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Running out mid-protocol means starting the titration process over, which wastes time and money

Values range from about 8 to 30 minutes after intravenous or intramuscular dosing

Theoretical and route-specific risks FDA's 2024 review specifically flagged that no published human exposure data exists for the subcutaneous, transdermal, or intranasal routes that compounding pharmacies have offered

Those most at risk include vegans and vegetarians, people with digestive conditions such as Crohn's disease, coeliac disease or IBS, those taking long-term metformin or proton pump inhibitors, older adults whose ability to absorb B12 through the gut declines naturally with age, those with pernicious anaemia, and anyone with a history of chronic alcohol use