{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:44:50Z","timestamp":1790034290140,"version":"4.0.1"},"reference-count":62,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Vitamin B12 deficiency is a widespread condition, particularly among elderly individuals, patients with malabsorption syndromes, and those following plant-based diets. This systematic review and meta-analysis aimed to evaluate and compare the effectiveness of sublingual and oral vitamin B12 administration in comparison with intramuscular (IM) injections, both for improving serum cobalamin and reducing homocysteine levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive search was conducted across PubMed, Scopus, and Embase up to July 2024. Eligible studies included randomised controlled trials, cohort, and case-control studies assessing B12 supplementation efficacy via oral, sublingual, or IM administration routes. Meta-analyses were performed using random-effects models. Subgroup analyses evaluated four key factors: administration route efficacy, daily dosage, age group and clinical conditions that may affect vitamin B12 metabolism (e.g., underlying pathology). Sixteen studies were included in the quantitative synthesis, comprising a total of 6,098 participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Vitamin B12 supplementation was associated with a significant increase in serum cobalamin levels across all routes of administration (pooled mean difference = +402.6\u00a0pg\/mL; 95% CI: 293.6 to 511.5; p &amp;lt; 0.001). Homocysteine levels were also significantly reduced across all groups (pooled mean difference = \u22124.83\u00a0\u03bcmol\/L; 95% CI: \u22126.55 to \u22123.11; p &amp;lt; 0.001). No statistically significant differences were observed between oral, sublingual, and intramuscular (IM) routes of administration (p = 0.270 for cobalamin levels and p = 0.485 for homocysteine levels), nor between randomised controlled trials and observational studies (p = 0.268 for cobalamin levels). No dose-response effect was observed (p = 0.485), suggesting that absorption efficiency rather than dosage may be the determining factor. Subgroup analyses by age and clinical conditions (e.g., gastrectomy, unspecified deficiency) revealed comparable efficacy across populations. However, heterogeneity was substantial (I\n                      <jats:sup>2<\/jats:sup>\n                      &amp;gt; 80% in most comparisons), and Egger\u2019s test indicated potential publication bias. Given the high heterogeneity, further studies are needed to confirm the results.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sublingual and oral B12 supplementation appear to be as effective as intramuscular (IM) injections in improving cobalamin status and reducing homocysteine levels. Given their non-invasive nature, accessibility, and cost-effectiveness of sublingual formulations, they may represent a promising approach for long-term B12 management, particularly in patients with impaired absorption or in resource-limited settings. Further high-quality RCTs are warranted to refine dosing strategies and confirm long-term outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>CRD42024554513.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2025.1602976","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T05:17:38Z","timestamp":1766121458000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Efficacy of sublingual and oral vitamin B12 versus intramuscular administration: insights from a systematic review and meta-analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Marta","family":"Mazur","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Artnora","family":"Ndokaj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Salerno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Vallone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"Ardan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabina","family":"Bietolini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"Carrouel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Wilk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Sarig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Livia","family":"Ottolenghi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Bourgeois","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1097\/00000658-200008000-00008","article-title":"Enteral