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Nutritional factors that may be useful to consider in pain management - evidence indicates substantial relief of neuropathic pain by thiamine, pyridoxine and cyanocobalamin separately, and in combination there was a synergistic benefit, low B12 exacerbates elevated TNF- which is an inflammatory response marker

Use should consider effects on seminal plasma composition, where proteins like osteopontin and adrenomedullin correlate with motility and semen biochemistry

Many research planning windows are shorter 12 to 24 weeks is common for tolerability and titration assessment, with longer cycles for efficacy endpoints

In one 2014 case study, a 64-year-old woman was on the hCG diet when blood clots developed in her leg and lungs