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2-adrenoceptor agonists Clonidine gel: A randomized, double-blind, placebo-controlled, parallel-group, multicenter trial showed that topical clonidine gel significantly reduced the level of pain in subjects with DN in whom there are functional (and possibly sensitized) nociceptors in the affected skin

This method is often the standard for anyone who needs to address low B12 levels fast, especially if they have issues with nutrient absorption

The Lancet 378, 169181 (2011)

Where It Acts The primary target cells are dermal fibroblasts (the cells responsible for producing collagen, elastin, and the extracellular matrix proteins that give skin its mechanical structure) and basal keratinocytes (the proliferating cell population at the bottom of the epidermis)

Heart palpitations and episodes of shortness of breath