But you can't practise evidence-based medicine on a substance that has no evidence," said Phillips
routine B12 level monitoring is generally unnecessary once replacement is established, as levels do not reliably correlate with tissue stores Important safety considerations: Older adults may have impaired renal function, though this rarely affects B12 therapy given its wide safety margin
Freezing and thawing a reconstituted peptide can damage its molecular structure
This article examines the side effect profile of B12 therapy in older adults, covering common reactions such as injection site discomfort and gastrointestinal symptoms, rare serious adverse events requiring urgent medical attention, important drug interactions with medications like proton pump inhibitors and metformin, and evidence-based dosing guidance aligned with NICE and BNF recommendations for safe, effective B12 replacement in this vulnerable population
Quick Answer: Potentially yes they work through different pathways and may be complementary but this combination requires careful medical supervision and has not been studied in clinical trials