The mechanism here is difficult to determine, however presumably stems from an increased production of transcobalamin II (22-24)
Many experts recommend using these on alternate nights or in separate routines (for example, acids or strong vitamin C in the morning and copper peptides at night) to maintain efficacy and a strong skin barrier
each case is judged individually.11 Solid evidence on the safety of parenteral, lifelong, high dose hydroxocobalamin is available from decades of treating patients with inborn errors of B 12 metabolism (eg, cobalamin C deficiency).6768 Symptom monitoring Monitor symptoms regularly (eg, every two to three months) as they may reappear, even after several months, if injection frequency is reduced
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