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Other markers are not commonly measured either in clinical practice or in many clinical trials, making it difficult to interpret whether positive outcomes in some studies are due to correcting a deficiency or due to other pharmacological functions of B12

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When stratified by administration route, the mean percentage changes were: Intramuscular (IM): 307% Oral: 285% Sublingual: 199% IM administration showed the highest average B12 increase, although oral and sublingual routes also yielded substantial improvements, supporting their use as effective and less invasive alternatives

This complication can induce malnutrition and compromise the patient's immune system, potentially impacting the long-term outcomes of individuals undergoing surgical treatment for malignant diseases (Koch et al

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