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These polymorphisms are unrelated to cobalamin metabolism and the elevated MMA levels do not, by themselves, indicate a B12 deficiency (Molloy, 2016)

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Salinas et al 27 The traditional treatment of vitamin B 12 deficiency is the intramuscular injection of cyanocobalamin, generally, 1 mg/d for 1 week, followed by 1 mg/wk for 1 month, and then 1 mg every 1 or2 months ad perpetuum

Phase II Clinical Trials These promising preclinical findings led to Phase I and Phase II clinical trials in humans

Cold water slows dissolution and can cause the powder to clump rather than dissolve evenly