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Macrocytic anaemia characterised by abnormally large red blood cellsdevelops as B12 deficiency impairs DNA synthesis

7,8 Alterations in DNA damage-response pathways have been further associated with immune deficiency, infertility, premature aging and the development of atherosclerosis

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However, the pharmacokinetic parameters after repeated IM administration changed slightly compared to those observed after a single IM injection, with a small decrease in C max and t 1/2 and an increase in T max

A 500 mcg oral dose might deliver the biological equivalent of 50 mcg or less via injection