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Sublingual B12, which bypasses the gastrointestinal tract, is the least invasive and potentially most cost-effective option, especially for individuals with impaired absorption, making it an attractive alternative for long-term and patient-friendly management ( Supplementation may involve various forms of cobalamin: adenosylcobalamin, cyanocobalamin, methylcobalamin, or hydroxocobalamin

An essential vitamin yes but it often played second fiddle to vitamin C, D and Omega-3

Even when pain relief is significant the patient should increase activities gradually over one to two weeks to avoid reappearance of pain

They are used as supportive therapy following clinical assessment