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As such, while in vitro investigations provide important mechanistic insights, their results cannot be directly generalised to pharmacological or clinical implications without rigorous validation

[1] Those who cannot digest or absorb B12 as a result of inherited genetics or damage to the stomach and small intestine require more than can be absorbed from sublingual supplementation

These include systemic medications such as methotrexate, cyclosporine, retinoids, 6-thioguanine, mycophenolate mofetil, troglitazone, and new biologic agents like adalimumab, alefacept, efalizumab, etanercept, and infliximab, as well as topical therapies like steroids, vitamin D analogues, psoralen, 5-aminolevulinic acid, salicylates, fumaric acid esters, anthralins (dithranol), tacrolimus, and retinoids, such as tazarotene

& Sultana, S