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B12 injections go straight into your muscle and bloodstream, so your body takes up most of the dose, while oral B12 has to pass through your digestive system first, where only a small fraction of a tablet gets absorbed

10.1093/toxsci/kfj111 63 KlicekR.KolencD.SuranJ.DrmicD.BrcicL.AralicaG.et al (2013)

NNMT is expressed in some cancer cells, which makes interpretation of inhibition complex: effects could differ by cancer type or stage, and the data are largely from models rather than long-term human study

Your provider must attest to your BMI and qualifying conditions at initiation

However, seek urgent medical advice if you experience severe persistent abdominal pain, continuous vomiting, or signs of dehydration