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The delayed-release formula is intended to reach the lower intestines without succumbing to the harsh environment of the upper digestive system.* Historically, peptides have been notoriously difficult to absorb orally

Additionally, accumulation of cyanocobalamin metabolites may occur in severe renal impairment, though this is rarely clinically significant

For people without diabetes who are not on blood-sugar-lowering medication, alcohol's hypoglycemic effect is a lower concern