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This pilot study suggest that the nasal drops may be used as an alternative to injections because two thirds of ME/CFS patients reported a positive effect, accompanied by an increased number of steps, improvement of the RAND-36 physical functioning scale and the CIS20r fatigue scale, and a significant increase in serum vitamin B12 levels

How Quickly Do B12 Injections Start Working

Reported effects are mild and transient: Localized irritation or redness at injection site, Mild fatigue or transient headache during initial days, Rare gastrointestinal upset (nausea, stomach discomfort)

The result is an increased energy expenditure