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Diabetes lowers exposure by about 15% and blunts the downstream response. Lean, metabolically healthy users sit outside every efficacy trial
They are often used for people who have difficulty absorbing B12 from food or supplements due to conditions like pernicious anemia, gastrointestinal disorders (e.g., Crohns disease, celiac disease), or after certain surgeries (e.g., gastric bypass)
Long-term safety monitoring includes periodic laboratory testing, but the medication appears safe for extended use in appropriate candidates
Research backs some of the hype: Studies show benefits for bone density, circulation, and muscle activation, 26 27 28 along with improved strength, mobility, and balance in older adults
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