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Sublingual B12 was administered in laboratory conditions, where there was no dose omission, making it difficult to extrapolate real-world effects, where patient compliance may not be as good

It also gives laboratories a clearer way to separate this format from single-compound products that do not offer the same paired-pathway perspective

18 Support for the poorer bioavailability of cyano-B12 comes from a study comparing sublingual cyano- with methyl-B12 (both 1000 g per day), which found that both forms led to a normalisation of B12 status, but B12 levels increased significantly more in the methyl-B12 form compared with the cyano-B12 form, although the formulations also had other differences the former was a tablet, the latter a spray