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Duncans patients often report a loss of interest in alcohol and cigarettes, though she is careful to tell them that while this effect is real, its not necessarily permanent or universal, given that everyones dopamine pathways are different

Internet sellers and research only vendors do not provide the same safeguards

Oral supplementation is more affordable and accessible but may be ineffective in individuals with gastric malabsorption

In the UK, hydroxocobalamin is the standard injectable form of B12 used in NHS practice

Intramuscular injections are generally inconvenient due to pain and require healthcare professionals for administration, thus increasing the economic burden on patients which ultimately leads to discontinuation of the treatment