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It does not require hepatic conversion

The clinical vignettes were a proxy for patient records with the most common and challenging cases HHAs would encounter, similar to the approach that we use to train HHAs on all new assessment items, and the results demonstrated strong agreement

Finally, a recent 2021 study performed in a paediatric population (03 years) in Turkey found that a sublingual methyl-Cbl treatment regimen, comprising 1 mg daily replacement for a week followed by every other day for 2 weeks, 2 days/week for 2 weeks and once a week for 3 months was as effective as similar dose schedules of IM and oral CN-Cbl at normalising B12 levels (Orhan Kili et al., 2021)

Banerji N, Kapur V, Kanjilal S (2007): Association of germ-line polymorphisms in the feline p53 gene with genetic predisposition to vaccine-associated feline sarcoma

In this systematic review, Pratama and colleagues highlight the paucity of studies specifically in those with metformin-induced B12 deficiency and the lack of guidance on best approaches to supplementation for treatment or prevention

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