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A licensed clinician must prescribe it, and a licensed pharmacist must compound it for individual patient use

The conversion is not a simple mg-to-mg translation because of the different receptor profiles and potencies

Therefore,

Oral supplements face challenges in the digestive system, where absorption can be low, mainly in those with certain gut issues

The lack of adequate cobalamin in the body hinders the regeneration of tetrahydrofolate, which eventually leads to megaloblastic anemia due to the functional folate deficiency.[9][10] On the other hand, the methylmalonyl-CoA mutase helps to metabolize odd chain fatty acids and branch chain amino acids.[5] Cobalamin is also thought to keep the bodys level of sulfhydryl (SH) groups in reduced form