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To be absorbed, the vitamin needs to be attached to a protein called intrinsic factor
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Multi-dose use requires careful storage and handling during repeated vial access
In one published case, an active, lean-adjacent man lost about one-third of his total weight as muscle on 2.5 mg and recovered it after adding resistance training and increasing protein. This is a cautionary case, not an incidence estimate
This is particularly relevant for oral administration, which is subject to intrinsic factor saturation and receptor limitations in the ileum ( Moreover, our results highlight the essential role of vitamin B12 in homocysteine metabolism, as supplementation was associated with a significant reduction in serum homocysteine levelsan important biomarker associated with cardiovascular and neurodegenerative diseases
