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Vitamin B12 deficiency that is allowed to progress for longer than 3 months may produce permanent degenerative lesions of the spinal cord

A 2025 meta-analysis of 16 studies involving 6,098 participants found no statistically significant difference between intramuscular, oral, and sublingual B12 supplementation routes (p=0.270)

The FDA recommends mixing the medication with an undesirable substance (used coffee grounds, dirt, or cat litter) in a sealed bag before disposing in household trash

Vitamin B 12 can also be absorbed by passive diffusion, but this process is very inefficient only about 1% to 2% of the oral vitamin B 12 dose is absorbed passively (2)