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This is believed to result from the increased blood volume induced by methylcobalamin

Este proceso es muy importante, sobre todo durante periodos de baja disponibilidad de carbohidratos o durante el ejercicio prolongado, ya que el cuerpo recurre a las grasas como fuente de energa primaria para preservar las reservas de glucgeno

Such effects are consistent with their established reduction in atherosclerotic cardiovascular events and may be particularly relevant in patients with obesity, insulin resistance, or HFpEF phenotypes, and taken together, these mechanistic differences provide a biologically plausible rationale for combination therapy: SGLT2 inhibitors primarily target HF-related hemodynamic and cardiorenal pathways, whereas GLP-1 receptor agonists may further improve metabolic and vascular risk

Cyanocobalamin has to go through a complex conversion process within the body in order to become active and many people cannot do these conversions well, so often much of the dose goes unused (even with a shot)