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All three mechanisms operate simultaneously, which is what makes TB-500 effective for the range of applications where it is prescribed

This includes confirmed low serum vitamin B12 levels, pernicious anaemia, malabsorption states such as coeliac disease, inflammatory bowel disease, or post-gastric or bariatric surgery, unexplained anaemia, neuropathy or neurological symptoms consistent with vitamin B12 deficiency, a long-term vegan diet with symptoms or low levels, or failure of oral vitamin B12 supplementation

Our experience shows that different peptides often have distinct, though sometimes overlapping, mechanisms of action

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An injectable form is considered far more effective than topical, as it works systemically and bypasses the top layer of the skin