitive changes and dementia, depression and mood disturbances, susceptibility to infection, poor balance and peripheral neuropathy which can manifest as numbness tingling, tremors.

Many vitamins, including B12, are not biologically active in the form in which they are normally found in food or supplements. In these cases, the body must convert a vitamin into its coenzyme form for the vitamin to exert its biological function. The conventional form of supplemental B12 is cyanocobalamin, but this form requires a multi-step process in order to be converted to the active forms, adenosylcobalamin or methylcobalamin. Hydroxocobalamin is a unique form of vitamin B12 which is more readily converted into adenosylcobalamin and methylcobalamin than conventional cyanocobalamin. Both active forms (adenosylcobalamin and methylcobalamin) serve different but important functions in the body. By supplementing with the hydroxy form, individuals can ensure to cover their needs for both adenosylcobalamin and methylcobalamin.

AOR Advantage

  • AOR’s Hydroxy B12 delivers the essential functions of standard vitamin B12 while at the same time binding and eliminating excess cyanide in a convenient and reliable lozenge form.

SKU: AOR04325   : NPN: 80005478

Serving Size: 1 Lozenge

Servings per Container: 60 Lozenges (60 Daily Servings of 1 Per Day)

Medicinal Ingredients

Per Lozenge

B12 (Hydroxocobalamin) 1000 mcg

Non-medicinal Ingredients: xylitol, sodium stearyl fumarate, microcrystalline cellulose, tapioca syrup, hyprolose and distilled water.


AOR™ guarantees that all ingredients have been declared on the label. Contains no wheat, gluten, nuts, peanuts, sesame seeds, sulphites, mustard, soy, dairy, eggs, fish, shellfish or any animal by product.

Recommended Use

Adults 19+:  Take one lozenge under the tongue daily with or without food, or as directed by a qualified health care practitioner.

AOR Advantage 

AOR puts pharmaceutical principles into practice to create the most effective products with the highest quality raw materials. Our processes allow us to ensure potency, purity and traceability from plant to product, giving our customers the certainty that they are always getting the same, effective formulation. We introduce and implement the latest testing strategies as part of our quality assurance process because we believe that it’s not about checking boxes, but how the boxes are checked that is important.


Do not use if you are hypersensitive or allergic to any of the ingredients. 


Consult a health care practitioner prior to use if you are taking any medications or if you have any pre-existing condition. Consult a health care practitioner for use beyond four months. If you are pregnant or breastfeeding, consult a health care practitioner prior to use. Discontinue 2 weeks prior to any scheduled surgery.

Side Effect Risks

Discontinue use and consult a healthcare practitioner if symptoms persist, worsen or you develop any reactions which may include: allergy or intolerance.  Keep out of reach of children. Sealed for your protection. Do not use if seal is broken. For freshness, store in a cool, dry place.


The information and product descriptions that appear on this website are for information and educational purposes only and are not intended to provide or replace medical advice to individuals from qualified health care professionals. Consult your physician if you have any health concerns, and before initiating any new dietary, exercise, supplements or other lifestyle changes.

Research Based Facts

Forms and Functions of B12

Vitamin B12 (or cobalamin) is essential for the health of the brain and nervous system, and provides nerve and methylation support. Vitamin B12 deficiencies are particularly likely among vegetarians, adults over age 50, people with malabsorption or gastrointestinal disorders such as Celiac, Crohn’s, Colitis, IBS and those with pernicious anemia. One German study reported that only 5.3% of vegetarians meet the recommended intake of B12.

The body uses vitamin B12 in the form of two different coenzymes, each of which plays a different role in the body. Adenosylcobalamin was discovered earlier and is the better-known of these coenzymes. Adenosylcobalamin helps the body to process some amino acids, and to form substances used in the body’s energy cycle. The second coenzyme is methylcobalamin, which prevents the neurological and cognitive damage and dysfunction seen in B12 deficiency.

While adenosylcobalamin is readily stored in the liver, methylcobalamin needs to be free to circulate in the body. Because of this, methylcobalamin doesn’t hang around in the body for very long.

Hydroxocobalamin and cyanocobalamin are two intermediate forms of cobalamin that are common in supplements. Hydroxocobalamin exhibits its own unique benefits, namely in regards to clearing toxins, and it is more readily converted into the active coenzyme forms of B12 than conventional cyanocobalamin.

Understanding B12 Deficiencies

Vitamin B12 (or cobalamin) is essential for the health of the brain and nervous system, and provides nerve and methylation support. A deficiency can be profoundly detrimental to overall health. However, in order to understand how to best correct a deficiency we need to understand how to interpret lab values, and what the progression of a deficiency looks like.

