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As of 2025, the entire human evidence base for a compound injected by millions amounts to a retrospective study of 16 knee patients, a 12-patient bladder pain pilot with no control group, and a two-person intravenous pharmacokinetic study

Medical guidance supports the use of vitamin B12 injections in cases of confirmed deficiency, particularly where absorption is an issue

However, an Eli Lilly study that identified chemical impurities in tirzepatide compounded with vitamin B12 shows that these are unapproved drugs with uncertain safety