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However, preclinical studies demonstrate therapeutic effects with once-daily or even less frequent administration, suggesting tissue distribution, receptor binding, or cellular signaling effects extend beyond plasma clearance

The first is to promote resistance to the colonization of harmful or pathogenic bacteria species by competing for nutrients, occupying attachment sites, and releasing antimicrobial substances (23, 24)

Several conditions interfere with the guts ability to absorb cobalamin effectively: Inflammatory bowel disease: Chronic inflammation of the small intestinal lining damages the cells responsible for absorbing nutrients, including B12

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When fatigue occurs, it typically resolves within the first few weeks