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For enhanced uptake, spray once under the tongue and delay swallowing before repeating SUPERIOR ABSORPTION - sublingual delivery boosts absorption by delivering vitamin B12 directly into the bloodstream via passive diffusion under the tongue, bypassing absorption challenges in the gut to achieve higher B12 levels* THREE BIOACTIVE B12 FORMS - we provide naturally occurring and bioactive forms of B12 methylated B12 as methylcobalamin, plus adenosylcobalamin & hydroxocobalamin (no synthetic cyanocobalamin) to achieve higher B12 uptake* PURE & CLEAN: vegan, non-GMO, hypoallergenic ingredients, with no sugars, artificial flavors, sweeteners or unpleasant additives

Some antibiotics, like chloramphenicol, can mess with B12 metabolism

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excess is renally excreted, though very high levels can cause dermatologic or metabolic effects

The patient had no history of allergic disease

That is generally the case, yes