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However, for patients with chronic illnesses, oxidative stress, or MTHFR gene mutations, this conversion process is often severely impaired, rendering cyanocobalamin largely ineffective for symptom management

Not because reconstitution is complicated, but because nobody explains the actual math clearly

8 weeks: ~2 vials 12 weeks: ~23 vials 16 weeks: ~3 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 ~3.0 mL per 10 mg vial for reconstitution

Several hold FDA approval for specific indications