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Pharmacokinetics: Cyanocobalamin is administered intranasally, orally, and parenterally, while hydroxocobalamin is administered only parenterally. Once absorbed, vitamin B12 is highly bound to transcobalamin II, a specific B-globulin carrier protein and is distributed and stored primarily in the liver as coenzyme B12. The bone marrow also stores a significant amount of the absorbed vitamin B12. This vitamin crosses the placenta and is distributed into breast milk. Enterohepatic recirculation conserves systemic stores. The half-life is about 6 days (400 days in the liver). Elimination is primarily through the bile; however, excess cyanocobalamin is excreted unchanged in the urine

Kanwal et al., 2024

This will allow your body to adjust to the medication and help reduce side effects

Involvement of OCTN1 (SLC22A4) in pH-dependent transport of organic cations

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IGF-1 LR3, by extending IGF-1like signaling, is used to assess how sustained pathway activation affects the timing and quality of differentiation events