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This makes annual cost predictable, removes the financial incentive to stay at sub-optimal doses, and aligns the financial structure with clinical best practice (titrate to effective dose)

A slightly more expensive soap with higher glutathione content might actually offer better value than a cheaper alternative with minimal active ingredients

The kidney is the primary excretory organ for platinum-based agents and their metabolites, with the vast majority of the agents ultimately excreted via urine

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After one week of treatment, the mean body weight in the 2.4mg treated group decreased by 4.2% compared to the placebo group

Other groups who may benefit include: Patients following gastric surgery (gastrectomy, bariatric procedures) where intrinsic factor production or absorption sites are compromised Individuals with malabsorption disorders such as Crohn's disease, coeliac disease, or chronic pancreatitis Strict vegans and vegetarians with dietary insufficiency, though oral supplementation is usually tried first Elderly patients with atrophic gastritis or reduced gastric acid production Patients on long-term metformin or proton pump inhibitors, which can impair B12 absorption [6] [8] Individuals with nitrous oxide exposure (recreational or medical), which can cause functional B12 deficiency Diagnosis typically involves serum B12 measurement, with levels below approximately 148 pmol/L (though thresholds vary between laboratories) generally indicating deficiency