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Endothelial dysfunction has been demonstrated in vivo (306, 311), in the large vessels of ME/CFS patients (307, 311) through flow-mediated dilation (FMD) and in the microcirculation through post-occlusive reactive hyperaemia

This creates challenges around purity, authenticity, and consistency that men must navigate carefully

Once acclimated to B12 therapy, most individuals dont experience detox reactions or concerns of feeling worse after each B12 injection

UK guidance recommends monitoring clinical response rather than routinely rechecking serum B12 levels once treatment is established

Unknown long-term effects : There is no long-term safety data for either compound used individually in the general population, let alone in combination