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It is not a drug, supplement, or medical product and is not approved for human or animal use, diagnosis, or treatment

Methylation issues are very common (up to 40% of patients) and many patients unknowingly supplement with cyanocobalamin which may increase serum levels but will not improve symptoms 5

Most protocols run 4 to 8 weeks

Compound-level reports from animal studies and small human exposure data describe low acute toxicity

Availability fluctuates bacteriostatic water has been subject to periodic supply shortages in the pharmaceutical distribution system, and community sources cite Fresenius Kabi as the backup manufacturer when Hospira supply is constrained

Though there are two different options, hydroxocobalamin and cyanocobalamin, hydroxocobalamin is usually recommended as it stays in the body for longer