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This clinical observation is possibly because the methylcobalamin delivered by this method is better absorbed into the bloodstream, or it is more bio-available, or the effect is more noticeable because of the constantly higher blood level

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In 1995, Cortellini et al

Disruption in iron homeostasis, including increased transferrin receptor expression and ferritin degradation via NCOA4-mediated ferritinophagy, contributes to ferroptotic susceptibility ( Lipid Peroxidation: Polyunsaturated fatty acids (PUFAs), especially arachidonic and adrenic acids, are substrates for lipoxygenases (LOX), which drive peroxidation in membrane phospholipids, generating cytotoxic lipid peroxides such as 4-hydroxynonenal (4-HNE) and malondialdehyde (MDA) ( Glutathione Depletion and GPX4 Inactivation: System Xc imports cystine for GSH synthesis