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Historically, sublingual and buccal delivery faced challenges due to low permeability for large molecules, enzymatic degradation, and limited residence time on the mucosa
[1] [3] Patients with dietary deficiency and intact absorption may require less frequent injections or may be suitable for high-dose oral supplementation instead (typically 50-150 micrograms of cyanocobalamin daily between meals)
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It also influences gene expression patterns that control whether cells store or burn fat
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