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Some sources suggest subcutaneous injection provides more reliable absorption

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Its a demanding route, especially because of the elevation change: you descend 1,500 meters and then climb back up the same amount

Nevertheless, studies utilizing more specific biomarkers of vitamin B 12 status, including measures of holo-transcobalamin and methylmalonic acid, have shown more consistent results and a trend towards associations between poor vitamin B 12 status and faster cognitive decline and increased risk of Alzheimers disease (82-86)