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This is likely due to the role of vitamin B12 in energy production and metabolism

Because the vitamin deposits into muscle rather than entering the vasculature immediately, intramuscular delivery produces a sustained release effect

However, since this is ineffective red blood cells the person continues to have anemia and develops bone thinning and facial abnormalities

Several vitamin deficiencies can contribute to joint and knee discomfort

[1] Those who cannot digest or absorb B12 as a result of inherited genetics or damage to the stomach and small intestine require more than can be absorbed from sublingual supplementation