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While direct cortisol measurements were not specifically reported in the published safety trials, the comprehensive metabolic monitoring across 900+ participants showed no clinically significant hormonal changes, and the mechanism of action provides no pathway for cortisol stimulation
Cochrane Database Syst Rev 2018
The upper arm will be cleaned and prepared and a small needle will be used to administer the B12 intramuscularly
High-dose oral therapy (10002000 micrograms daily) can be effective even in pernicious anaemia, as approximately 1% of B12 is absorbed through passive diffusion independent of intrinsic factor
Clinical trials have utilized doses ranging from 1 mg per day up to 30 mg per day in divided doses for various administration routes, demonstrating safety across a wide dose spectrum
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