Vitamin B9 (Folic Acid) + Vitamin B12 (Methylcobalamin) + Vitamin B3 (Niacin) is a B-vitamin combination supplement that brings together folic acid (vitamin B9), methylcobalamin (the active coenzyme form of vitamin B12), and niacin (vitamin B3). These three B vitamins are involved in red blood cell formation, nerve function, DNA synthesis, and energy metabolism. The combination is used to prevent and manage deficiencies of these vitamins, to support pregnancy needs (folic acid), and to address peripheral neuropathy and macrocytic anaemia related to B12 and folate insufficiency.

B vitamins are water-soluble micronutrients that the body cannot store in large amounts, so a regular dietary supply is essential. They serve as coenzymes for enzymes involved in DNA synthesis, methylation, red blood cell production, nervous system maintenance, and the conversion of food into energy.

Folic acid (vitamin B9) is the synthetic form of folate used in supplements and fortified foods. It is reduced in the body to tetrahydrofolate, the active coenzyme required for DNA synthesis and amino acid metabolism. Adequate folate is critical in early pregnancy, where it reduces the risk of neural tube defects in the developing baby.

Methylcobalamin is one of the two active coenzyme forms of vitamin B12. It is a cofactor for methionine synthase, the enzyme that converts homocysteine to methionine (which is important for healthy nerve myelin). Vitamin B12 deficiency causes megaloblastic anaemia and a progressive peripheral neuropathy that can be irreversible if not treated.

Niacin (vitamin B3) is the precursor to nicotinamide adenine dinucleotide (NAD) and its phosphate form (NADP), coenzymes involved in over 400 enzymatic reactions, particularly those of energy metabolism and the oxidative stress response. NAD is also a substrate for cellular signalling enzymes (sirtuins) and DNA repair enzymes (PARPs). Severe niacin deficiency causes pellagra, characterised classically by dermatitis, diarrhoea, and dementia. Together, the three B vitamins support haematological, neurological, and metabolic health, and combined deficiency is particularly common in older adults, vegetarians and vegans, those on long-term acid-suppressing medication, and people with malabsorption.

• To prevent and manage dietary deficiency of folate, vitamin B12, and niacin.

• To support macrocytic (megaloblastic) anaemia related to folate or B12 deficiency.

• To support nerve function in peripheral neuropathy associated with B12 deficiency.

• To meet increased folate requirements in pregnancy and lactation, as advised.

• As a general nutritional supplement in conditions where B vitamin intake or absorption is reduced (older adults, vegetarians and vegans, malabsorption, post-bariatric surgery).

• Folic acid supports red blood cell formation and is critical in early pregnancy for normal neural tube development.

• Methylcobalamin is the active coenzyme form of B12, useful where conversion of cyanocobalamin to active forms may be limited.

• Niacin supports energy metabolism and normal nervous system function.

• Combined supplementation addresses three commonly co-occurring B-vitamin deficiencies in one dose.

• Generally well tolerated and suitable for daily use under medical guidance.

Common

• Mild gastrointestinal upset presenting as nausea and abdominal discomfort
• Flushing, warmth, or tingling of the face and upper body (most often from niacin)
• Headache
• Itching or mild rash

Uncommon

• Loose stools or constipation
• Sleep disturbance
• Dizziness

Serious side effects requiring immediate attention

• Severe allergic reaction (rash, swelling, breathing difficulty)
• Liver injury, which can manifest as yellowing of skin or eyes, dark urine or severe fatigue (especially with high-dose niacin)
• Pronounced flushing with dizziness or palpitations (high-dose niacin)
• Worsening of gout symptoms or new-onset gout (high-dose niacin)

Take Vitamin B9 (Folic Acid) + Vitamin B12 (Methylcobalamin) + Vitamin B3 (Niacin) orally with or just after a meal to reduce gastrointestinal upset and lessen niacin-related flushing. Swallow whole with water. Do not exceed the prescribed dose. If you experience niacin flushing, taking the dose with food and avoiding hot drinks or alcohol around the time of dosing can help. For severe B12 deficiency that maybe causing significant neurological symptoms, your doctor may use injectable form of B12 initially before transitioning to oral therapy.

Folic acid is absorbed in the small intestine and reduced to tetrahydrofolate (THF) with the help of the enzyme dihydrofolate reductase. THF and its derivatives carry single-carbon units used in the production of DNA bases (purines and thymidylate) and in amino acid metabolism. Therefore, folate is critical for rapidly dividing cells, including erythroblasts (red blood cell precursors in the bone marrow) and developing foetal tissue.

Methylcobalamin is the active cobalamin coenzyme that participates in the methionine synthase reaction. This enzyme transfers a methyl group from 5-methyltetrahydrofolate to homocysteine, regenerating methionine (and tetrahydrofolate). Methionine is then activated to S-adenosylmethionine (SAM), which is the body's universal methyl donor for DNA, protein, and lipid methylation. This methylation activity is essential for maintenance of nerve myelin (insulating sheath around nerves). This is why B12 deficiency causes damage to peripheral nerves and the spinal cord.

Niacin is converted to NAD and NADP, two coenzymes involved in hundreds of redox (oxidation–reduction) reactions, including those of glycolysis, the citric acid cycle, and fatty acid metabolism. NAD is also a substrate for enzymes involved in DNA repair (PARPs) and cell signalling (sirtuins). At high pharmacological doses (used historically to lower cholesterol), niacin also affects lipid metabolism, as described in a clinical study.

• Meals (BENEFICIAL): Lower niacin flushing and gastrointestinal upset.

• Alcohol around dosing (CAUTION): Worsens niacin flushing. Further, chronic alcohol intake increases the risk of liver disease.

• Very hot drinks around dosing (CAUTION): Can intensify niacin flushing.

• Methotrexate, sulfasalazine, trimethoprim (CAUTION): These have antifolate effects. Folate supplementation may be advised or specifically timed.

• Anticonvulsants such as phenytoin and phenobarbital (CAUTION): These can reduce folate and B12 levels. It can also affect the efficiency of anticonvulsants.

• Proton pump inhibitors and metformin (CAUTION): Long-term use can reduce B12 absorption.

• Statins (CAUTION): When combined with high-dose niacin, increased risk of myopathy and liver effects.

• Antihypertensives (CAUTION): Niacin can have additional blood-pressure-lowering effects, especially at higher doses.

• Liver disease (CAUTION): High-dose niacin can cause hepatotoxicity.

• Gout or hyperuricaemia (CAUTION): Niacin can raise uric acid and precipitate gout.

• Diabetes (CAUTION): High-dose niacin may worsen glycaemic control.

• Peptic ulcer disease (CAUTION): Niacin may aggravate ulcers.

• Untreated B12 deficiency with neurological symptoms (CONSULT YOUR DOCTOR): Folate alone can mask B12 deficiency and worsen neurological injury; ensure B12 is adequately treated.

Overdosing of Vitamin B9 (Folic Acid) + Vitamin B12 (Methylcobalamin) + Vitamin B3 (Niacin) can result in severe niacin-related flushing, dizziness, hypotension (low blood pressure), gastrointestinal upset, liver injury, and elevated uric acid. Further, intake of very high folate doses can mask underlying B12 deficiency. If you are suspecting an ov

If you miss a dose, take it as soon as you remember on the same day with a meal. If it is close to the next scheduled dose, skip the missed dose and continue. Do not double the dose.