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However, if you have autoimmune thyroid disease like Hashimoto's disease (the most common cause of hypothyroidism or underactive thyroid), you may have more difficulty absorbing B12 in your gut

In another study 13 of patients with known pernicious anemia who had not received maintenance vitamin B 12 injections for months to years, the rise of methylmalonic acid and homocysteine levels was found to precede the decrease in serum vitamin B 12 and the decline in hematocrit

Dosing regimen differences further complicate comparative analysis

Calderon-Ospina, C.A., M.O

It is not approved for human consumption or medical application