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This timeline matches B12 pharmacokinetics: intramuscular methylcobalamin reaches peak serum concentration at 8-12 hours, but tissue saturation (particularly in the liver and nervous system) occurs over 48-72 hours as the vitamin is transported into cells and converted to active coenzyme forms (Andrs et al., 2018)

[26] A complication of severe chronic PA is subacute combined degeneration of spinal cord, which leads to distal sensory loss (posterior column), absent ankle reflex, increased knee reflex response, and extensor plantar reflex response

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Basic and Applied Zoology, 81, 110

An overview of Vitamin B12 Vitamin B12 (also called cobalamin) is a water-soluble vitamin