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The dose that reaches fibroblasts is still low compared to what systemic delivery achieves

"Kenyan school children have multiple micronutrient deficiencies, but increased plasma vitamin B-12 is the only detectable micronutrient response to meat or milk supplementation"

B12 Deficiency in Thalassemia Patients: Prevalence and Causes B12 deficiency in thalassemia patients Thalassemia and B12 deficiency have a complex relationship

Serious adverse events are rare but include pituitary axis suppression with long-term high-dose use and worsening insulin resistance in patients with pre-existing glucose issues

This article examines the mechanisms of B12 uptake, practical guidance on supplement timing, and the clinical factors that affect how quickly deficiency can be corrected