vitamin B12 supplements reverse postgastrectomy B12 deficiency","volume":"232","author":"Adachi","year":"2000","journal-title":"Ann. Surgery"},{"key":"B2","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1080\/088800199277489","article-title":"Vitamin B12 absorption test and oral treatment in 14 children with selective vitamin B12 malabsorption","volume":"16","author":"Altay","year":"1999","journal-title":"Pediatr. Hematology Oncology"},{"key":"B3","doi-asserted-by":"publisher","first-page":"365","DOI":"10.4103\/jpn.JPN_130_19","article-title":"Various neurological symptoms with vitamin B12 deficiency and posttreatment evaluation","volume":"15","author":"Ar\u0131can","year":"2020","journal-title":"J. Pediatr. Neurosci."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1041","DOI":"10.1002\/ncp.10596","article-title":"Lingual linear lesions: a clinical sign strongly suggestive of severe vitamin B12 deficiency","volume":"36","author":"Bao","year":"2021","journal-title":"Nutr. Clin. Pract."},{"key":"B6","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1007\/s13346-018-00613-y","article-title":"Comparison of sublingual vs. intramuscular administration of vitamin B12 for the treatment of patients with vitamin B12 deficiency","volume":"9","author":"Bensky","year":"2019","journal-title":"Drug Delivery Translational Research"},{"key":"B7","doi-asserted-by":"publisher","first-page":"3124","DOI":"10.1016\/s0149-2918(03)90096-8","article-title":"Oral versus intramuscular cobalamin treatment in megaloblastic anemia: a single-center, prospective, randomized, open-label study","volume":"25","author":"Bolaman","year":"2003","journal-title":"Clin. Therapeutics"},{"key":"B8","doi-asserted-by":"publisher","first-page":"571","DOI":"10.3945\/ajcn.2009.28082","article-title":"Daily intake of 4 to 7 \u03bcg dietary vitamin B-12 is associated with steady concentrations of vitamin B-12\u2013related biomarkers in a healthy young population","volume":"91","author":"Bor","year":"2010","journal-title":"Am. Journal Clinical Nutrition"},{"key":"B9","doi-asserted-by":"publisher","first-page":"109931","DOI":"10.1016\/j.ijscr.2024.109931","article-title":"Oral manifestations of vitamin B12 deficiency associated with pernicious anemia: a case report","volume":"121","author":"Boukssim","year":"2024","journal-title":"Int. J. Surg. Case Rep."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1341","DOI":"10.1111\/j.1398-9995.2007.01389.x","article-title":"Allergy to vitamin B12: two cases of successful desensitization with cyanocobalamin","volume":"62","author":"Caballero","year":"2007","journal-title":"Allergy"},{"key":"B11","doi-asserted-by":"publisher","first-page":"2214","DOI":"10.1182\/blood-2008-03-040253","article-title":"How I treat cobalamin (vitamin B12) deficiency","volume":"112","author":"Carmel","year":"2008","journal-title":"Blood, J. Am. Soc. Hematol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1007\/s11901-006-0019-7","article-title":"Diagnosis and management of clinical and subclinical cobalamin deficiency: advances and controversies","volume":"5","author":"Carmel","year":"2006","journal-title":"Curr. Hematology Reports"},{"key":"B13","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1016\/j.clinthera.2011.03.003","article-title":"Comparing the efficacy and tolerability of a new daily oral vitamin B12 formulation and intermittent intramuscular vitamin B12 in normalizing low cobalamin levels: a randomized, open-label, parallel-group study","volume":"33","author":"Castelli","year":"2011","journal-title":"Clin. Therapeutics"},{"key":"B14","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1111\/j.1365-2141.2000.02238.x","article-title":"A history of pernicious anaemia","volume":"111","author":"Chanarin","year":"2000","journal-title":"Br. Journal Haematology"},{"key":"B15","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1111\/scd.12685","article-title":"Recognition and management of vitamin B12 deficiency: report of four cases with oral manifestations","volume":"42","author":"da Silva","year":"2022","journal-title":"Special Care Dent."},{"key":"B16","doi-asserted-by":"publisher","first-page":"S238","DOI":"10.1177\/15648265080292S129","article-title":"Conclusions of a WHO technical consultation on folate and vitamin B12 deficiencies","volume":"29","author":"de Benoist","year":"2008","journal-title":"Food Nutrition Bulletin"},{"key":"B17","doi-asserted-by":"publisher","first-page":"37","DOI":"10.20982\/tqmp.11.1.p037","article-title":"A practical tutorial on conducting meta-analysis in R","volume":"11","author":"Del","year":"2015","journal-title":"Quant. Meth Psych."