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In the alkaline environment of the small intestine, R-proteins are degraded by pancreatic enzymes, freeing vitamin B 12 to bind to intrinsic factor (IF), a protein secreted by specialized cells in the stomach (parietal cells)

1,2,6 Skin hyperpigmentation, glossitis, and infertility have also been reported

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Golding points out that unless the enterohepatic circulation is disrupted, holotranscobalamin levels wont significantly decrease until the livers B12 stores are depleted (Golding, 2016)

If the product has a specified duration of use, rinse off after this time has elapsed