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Early evidence for the potential efficacy of this route was published in 1999, where 18 patients with B12 deficiency treated exclusively with 712 days of 2 mg of sublingual cobalamin daily had 4 times higher B12 levels compared to pre-treatment, reaching therapeutic ranges ( There have also been further studies comparing treatment outcomes from the sublingual route to the more established IM and oral routes

It activates key transcription factors such as Nrf2, thereby significantly enhancing the activity of endogenous antioxidant enzymes including superoxide dismutase (SOD), catalase, and glutathione peroxidase ( 2.2.2 Anti-inflammatory and analgesic effects One characteristic of osteoarthritis is persistent low-grade inflammation within the synovium and cartilage

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