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1504","DOI":"10.1093\/ajcn\/nqaa221","article-title":"Measuring vitamin B-12 bioavailability with [13C]-cyanocobalamin in humans","volume":"112","author":"Devi","year":"2020","journal-title":"Am. J. Clin. Nutr."},{"key":"B19","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1159\/000346968","article-title":"Systematic review on daily vitamin B12 losses and bioavailability for deriving recommendations on vitamin B12 intake with the factorial approach","volume":"62","author":"Doets","year":"2013","journal-title":"Ann. Nutr. Metabolism"},{"key":"B20","doi-asserted-by":"publisher","first-page":"4150","DOI":"10.2903\/j.efsa.2015.4150","article-title":"Scientific opinion on dietary reference values for cobalamin (vitamin B12)","volume":"13","year":"2015","journal-title":"EFSA J."},{"key":"B21","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"Egger","year":"1997","journal-title":"BMJ"},{"key":"B22","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1111\/j.1600-0714.1995.tb01136.x","article-title":"Oral signs and symptoms in patients with undiagnosed vitamin B12 deficiency","volume":"24","author":"Field","year":"1995","journal-title":"J. Oral Pathology & Medicine."},{"key":"B23","doi-asserted-by":"publisher","first-page":"13186","DOI":"10.1074\/jbc.R113.458810","article-title":"Navigating the B12 road: assimilation, delivery, and disorders of cobalamin","volume":"288","author":"Gherasim","year":"2013","journal-title":"J. Biol. Chem."},{"key":"B24","doi-asserted-by":"publisher","first-page":"2603","DOI":"10.1182\/blood-2016-10-569186","article-title":"Vitamin B12 deficiency from the perspective of a practicing hematologist","volume":"129","author":"Green","year":"2017","journal-title":"Blood, J. Am. Soc. Hematol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/nrdp.2017.40","article-title":"Vitamin B12 deficiency","volume":"3","author":"Green","year":"2017","journal-title":"Nat. Reviews Dis. Primers"},{"key":"B26","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1002\/9780470712184","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series","author":"Higgins","year":"2008"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1539","DOI":"10.1002\/sim.1186","article-title":"Quantifying heterogeneity in a meta-analysis","volume":"21","author":"Higgins","year":"2002","journal-title":"Stat. Med."},{"key":"B28","doi-asserted-by":"publisher","first-page":"e004501","DOI":"10.1136\/bmjopen-2013-004501","article-title":"Should vitamin B12 tablets be included in more Canadian drug formularies? an economic model of the cost-saving potential from increased utilisation of oral versus intramuscular vitamin B12 maintenance therapy for Alberta seniors","volume":"4","author":"Houle","year":"2014","journal-title":"BMJ Open"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/0197-2456(95)00134-4","article-title":"Assessing the quality of reports of randomized clinical trials: is blinding necessary?","volume":"17","author":"Jadad","year":"1996","journal-title":"Control. Clinical Trials"},{"key":"B30","doi-asserted-by":"publisher","first-page":"3711","DOI":"10.1245\/s10434-011-1764-6","article-title":"Oral vitamin B12 replacement: an effective treatment for vitamin B12 deficiency after total gastrectomy in gastric cancer patients","volume":"18","author":"Kim","year":"2011","journal-title":"Ann. Surgical Oncology"},{"key":"B31","doi-asserted-by":"publisher","first-page":"124482","DOI":"10.1016\/j.talanta.2023.124482","article-title":"Investigating the applicability of polar fabric phase sorptive extraction for the HPLC quantitation of salivary vitamin B12 following administration of sublingual tablets and oral sprays","volume":"258","author":"Korpeti","year":"2023","journal-title":"Talanta"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1182\/blood.v92.4.1191.416k15_1191_1198","article-title":"Effective treatment of cobalamin deficiency with oral cobalamin","volume":"92","author":"Kuzminski","year":"1998","journal-title":"Blood, J. Am. Soc. Hematol."