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Sublingual absorption bypasses potential GI absorption issues the B12 absorbs directly through the mucous membranes under your tongue, avoiding the intrinsic factor pathway that can be impaired by low stomach acid, metformin use, or age-related GI changes

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[DOI] [PMC free article] [PubMed] [Google Scholar] 382.Cheah E, Wu Z, Thakur SS, OCarroll SJ, Svirskis D

B12 absorption specifically depends on several coordinated steps that rely on normal gastric acid production and transit timing

Dickenson AH, Sullivan AF (1987) Evidence for a role of the NMDA receptor in the frequency dependent potentiation of deep rat dorsal horn nociceptive neurons following C fibre stimulation