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Week 4-8: Progressive improvement for responders

8 weeks: ~5 vials 12 weeks: ~9 vials 16 weeks: ~12 vials Insulin Syringes (U-100, 1 mL) Per injection: 1 syringe 8 weeks (once daily): ~56 syringes 16 weeks (once daily): ~112 syringes Bacteriostatic Water (10 mL bottles) Use 2.0 mL per 2 mg vial for reconstitution

Since vitamin B 12 is found predominantly in foods of animal origin, strict vegetarian and vegan diets can result in vitamin B 12 deficiency (2, 16)

Alternatively, continued regulatory restriction could push more research into countries with more permissive frameworks, potentially fragmenting the evidence base geographically

The Practical Takeaway If you're having symptoms and your B12 is high, here's how to think about it: First, separate the two questions

RSC Adv (2025) 13(40):2823049