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Hogan, K

Oral Supplementation Studies suggest that about 56% of an oral B12 supplement is absorbed, but this is largely dependent on the capacity of intrinsic factor (a glycoprotein released by the stomach that is needed for B12 absorption)

Hormonal birth control: Other GLP-1 medications have been shown to potentially decrease the efficacy of oral birth control pills

each case is judged individually.11 Solid evidence on the safety of parenteral, lifelong, high dose hydroxocobalamin is available from decades of treating patients with inborn errors of B 12 metabolism (eg, cobalamin C deficiency).6768 Symptom monitoring Monitor symptoms regularly (eg, every two to three months) as they may reappear, even after several months, if injection frequency is reduced