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For those with a B12 deficiency and an MTHFR mutation, one major advantage of B12 injections is that they are readily absorbed in the body and do not have to be taken as often as oral tablets

[5] [6] Methylcobalamin is available as an unlicensed supplement but is not a routinely recommended medicinal product in the UK and should not be substituted for licensed preparations without clinical advice

These patients face elevated b12 deficiency risk regardless of medication use

References Oh R, Brown DL

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Understanding NNMT Inhibition and Metabolic Function The NNMT enzyme plays a crucial role in cellular metabolism by regulating the conversion of nicotinamide to 1-methylnicotinamide (1-MNA)