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Anyone with these conditions should obtain explicit medical clearance before receiving a B12 injection

They provide strong proof that a compound has a direct biological effect on the target tissue, but they cannot tell us how that compound will behave when applied to human skin (where absorption, distribution, and metabolism add complexity)

Metformin, commonly prescribed for type 2 diabetes, is known to reduce B12 absorption over time, as highlighted in MHRA safety updates

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Nevertheless, focusing exclusively on a NE threshold for AVP initiation may have shortcomings, as it appears plausible that other patient-dependent factors may also play a role [15]