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When stratified by administration route, the mean percentage changes were: Intramuscular (IM): 307% Oral: 285% Sublingual: 199% IM administration showed the highest average B12 increase, although oral and sublingual routes also yielded substantial improvements, supporting their use as effective and less invasive alternatives

A 2025 meta-analysis of 16 studies involving 6,098 participants found no statistically significant difference between intramuscular, oral, and sublingual B12 supplementation routes

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