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Supplementation strategies vary depending on the underlying cause of deficiency or risk factors: Oral supplements (typically 25-2000 micrograms daily) are suitable for individuals with adequate intrinsic factor production but insufficient dietary intake Sublingual or buccal preparations have no proven superiority over standard oral tablets at equivalent doses Intramuscular injections (usually 1000 micrograms of hydroxocobalamin) are the preferred treatment for pernicious anaemia and severe malabsorption

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It was shown that BRCA1 occupied the NNMT promoter and regulating its expression ( BRCA1 and CDK12 depletion contribute to mitochondrial respiration defects and decreased ATP levels due to the reduced mitochondrial DNA copy number rather than mitochondrial number, which suggest that they stem from decreased flux through electron transport complexes rather than a decrease in mitochondria (66)

doi: 10.1002/jps.20094 195 PardridgeW

Critics, including the FDA's own scientific staff, argue that insufficient evidence exists to ensure these compounds are safe for human use