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2021;11:e049390

As damage from smoking or even pollution accumulates to the respiratory tract and the lungs, oxygen and carbon dioxide (CO2) exchange suffers, making it difficult to breathe

5 Conclusion This systematic review and meta-analysis indicate that sublingual and oral vitamin B12 administration provide efficacy comparable to intramuscular injection in improving serum cobalamin levels and reducing hyperhomocysteinaemia

Anaphylactic shock and death have been reported with administration of parenteral Vitamin B12 (see WARNINGS)

This form of B12 has been used safely for decades to treat B12 deficiency and is approved by regulatory agencies like the FDA