Then, in 2015, Lee and colleagues identified a previously overlooked open reading frame within the 12S ribosomal RNA gene of mtDNA and found that it encodes a functional peptide, MOTS-c (Mitochondrial Open Reading Frame of the 12S rRNA-c) [1]
After initial repletion, a maintenance dose is given, often 1,000 mcg intramuscularly every month or every 2 to 3 months, to prevent recurrence of deficiency
They build up slowly over months
However, homocysteine-lowering trials have produced equivocal results regarding the prevention of cognitive deterioration in this population
Certain individuals should not receive B12 injections without explicit medical clearance or should avoid them altogether
Evidence Gaps and Expectations: Crucially, patients must understand the experimental nature