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Without a clinical deficiency, the benefits dont justify the risks for most people, he says

Healthcare providers should ensure that any use in athletic populations is medically justified and compliant with applicable anti-doping regulations

No personalized use recommendation outputs

There are two forms of B12methylcobalamin or cyanocobalamin

SS-31 (elamipretide) , a mitochondria-targeted peptide that stabilizes cardiolipin to support energy production, became the first FDA-approved mitochondrial therapeutic in 2025, though only for the rare Barth syndrome, with the brain rationale still mechanistic and no cognitive trials

This gradual progression is one reason vitamin B12 deficiency is often missed. By the time injections are recommended, the body usually needs a more direct and reliable way to restore levels