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Conditions that can cause cobalamin deficiency include: Inflammatory bowel disease (IBD) Exocrine pancreatic insufficiency (EPI) Pancreatic cancer Chronic enteropathy Alimentary lymphoma Small intestinal dysbiosis Inherited selective cobalamin malabsorption Inherited selective cobalamin malabsorption, which is known as Imerslund-Grsbeck syndrome (IGS) in humans, makes a dog genetically predisposed to have difficulty absorbing cobalamin

The FDA issued warning letters in March 2026 (FDA.gov press announcement, March 3, 2026) specifically targeting companies that implied otherwise

It noted that oral and intra-articular peptides showed distinct advantages in soft tissue regeneration, with intra-articular routes providing localized effects and oral routes offering systemic benefits

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Although its orobuccal route of administration (i.e., through the tissues lining the mouth) leads to greater absorption, even the lowest orobuccal dose used in studies is 50mg higher.22 Safety Winner: Codeage Liposomal Glutathione Oral glutathione is generally safe for most people

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