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Therefore, the aim of this study was twofold: 1) to assess vitamin B12 serum levels in ME/CFS patients before and after use of high dose vitamin B12 nasal drops and 2) to compare the changes in function before and after starting therapy, using an activity meter, the physical functioning score of the Rand 36 questionnaire, and both the fatigue and concentration scales of CIS20r questionnaire

However: Bioavailability is still significantly lower than injection (estimated 5-25%) Absorption is highly variable based on saliva production, food timing, and individual anatomy Higher doses are needed to compensate for lower absorption, increasing cost No clinical trials have validated sublingual CJC-1295/Ipamorelin dosing For patients who absolutely can't tolerate injections, sublingual may be worth discussing with your physician, but expectations should be adjusted accordingly

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The B-12 injection is typically quick and designed to fit easily into a clinic visit