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(2019) Open trial of vitamin B12 nasal drops in adults with myalgic encephalomyelitis/chronic fatigue syndrome: comparison of responders and non-responders

The biphasic response suggests possible mechanisms: lower doses (nanogram range) might work through growth factor upregulation and signaling cascade amplification, while higher doses (microgram range) might involve direct receptor activation or substrate provision for cellular repair

Interaction with Medications: May interact with certain medications (PPIs, metformin, anticonvulsants)

The injection is administered quickly, and any discomfort usually subsides within minutes

Sometimes the change will only last a few days and revert back to the previous health state

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