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However, individual results may vary, and some may require repeat injections for sustained relief

But there are problems with so-called specificity, meaning there are other reasons values can be abnormal, like diminished kidney function in the case of MMA, and folate deficiency in the case of homocysteine

Baseline assessment should establish B12 status (serum cobalamin, methylmalonic acid, homocysteine) and evaluate whether metabolic demands or absorption limitations suggest supplementation

Bromberg A, Lerer E, Udawela M, Scarr E, Dean B, Belmaker RH, Ebstein R, Agam G (2012) Nicotinamide- N -methyltransferase (NNMT) in schizophrenia: genetic association and decreased frontal cortex mRNA levels

This date is determined based on stability studies, compounding conditions, and regulatory guidelines