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Clean the injection site gently with alcohol swab to avoid any kind of infection
The protocols in use come from extrapolation of animal data, pharmacokinetic studies, and clinical experience from practitioners who have incorporated the compound into their practice
The methodological quality of the included studies, as assessed through the Jadad and NewcastleOttawa scales, varied from moderate to high, while the GRADE assessment indicated moderate certainty of evidence for serum vitamin B12 increase and low certainty for homocysteine reduction
Another possibility is that obesity could lower serum vitamin B12 levels through decreased dietary intake or absorption, increased catabolism, and sequestration in adipose tissue, or changes in the gut microbiota profiles which could affect the metabolism of vitamin B12
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