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I take esomaprazole for heartburn and this can reduce the ability to absorb vit b12 hence mt taking the oral spray

This work was supported by the Department of Defense Peer Reviewed Medical Research Program grant PR141776 (S.J.W.), University of Texas Medical Branch Technology Commercialization Award (S.J.W), and NIH grant R01GM112936 (C.C.F)

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Similar to the effect on cartilage cells, in vitro studies have demonstrated cytotoxic effects of local anaesthetics such as lidocaine and bupivacaine on tenocytes (tendon cells)

Best for: Chronic fatigue and low energy Mitochondrial dysfunction Supporting cellular energy (ATP production) Combining with methyl-B12 for comprehensive support Advantages: Directly supports energy production Doesnt add methyl groups (wont cause overmethylation) Essential for mitochondrial function Complements methylcobalamin well Potential downsides: Doesnt directly support methylation Less commonly available as standalone supplement Often needs to be combined with other B12 forms Typical dosage: 1000-3000mcg daily 4