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Importantly, The average molecular weight is approximately 290.32 g/mol

One systematic review found that 3.6% to 17.1% of patients remained deficient 1 year after surgery despite receiving recommended supplementation (6)

Underground forums report anecdotal side effects including joint pain, injection site reactions, and fatigue, though causality is unclear

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Skin Aging and Collagen Loss Skin aging involves several structural changes: reduced collagen synthesis increased collagen degradation decreased elastin integrity slower cellular turnover These processes contribute to wrinkles, skin laxity, and reduced resilience

chronic liver disease and hepatitis may present with elevated levels Renal impairment : Reduced clearance can contribute to accumulation, though this is rarely clinically significant Solid tumours : Certain malignancies, particularly hepatocellular carcinoma and metastatic disease, may elevate B12 levels [3] Evidence suggests that unexplained markedly elevated B12 levels without supplementation may sometimes be associated with underlying disease