},{"key":"B33","first-page":"200","volume-title":"Management sanitario, Un approccio metodologico","author":"La Torre","year":"2014"},{"key":"B34","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1016\/j.copbio.2012.08.005","article-title":"Bacteria as vitamin suppliers to their host: a gut microbiota perspective","volume":"24","author":"LeBlanc","year":"2013","journal-title":"Curr. Opinion Biotechnology"},{"key":"B35","first-page":"293","article-title":"US department of agriculture and US department of health and human services, dietary guidelines for Americans","author":"McGuire","year":"2010"},{"key":"B36","doi-asserted-by":"publisher","first-page":"w14421","DOI":"10.4414\/smw.2017.14421","article-title":"Early biomarker response and patient preferences to oral and intramuscular vitamin B12 substitution in primary care: a randomised parallel-group trial","volume":"147","author":"Metaxas","year":"2017","journal-title":"Swiss Medical Weekly"},{"key":"B37","doi-asserted-by":"publisher","first-page":"e1000097","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"6","author":"Moher","year":"2009","journal-title":"PLoS Med."},{"key":"B4","unstructured":"2025"},{"key":"B38","doi-asserted-by":"publisher","first-page":"1364","DOI":"10.1002\/mnfr.201500019","article-title":"Cobalamin coenzyme forms are not likely to be superior to cyano\u2010and hydroxyl\u2010cobalamin in prevention or treatment of cobalamin deficiency","volume":"59","author":"Obeid","year":"2015","journal-title":"Mol. Nutrition & Food Research"},{"key":"B39","volume-title":"The implications for training of embracing: a life course approach to health","author":"Organization","year":"2000"},{"key":"B40","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.1080\/16078454.2021.2010877","article-title":"Sublingual methylcobalamin treatment is as effective as intramuscular and peroral cyanocobalamin in children age 0\u20133 years","volume":"26","author":"Orhan Kili\u00e7","year":"2021","journal-title":"Hematology"},{"key":"B41","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1186\/s13643-016-0384-4","article-title":"Rayyan\u2014a web and Mobile app for systematic reviews","volume":"5","author":"Ouzzani","year":"2016","journal-title":"Syst. Reviews"},{"key":"B54","first-page":"67","article-title":"Sublingual vitamin B12 compared to intramuscular injection in patients with type 2 diabetes treated with metformin: a randomised trial","volume":"129","author":"Parry-Strong","year":"2016","journal-title":"N. Z. Med. J. (Online)"},{"key":"B42","first-page":"42","article-title":"Comparative bioavailability and utilization of particular forms of B12 supplements with potential to mitigate B12-related genetic polymorphisms","volume":"16","author":"Paul","year":"2017","journal-title":"Integr. Med. A Clinician's J."},{"key":"B43","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/j.orcp.2021.02.002","article-title":"Vitamin B12 supplementation orally and intramuscularly in people with obesity undergoing gastric bypass","volume":"15","author":"Ramos","year":"2021","journal-title":"Obes. Res. & Clin. Pract."},{"key":"B44","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1016\/j.amjmed.2003.09.046","article-title":"Oral vitamin B12 therapy in vitamin B12 deficiency","volume":"116","author":"Roth","year":"2004","journal-title":"Am. Journal Medicine"},{"key":"B45","doi-asserted-by":"crossref","DOI":"10.1201\/9781420005806","volume-title":"Handbook of vitamins","author":"Rucker","year":"2007"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.7860\/JCDR\/2022\/53256.16055","article-title":"Long-term use of metformin and its effect on serum vitamin B12 with its oral manifestations: a review","volume":"16","author":"Sanjay","year":"2022","journal-title":"J. Clin. Diagn Res."},{"key":"B47","doi-asserted-by":"publisher","first-page":"e033687","DOI":"10.1136\/bmjopen-2019-033687","article-title":"Oral versus intramuscular administration of vitamin B12 for vitamin B12 deficiency in primary care: a pragmatic, randomised, non-inferiority clinical trial (OB12)","volume":"10","author":"Sanz-Cuesta","year":"2020","journal-title":"BMJ Open"},{"key":"B48","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1016\/s0016-5085(12)60808-7","article-title":"Sa1100 randomized open label trial comparing efficacy of oral versus intramuscular vitamin B12 supplementation for treatment of vitamin B12 deficiency","volume":"5","author":"Saraswathy","year":"2012","journal-title":"Gastroenterology"},{"key":"B49","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1093\/ajcn\/nqy072","article-title":"Efficacy of oral compared with intramuscular vitamin B-12 supplementation after Roux-en-Y gastric bypass: a randomized controlled trial","volume":"108","author":"Schijns","year":"2018","journal-title":"Am. J. Clin. Nutr."