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Individual response depends on dose and duration, but also on zinc, glutathione, protein intake, mitochondrial reserve, liver metabolism, kidney filtration, bowel elimination, gut health and methylation
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The Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) tool was used to assess the certainty of the evidence for the two primary biochemical outcomesserum vitamin B12 concentration increase and homocysteine reductionacross all included studies, and separately for randomised controlled trials (RCTs) and observational studies
Prior to opening any frozen vial, researchers should allow the container to equilibrate to room temperature for at least 30 to 45 minutes to prevent moisture condensation directly onto the powder, which can initiate localized hydrolysis
