It's whether the evidence of benefit outweighs the evidence of harm at a population scale, across diverse patients, over meaningful time horizons
Although cyanocobalamin is more readily absorbed, much of it is excreted through the urine before it can reach the cells Cyanocobalamin vs Hydroxocobalamin In comparison to hydroxocobalamin, cyanocobalamin has a significantly worse absorption rate and storability, which is why today mostly hydroxocobalamin is used in B12 injections
Vakil N, Kahrilas P, Magner D, Skammer W, Levine J
BPC-157 delivers the localized signal
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It seems that B12 from meat, chicken and fish is not as well absorbed as we thought