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FACT 3 OF 6 IM injections for severe deficiency or absorption failure If your sublingual dose doesnt maintain serum B12 above 400 pg/mL, switch to intramuscular injections: 1,000 mcg monthly (more often initially if very deficient)

Retching is a strong involuntary unproductive effort to vomit associated with abdominal muscle contraction but without expulsion of gastric contents through the mouth

191 YinL.LundinB.BertrandM.NurmiM.SolymosiK.KangasjarviS.et al (2010)

synthesized gelatin nanoparticles (GNPs) and conjugated AMP-Cypate to fabricate composite AMP-Cypate@GNPs [191]