Testing for deficiency:

While it is becoming less common to see a severe deficiency in North Americans, we tend to see more suboptimal levels in the population. Supplementing with only one form of vitamin B12 for all deficient cases can miss the mark. While it’s true that there is some degree of interconversion between the different active co-factor forms, and with hydroxycobalamin able to convert into both forms, we still see difficulty in correcting deficiencies when supplementing with the wrong form of B12. Depending on what lab value we use from testing we can learn a lot about which form is deficient. When cobalamin is transported in the body it is bound to a molecule forming holotranscobalamin. Testing holotranscobalamin levels gives an accurate reading of how much B12 is actually getting absorbed and delivered to cells. Another test looks at markers of enzymes that the B12 forms are involved in; For example, MMA, which we know is a by-product of the MMCoA mutase enzyme not working properly. Thus, increased levels of MMA would be more indicative of an adenosylcobalamin deficiency.


Interestingly, even though adenosylcobalamin was discovered earlier and is the better-known of these coenzymes, it is often not seen in supplemental form. This is likely due to the fact that it is stored in the liver and is more abundant within cells. Conversely, methylcobalamin is found mostly in the blood and, in times of deficiency (even mild deficiencies), is disproportionately depleted faster. A number of factors can lead to methylcobalamin deficiency including: genetic polymorphisms, dietary choices, and issues with absorption. This makes it harder for these individuals (also called “poor methylators”) to recycle homocysteine and to produce red blood cells. While supplementing with only methylcobalamin can improve these processes, the adenosylcobalamin pathways are often left under-supported.

Hydoxycobalamin is the clinical standard for treating B12 deficiency. It is the most common form in doctor’s offices and clinics for injections, treating deficiency, and of as an antidote to cyanide poisoning. The reason being that it forms both adenosyl and methyl cobalamin. Thus when a B12 deficiency is clinically supported but not corroborated with lab tests- treatment with the precursor to both forms is safe and effective. This form is particularly effective in individuals who do not respond well to methylcobalamin forms ( hyper stimulated) as a result of their genertic polymporphisms.

Hydroxocobalamin and Cyanide Exposure

While many people significantly benefit from taking methylcobalamin, hydroxocobalamin offers unique benefits to individuals who may have been exposed to cyanide. Hydroxocobalamin helps the body to rid itself of cyanide by enhancing detoxification through its conversion of cyanide into the less toxic thiocyanate. In isolated human cells, hydroxocobalamin penetrates cyanide-laden cells and binds to cyanide directly. Hydroxocobalamin has a long history of use for such purposes (such as during industrial disasters) and is approved for this use in many European countries. At lower doses, oral hydroxocobalamin increases the urinary excretion of thiocyanate in laboratory animals fed cyanide-containing diets. Sublingual hydroxocobalamin, complexed with betacyclodextrin, is an ideal choice for a B12 supplement in persons concerned with chronic, low-level cyanide exposure.

A study investigated the effects of administering hydroxocobalamin to firefighters who have suffered from hydrogen cyanide smoke inhalation, in order to determine if an early intervention with the administration of vitamin b12 coenzyme could have a positive effect. 161 firefighters who were suspected or confirmed to have hydrogen cyanide poisoning were studied in a multicenter retrospective case review from the Emergency Medical Assistance Unit (Service d’Aide Médical d’Urgence) in France. All patients were given an initial dose of 5 g of hydroxocobalamin. Non-responders received a second dose of 5 g of hydroxocobalamin. Of the patients that were initially in cardiac arrest, 30 died at the scene, 24 died in hospital, and 5 survived without cardiovascular sequelae. An improvement in cardiac disorders was noted with increasing doses of hydroxocobalamin. With higher dose administrations of the antidote, a superior outcome in patients with an initial cardiac arrest was observed.

Methylation and Detoxification:

Methylation is a key biochemical process essential for the proper function of almost all of your body’s systems. First, it acts as a factory to supply methyl (CH3) groups used for numerous reactions in the body. Some of these reactions are involved in the making of creatine, carnitine, coenzyme Q10, phosphatidylcholine, melatonin, and other important substances for the body. This process supplies methyl groups to be attached to DNA molecules in order to determine whether the blueprints in the DNA will be used to make certain proteins according to their patterns.  Another function of methylation is to regulate the overall use of sulfur in the body. Sulfur is found in the diet in the form of the amino acids methionine and cysteine in protein. One of the most important sulfur-containing substances in the body is glutathione, our master antioxidant. The body’s detoxification system depends to a large extent on sulfur metabolism, therefore sub-optimal methylation also leads to toxin accumulation. The body stores much of these toxins (heavy metals, pesticides residues, etc.) in fat, but eventually, the accumulated toxins begin to cause problems throughout the biochemistry of the cells leading to premature aging, disease and immune malfunction problems such as increased homocysteine levels.

The body’s methylation system is one of the most important biochemical processes for long-term health. If your body’s methylation cycle is not working at an optimal level it will translate into many different health problems and will accelerate the aging process. The main key to activating the methylation cycle is to support the activity of the methionine synthase enzyme so that the partial blocks in the methylation process are lifted, and glutathione levels are brought back to normal. When this occurs, the body’s detoxification processes are supported and health is enhanced as a result of effective methylation.