Routes of Vitamin B12 Supplementation: Clinical Evidence, Limitations, and Practical Considerations
Introduction and purpose Vitamin B12 deficiency remains an underdiagnosed condition with significant hematological, neurological, and psychiatric consequences. The aim of this review is to evaluate and compare the efficacy, indications, and clinical applicability of oral, sublingual, intramuscular,...
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Nicolaus Copernicus University in Toruń
2025-08-01
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| Series: | Quality in Sport |
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| Online Access: | https://apcz.umk.pl/QS/article/view/62910 |
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| author | Alina Semianiuk Małgorzata Stopa Ewa Szczęsna Paweł Drymluch Wiktoria Lewicka Konrad Szaliński Izabella Sośniak Adrianna Moreń |
| author_facet | Alina Semianiuk Małgorzata Stopa Ewa Szczęsna Paweł Drymluch Wiktoria Lewicka Konrad Szaliński Izabella Sośniak Adrianna Moreń |
| author_sort | Alina Semianiuk |
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Introduction and purpose
Vitamin B12 deficiency remains an underdiagnosed condition with significant hematological, neurological, and psychiatric consequences. The aim of this review is to evaluate and compare the efficacy, indications, and clinical applicability of oral, sublingual, intramuscular, and subcutaneous vitamin B12 supplementation routes, and to provide evidence-based recommendations tailored to patient-specific conditions.
Brief description of the state of knowledge
Vitamin B12 is primarily absorbed in the distal ileum via an intrinsic factor-mediated mechanism. Deficiency is commonly caused by malabsorption syndromes, restrictive diets, medication use, and autoimmune disorders such as pernicious anemia. Intramuscular and subcutaneous administration bypass absorption defects and are considered the gold standard, especially in symptomatic patients. Oral and sublingual routes are increasingly used due to ease of use and cost-effectiveness. Sublingual supplementation, in particular, shows comparable biochemical efficacy to intramuscular injection and offers higher patient satisfaction. However, the variability in absorption and the use of surrogate biomarkers limit the consistency of clinical outcomes across studies.
Summary
All forms of vitamin B12 supplementation can be effective when used appropriately. Intramuscular administration remains superior in cases of severe deficiency and neurological involvement. Oral and sublingual supplementation are suitable for long-term maintenance and mild deficiencies, especially in patients with adherence capacity and no profound malabsorptive conditions. Clinical decision-making should be guided by etiology, severity, patient preference, and logistical feasibility.
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| format | Article |
| id | doaj-art-13b1ff89c8b74bf8bbde84e0c4083b86 |
| institution | Kabale University |
| issn | 2450-3118 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Nicolaus Copernicus University in Toruń |
| record_format | Article |
| series | Quality in Sport |
| spelling | doaj-art-13b1ff89c8b74bf8bbde84e0c4083b862025-08-20T03:42:05ZengNicolaus Copernicus University in ToruńQuality in Sport2450-31182025-08-014410.12775/QS.2025.44.62910Routes of Vitamin B12 Supplementation: Clinical Evidence, Limitations, and Practical ConsiderationsAlina Semianiuk0https://orcid.org/0009-0000-7300-7260Małgorzata Stopa1https://orcid.org/0000-0002-3456-2891Ewa Szczęsna2https://orcid.org/0009-0001-4767-7356Paweł Drymluch3https://orcid.org/0009-0003-1552-7737Wiktoria Lewicka4https://orcid.org/0000-0002-6459-419XKonrad Szaliński5https://orcid.org/0009-0000-2753-5353Izabella Sośniak6https://orcid.org/0009-0000-9438-6175Adrianna Moreń7https://orcid.org/0009-0002-9956-297XLower Silesian Center for Oncology, Pulmonology and Hematology in WroclawJ. Gromkowski Regional Specialist Hospital in WroclawLower Silesian Center for Oncology, Pulmonology and Hematology in WroclawRegional Specialist Hospital in WroclawLower Silesian Center for Oncology, Pulmonology and Hematology in WroclawUniversity Clinical Hospital named after Jan Mikulicz-Radecki in Wrocław Brothers Hospitallers Hospital in KrakówUniversity Clinical Hospital named after Jan Mikulicz-Radecki in Wrocław Introduction and purpose Vitamin B12 deficiency remains an underdiagnosed condition with significant hematological, neurological, and psychiatric consequences. The aim of this review is to evaluate and compare the efficacy, indications, and clinical applicability of oral, sublingual, intramuscular, and subcutaneous vitamin B12 supplementation routes, and to provide evidence-based recommendations tailored to patient-specific conditions. Brief description of the state of knowledge Vitamin B12 is primarily absorbed in the distal ileum via an intrinsic factor-mediated mechanism. Deficiency is commonly caused by malabsorption syndromes, restrictive diets, medication use, and autoimmune disorders such as pernicious anemia. Intramuscular and subcutaneous administration bypass absorption defects and are considered the gold standard, especially in symptomatic patients. Oral and sublingual routes are increasingly used due to ease of use and cost-effectiveness. Sublingual supplementation, in particular, shows comparable biochemical efficacy to intramuscular injection and offers higher patient satisfaction. However, the variability in absorption and the use of surrogate biomarkers limit the consistency of clinical outcomes across studies. Summary All forms of vitamin B12 supplementation can be effective when used appropriately. Intramuscular administration remains superior in cases of severe deficiency and neurological involvement. Oral and sublingual supplementation are suitable for long-term maintenance and mild deficiencies, especially in patients with adherence capacity and no profound malabsorptive conditions. Clinical decision-making should be guided by etiology, severity, patient preference, and logistical feasibility. https://apcz.umk.pl/QS/article/view/62910Vitamin B12cobalamin deficiencydietary supplementationclinical indications |
| spellingShingle | Alina Semianiuk Małgorzata Stopa Ewa Szczęsna Paweł Drymluch Wiktoria Lewicka Konrad Szaliński Izabella Sośniak Adrianna Moreń Routes of Vitamin B12 Supplementation: Clinical Evidence, Limitations, and Practical Considerations Quality in Sport Vitamin B12 cobalamin deficiency dietary supplementation clinical indications |
| title | Routes of Vitamin B12 Supplementation: Clinical Evidence, Limitations, and Practical Considerations |
| title_full | Routes of Vitamin B12 Supplementation: Clinical Evidence, Limitations, and Practical Considerations |
| title_fullStr | Routes of Vitamin B12 Supplementation: Clinical Evidence, Limitations, and Practical Considerations |
| title_full_unstemmed | Routes of Vitamin B12 Supplementation: Clinical Evidence, Limitations, and Practical Considerations |
| title_short | Routes of Vitamin B12 Supplementation: Clinical Evidence, Limitations, and Practical Considerations |
| title_sort | routes of vitamin b12 supplementation clinical evidence limitations and practical considerations |
| topic | Vitamin B12 cobalamin deficiency dietary supplementation clinical indications |
| url | https://apcz.umk.pl/QS/article/view/62910 |
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