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Even with oral supplementation, deficiencies may persist due to reduced intrinsic factor or altered digestion

This makes it particularly interesting for central obesity, metabolic syndrome, and body composition optimization

One important limitation: the clinical weight loss results were modest

For example, FDA labeling for cyanocobalamin injection includes contraindications (such as hypersensitivity) and important warnings (see the FDA prescribing information for cyanocobalamin injection )

Topical formulations require penetration enhancers or vehicle optimization, and in vivo data suggest lower bioavailability compared to subcutaneous administration