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Because of these roles, B12 is fundamental to: Red blood cell formation : Preventing macrocytic anemia and ensuring efficient oxygen transport Myelin synthesis : Maintaining the protective sheath around nerve fibers for rapid signal transmission DNA replication and repair : Supporting healthy cell division across all tissues, particularly the gastrointestinal lining and bone marrow Without adequate B12, you may experience fatigue, neurological symptoms, and hematologic problems that progressively worsen over time

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Pregnancy and breastfeeding contraindicate its use due to potential fetal effects

So, we recommend using SL vitamin B12 rather than oral and IM, especially in patients who do not tolerate IM injection and patients who need prolonged vitamin B12 supplementation, such as patients with long-term metformin use and patients with pernicious anemia or with gastro-duodenal resection [5154]

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