Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Vitamin B12, particularly in the forms of methylcobalamin and adenosylcobalamin, has been studied for its potential role in supporting nerve regeneration and reducing nerve inflammation, which are relevant mechanisms in the treatment of Bell's Palsy. Bell's Palsy is an acute, idiopathic facial nerve paralysis, and the mainstay of therapy is corticosteroids, sometimes with antiviral agents. However, there is some clinical evidence suggesting that Vitamin B12 supplementation may improve facial nerve function recovery when used as an adjunct to standard therapy.

A number of small randomized controlled trials, mostly from East Asia, have investigated the effects of intramuscular or oral Vitamin B12 (often in the form of methylcobalamin, but adenosylcobalamin is also biologically active) on Bell's Palsy recovery. Meta-analyses and systematic reviews have found that patients treated with Vitamin B12 in addition to standard therapy may recover facial function more rapidly and more completely than those treated with standard therapy alone. The proposed mechanisms include enhanced nerve regeneration, myelin repair, and reduced oxidative stress.

However, the quality of evidence is limited by small sample sizes, lack of blinding in some studies, and variability in dosing regimens. Most guidelines do not currently recommend Vitamin B12 as a standard therapy, but recognize that it may be considered, especially in cases where B12 deficiency is suspected. Thus, while there is scientific evidence supporting its adjunctive use, it is not definitive, and more high-quality studies are needed.

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