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For patients whose prior B12 supplementation hasn't worked, injection is the solution not a higher oral dose

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There is a similar beneficial effect in the rats with the Pringle maneuver, ischemia, reperfusion, and suprahepatic inferior caval vein occlusion (BuddChiari syndrome) (Kolovrat et al., 2020)

Several mechanisms contributing to increased oxidative stress in the diabetic milieu have been proposed, including glucose auto-oxidation, weakened antioxidant defense systems, metabolic abnormalities, and mitochondrial damage [45,46,47]

A 2026 biopharmaceutical review in a journal I do not trust said there is no identified high-affinity receptor, no validated molecular target, and a wide disconnect between the tidy preclinical effects and any coherent pharmacology

Pregnancy/Breastfeeding: Safe when prescribed by a doctor, but consult before use