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The rate at which your body converts food into energy is one indicator of your metabolic rate

Pharmacokinetics: Cyanocobalamin is administered intranasally, orally, and parenterally, while hydroxocobalamin is administered only parenterally. Once absorbed, vitamin B12 is highly bound to transcobalamin II, a specific B-globulin carrier protein and is distributed and stored primarily in the liver as coenzyme B12. The bone marrow also stores a significant amount of the absorbed vitamin B12. This vitamin crosses the placenta and is distributed into breast milk. Enterohepatic recirculation conserves systemic stores. The half-life is about 6 days (400 days in the liver). Elimination is primarily through the bile; however, excess cyanocobalamin is excreted unchanged in the urine

61 In practice, some patients may be able to switch to very high dose (ie, 2000 mcg daily) oral supplementation instead of continuing parenteral administration, but it is impossible to predict in whom this can be done safely, and many are at risk of worsening symptoms which may become permanent

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