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Although cyanocobalamin is more readily absorbed, much of it is excreted through the urine before it can reach the cells Cyanocobalamin vs Hydroxocobalamin In comparison to hydroxocobalamin, cyanocobalamin has a significantly worse absorption rate and storability, which is why today mostly hydroxocobalamin is used in B12 injections

Cobalamin deficiency can lead to neurological manifestations such as progressive axonal demyelination, impaired peripheral and sensory nerve function, areflexia, loss of proprioception and vibration sensitivity, and subacute combined spinal cord degeneration (, )

GIP receptor activation becomes more significant at the 4mg dose level and continues to increase through the dose range

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