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pH matters more

Too much water and you will have an extremely dilute solution where huge volumes are needed per dose

The FDA placed it in 503A Category 2 ("may present significant safety risks") in 2023, effectively barring compounding pharmacies from using it, then removed it from that category in April 2026 after nominators withdrew their submission, without adding it to the approved Category 1 compounding list

In UK practice, monitoring is primarily based on clinical response rather than routine blood tests, as post-treatment serum B12 measurements can be misleadingly high and may not reflect tissue levels

They can check your condition and adjust your B12 injection schedule