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A 2025 meta-analysis of 16 studies involving 6,098 participants found no statistically significant difference between intramuscular, oral, and sublingual B12 supplementation routes (p=0.270)
Nature Reviews Endocrinology, 16(3), 135-146
People with malabsorption problems or certain health conditions may need B12 injections more often to maintain their levels
Although fundamental 5A-1MQ and LD-mediated changes to the microbiome were identified, this work is similar to many current studies where further investigations will clarify if changes in the microbiome are causative or associative 100
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