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In the absence of coenzyme B12, tetrahydrofolate cannot be regenerated from its inactive storage form, 5-methyltetrahydrofolate, and a functional folate deficiency occurs

Human clinical evidence There are only two categories of human dataand neither supports its use in arthritis

We prioritize personalized care and encourage patients to discuss their individual circumstances with our healthcare professionals

Greenfield, B

While this isn't the same as drug approval, it does indicate a favorable safety profile based on toxicology data

NICE guidance recommends 1 mg hydroxocobalamin three times weekly for 2 weeks for patients without neurological symptoms, with lifelong maintenance therapy for irreversible causes