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CAA progression is promoted as A deposition in vessel walls impairs endothelial mitochondrial function, reducing NO production and causing vasoconstriction

18 Support for the poorer bioavailability of cyano-B12 comes from a study comparing sublingual cyano- with methyl-B12 (both 1000 g per day), which found that both forms led to a normalisation of B12 status, but B12 levels increased significantly more in the methyl-B12 form compared with the cyano-B12 form, although the formulations also had other differences the former was a tablet, the latter a spray

The NIH Office of Dietary Supplements and the American Academy of Family Physicians identify the following groups as most vulnerable: Adults over 50 Age-related decline in stomach acid production reduces the ability to release B12 from food proteins

PubMed Philp, D., Badamchian, M., Scheremeta, B., Nguyen, M., Goldstein, A.L., & Kleinman, H.K

Third-party testing certificates and proper storage throughout the supply chain are indicators of quality sourcing