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If you get digestive symptoms after taking B12, often there is a bacterial overgrowth or possibly fungal overgrowth creating the digestive symptoms

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5-Amino-1MQ (5-amino-1-methylquinolinium) is a small-molecule inhibitor of nicotinamide N-methyltransferase (NNMT), an enzyme that methylates nicotinamide using S-adenosyl methionine (SAM)

In the duodenum, pancreatic enzymes cleave B12 from R-proteins, allowing binding to intrinsic factor produced by gastric parietal cells

In other situations, lab testing is very important

The detailed uses of Methycobal 500 MCG Injection 5 x 1 ml are as follows: Caution It is advisable to avoid or limit alcohol while on methylcobalamin injections