},{"key":"B50","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1080\/10245332.2018.1456023","article-title":"Comparison of the efficacy of parenteral and oral treatment for nutritional vitamin B12 deficiency in children","volume":"23","author":"Sezer","year":"2018","journal-title":"Hematology."},{"key":"B51","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1046\/j.1365-2125.2003.01907.x","article-title":"Replacement therapy for vitamin B12 deficiency: comparison between the sublingual and oral route","volume":"56","author":"Sharabi","year":"2003","journal-title":"Br. Journal Clinical Pharmacology"},{"key":"B52","doi-asserted-by":"publisher","first-page":"i4919","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"ROBINS-I A Tool Assessing Risk Bias Non-randomised Studies Interventions"},{"key":"B53","doi-asserted-by":"publisher","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"Bmj"},{"key":"B55","first-page":"155","article-title":"Fate of cobalamins in humans following oral and intramuscular administration of cyanocobalamin, hydroxocobalamin, adenosyl-cobalamin and methylcobalamin","volume":"55","author":"Tanaka","year":"1981","journal-title":"Vitamins"},{"key":"B56","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1007\/s13312-022-2594-2","article-title":"Parenteral vs oral vitamin B12 in children with nutritional macrocytic anemia: a randomized controlled trial","volume":"59","author":"Tandon","year":"2022","journal-title":"Indian Pediatr."},{"key":"B57","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.curtheres.2014.01.001","article-title":"Effect of administration route on the pharmacokinetics of cobalamin in elderly patients: a randomized controlled trial","volume":"76","author":"Tillemans","year":"2014","journal-title":"Curr. Ther. Res."},{"key":"B58","doi-asserted-by":"publisher","first-page":"380","DOI":"10.24875\/RIC.20000208","article-title":"Comparison of sublingual and intramuscular administration of vitamin B12 for the treatment of vitamin B12 deficiency in children","volume":"72","author":"Tu\u011fba-Kartal","year":"2020","journal-title":"Rev. Investig. Cl\u00ednica"},{"key":"B59","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1080\/14017430601049449","article-title":"Comparing costs of intramuscular and oral vitamin B12 administration in primary care: a cost-minimization analysis","volume":"12","author":"Vidal-Alaball","year":"2006","journal-title":"Eur. Journal General Practice"},{"key":"B60","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v036.i03","article-title":"Conducting meta-analyses in R with the metafor package","volume":"36","author":"Viechtbauer","year":"2010","journal-title":"J. Statistical Software"},{"key":"B61","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1016\/0011-393x(95)85135-6","article-title":"Clinical efficacy of intravenous plus oral mecobalamin in patients with peripheral neuropathy using vibration perception thresholds as an indicator of improvement","volume":"56","author":"Yamane","year":"1995","journal-title":"Curr. Therapeutic Research"},{"key":"B62","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1089\/acm.2006.12.881","article-title":"A single-center, double-blinded, randomized controlled study to evaluate the relative efficacy of sublingual and oral vitamin B-complex administration in reducing total serum homocysteine levels","volume":"12","author":"Yazaki","year":"2006","journal-title":"J. Altern. & Complementary Med."}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2025.1602976\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T05:17:40Z","timestamp":1766121460000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2025.1602976\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,19]]},"references-count":62,"alternative-id":["10.3389\/fphar.2025.1602976"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2025.1602976","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,19]]},"article-number":"1602976"}}