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26.8 30.3 min, p = 0.39)

Injectable forms generally offer stronger and more predictable results, while nasal sprays provide a simpler and more approachable option for patients prioritizing ease of use

Funding This work was supported by grants from a DOD Career Development Award to Z.Q

Gennev : Accepts a selection of insurance plans, but prescriptions can only be sent to your local pharmacy, so you may need to cover a variable co-pay

Methylmalonic acid level (MMA)

Your provider will consider these factors when designing your treatment plan and may recommend a slower dose escalation schedule, more frequent follow-up, and closer attention to nutrition and exercise