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Access depends on physician involvement and pharmacy sourcing

This may be considered for individuals with certain genetic variations, such as methylenetetrahydrofolate reductase (MTHFR) polymorphisms, although the clinical relevance can vary and typically requires genetic testing to confirm In contrast, cyanocobalamin is a synthetic form of vitamin B12 that must be converted before it can be utilized by the body and is less efficiently retained

[cited 2023 Jul 12]

These considerations reinforce the importance of patient selection, dosing strategy, and ongoing monitoring

The absorbed vitamin B12 then binds to transcobalamin II where approximately 50% of the vitamin B12 will be delivered to the liver and the remainder will be delivered to other tissues