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According to the 2025 meta-analysis by Alfalasi and colleagues, sublingual B12 showed an approximate 199% mean increase in serum B12 compared to approximately 307% for intramuscular injections

While menstrual irregularities were not systematically reported as adverse events in published results, the substantial weight loss achieved (approximately 20.9% with the 15 mg dose) would be expected to influence reproductive hormone dynamics in premenopausal women based on established weight loss physiology