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A normal serum B12 of 350 pg/mL with elevated MMA is still deficiency

Step #4: Refrain from agitating the vial, as this may damage the contents

It influences several overlapping repair pathways simultaneously: it may promote new blood vessel growth (VEGF), modulate the nitric oxide system, support collagen synthesis, and protect gut mucosal tissue

Institutional protocols often start at 50mg daily for two weeks, then escalate to 75100mg based on tolerance and objective metabolic markers like NAD+ levels and urinary methylnicotinamide excretion

Animal studies show healed tissue approaches normal tensile strength at 6 weeks

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