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Key markers include fasting glucose and insulin (to assess insulin sensitivity), HbA1c (long-term glucose regulation), lipid panel (triglycerides, HDL, LDL), resting metabolic rate via indirect calorimetry, and body composition via DEXA scan (to differentiate fat loss from lean mass changes)

But do not heat it

This makes methylcobalamin injections a more direct and potent option for replenishing B12 stores

Severe hepatic or renal impairment high-dose protocols may add metabolic burden

B12 is a co-substrate of various cell reactions involved in methylation synthesis of nucleic acid and neurotransmitters

Despite this, cyanocobalamin has been increasingly criticised in recent years, due to the following reasons: Toxicity: cyanocobalamin is often claimed to be toxic, as the cyano group form the poison cyanide