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Cyanocobalamin is indicated for vitamin B12 deficiencies due to malabsorption which may be associated with the following conditions: It may be possible to treat the underlying disease by surgical correction of anatomic lesions leading to small bowel bacterial overgrowth, expulsion of fish tapeworm, discontinuation of drugs leading to vitamin malabsorption (see Drug Interactions), use of a gluten-free diet in nontropical sprue, or administration of antibiotics in tropical sprue

Diet strategy Caloric deficit is mandatory

The major advantage is that the vitamin is absorbed directly through the oral mucosa

Most robust clinical data comes from injectable or intravenous protocols, not topical application