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This information complements, not replaces, clinical evaluation and biomarker testing

A lack of this can cause B12 deficiency

Slowing the ramp to the label cadence (2.5 mg start, 2.5 mg steps, four-week holds) dropped that to mid-single digits at every maintenance dose, at no cost to the 12-week result, and the dedicated slow-titration trial reached placebo range. Reaching 15 mg is not the problem

Although some compounding pharmacies meet high manufacturing standards and submit to third-party testing, variability in purity, potency, and sterility persists, especially among unregulated, direct-to-consumer online sources

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