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When stratified by administration route, the mean percentage changes were: Intramuscular (IM): 307% Oral: 285% Sublingual: 199% IM administration showed the highest average B12 increase, although oral and sublingual routes also yielded substantial improvements, supporting their use as effective and less invasive alternatives

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While necessary for purification and stability, high concentrations of some counter-ions, particularly TFA, can have their own biological effects (e.g., cytotoxicity in sensitive assays)

At the same time, things like hormonal changes, friction, and even certain products can spark melanin production too

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