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According to the 2025 meta-analysis by Alfalasi and colleagues, sublingual B12 showed an approximate 199% mean increase in serum B12 compared to approximately 307% for intramuscular injections
In SLE, dysregulated autophagy contributes to immune hyperactivation, defective apoptotic cell clearance, and increased autoantigen availability
This differs from sterile water, which contains no preservative and is generally intended for single-use applications
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Published work on intranasal peptide delivery (for insulin analogs, calcitonin, and oxytocin) demonstrates that bioavailability for this size class without enhancers is typically in the low single-digit percent range, though these data are from different peptides with different charge profiles
