This Methylcobalamin 1 mg/ml to 20 mg/ml Injection Solution is a compounded formulation designed for the treatment of various conditions including neuropathy, anemia, B12 deficiency, megaloblastic anemia, and Leber's disease
"Brain-gut Axis and Pentadecapeptide BPC 157: Theoretical and Practical Implications." Current Neuropharmacology, 2016;14(8):857-865
All of the studies used both in vivo and some form of in vitro methods of data collection in order to observe different treatment effects, allowing for biomechanical, functional (use of AFI index and load to failure), macroscopic and microscopic histological analysis
So, you measure a higher B12, but part of that B12 is inactive, so useless Oral B12 supplementation, even in the form of a multivitamin preparation, may result in serum B12 concentrations just within the normal range without abolishing symptoms
The clinician can also help determine whether standard care, physical therapy, imaging, nutrition, sleep optimization, hormone evaluation, or another treatment should come first