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Omeprazole and other PPIs reduce dietary B12 absorption (less critical with nasal forms but still relevant to overall status)
Animal vs
A useful overview of that link is in microbiota-immune, which explains how microbes steer immune behavior
Cyanocobalamin, the most common, readily available and stable form of artificial vitamin B12, tends to get largely and extensively destroyed by the rumen microbes so that very little of it, if any, gets utilized in a cows body beyond the rumen
Common themes include rapid onset of anti-inflammatory effects (often within days), gradual improvement in function over weeks, and best results when combined with appropriate physical therapy and lifestyle modifications
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