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Oral supplements must be absorbed through the digestive tract, which can be an inefficient process, especially for individuals with absorption issues

Excellent dietary sources include: Liver and organ meats : Beef liver provides approximately 70 mcg per 100gfar exceeding daily needs Shellfish : Clams, mussels, and crab are exceptionally rich sources Fish : Salmon (5 mcg per 100g), trout, tuna, and mackerel provide substantial amounts Meat and poultry : Beef, lamb, and chicken contain 13 mcg per 100g Dairy products : Milk (0.4 mcg per 100ml), cheese, and yoghurt contribute meaningfully Eggs : One large egg provides approximately 0.6 mcg For vegans and vegetarians , reliable B12 sources are essential as plant foods contain no bioavailable B12 (despite some claims about algae or fermented products)

Bacterial richness measured by the unique ASV counts observed did not significantly differ between treatment groups (Fig

This surplus of electron donors in the mitochondrial electron transport chain can overwhelm and impair mitochondrial complex I (Yan et al., 2016)

Only one patient did not tolerate the oral form