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The Science Behind Sublingual Absorption Sublingual delivery works because the tissue under your tongue is: Highly vascularized (rich in blood vessels) Thin and permeable to nutrients Connected directly to systemic circulation Not subject to first-pass metabolism This allows B12 to enter your bloodstream almost as efficiently as an injection, without the needle

In practice for clinicians, it is important to note that certain complications of vitamin B12 deficiency, in particular psycho-neurological and hematological complications are potentially serious, as seen in Table 1, and therefore require investigation in all patients who present with vitamin or nutritional deficiency