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It works through different central nervous system pathways and does not directly inhibit COX enzymes in the same way, making it a less disruptive choice for pain management in this context

NIH 2013

From a cardiovascular perspective, Vitamin B12 nasal spray helps lower homocysteine levels in the blood, a compound associated with an increased risk of heart disease

A commonly used protocol involves administration five times per week for approximately eight weeks, followed by a two-week break before repeating the cycle, if appropriate

B12 supplementation is one of the most common additions, addressing the potential for micronutrient deficiency when caloric intake drops significantly