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The remaining difference can be explained by the well-known differences in the barrier function of skin models and human skin 46

Aside from vegetarians, people at risk for a deficiency include those with pernicious anemia, people who have had intestinal surgery such as gastric bypass, those with Crohns or celiac disease, and anyone whose stomach does not produce enough hydrochloric acid to absorb the vitamin B12 thats naturally present in food

The oral vs injection comparison shows that efficacy appears similar in clinical studies, though oral formulations have their own considerations including specific fasting requirements and potentially different GI side effect profiles

Fertility considerations Endometriosis and fertility are deeply intertwined, with 30 to 50% of affected individuals experiencing difficulty conceiving