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Thus, this might be recognized as a special heart-brain-blood vessels interacting axis (providing in the counteracted multiorgan failure, the attenuated myocardial lesions, and arrhythmias as an achieved important tool, either as a cause or as a consequence), peripheral and central interplay, as an essential defensive response [19,22,23,24,27,28,29,31,37,38,39,40]
However after 2 - 3 months on B12 it disappeared, although I still occasionally have pulsatile tinnitus especially after rising in morning

doi:10.1210/endo.142.12.8522

Oral bioavailability studies would require dose-escalation trials measuring plasma concentrations after oral dosing versus subcutaneous dosing those trials have not been conducted or published as of 2026.
