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Some vitamins and their metabolites are excreted through the kidneys, and accumulation may occur in severe renal impairment

FIGURE 2 Vitamin B12 Inhibited ER Stress Signaling Pathway Under chronic ER stress, the associated apoptosis may contribute to pathophysiological processes involved in a number of prevalent diseases, including neurodegenerative diseases, diabetes, atherosclerosis and renal disease (Tabas and Ron, 2011)

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May be fed directly from the dropper, added to drinking water or mixed with food

In people without deficiency, evidence does not consistently show that additional B12 improves energy, mental performance, or weight control