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The complex travels through the small intestine until it reaches the terminal ileum, where specialised receptors called cubam (a complex of cubilin and amnionless proteins) recognise and facilitate the uptake of the B12-IF complex into enterocytes (intestinal cells)
Because adequate, well-controlled studies in pregnant individuals are lacking, use should be limited to circumstances in which the potential maternal benefit clearly outweighs theoretical fetal risk-such as treatment of documented systemic carnitine deficiency
B12 injections are often given for conditions such as pernicious anemia or after stomach surgery, where stopping can allow nerve damage to develop
The FDA advisory committee's vote is not a final approval, but a recommendation
While B12 is not a stimulant, weight-loss medication, or a cure for fatigue, patients who are low or borderline low in B12 may feel better once their levels are supported
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