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The compound's high membrane permeability and metabolic stability make it suitable for both acute and chronic study designs, but researchers should be aware that its effects on NAD+ and methylation metabolism may require time to fully manifest

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doi:10.1016/j.ymgme.2009.04.005

Because B12 is water-soluble, the NIH Office of Dietary Supplements notes that no tolerable upper intake level has been established excess B12 is excreted by the body rather than accumulating to toxic levels

Patients should be offered this alternative after an informed discussion on the advantages and disadvantages of both treatment options. oral vitamin B12 is an effective alternative to vitamin B12 IM injections Cochrane Review