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In this situation, it can be challenging to demonstrate B12 deficiency even when there are typical symptoms (including neuropathy-like paraesthesia and numbness), as serum B12 concentrations may be just within, or sometimes above, the normal range due to the oral supplementation

Low doses of methyl donors once the rest of the pathways are better and later maybe some GSH can be tolerated.

Always check current local rules before buying or importing racetams

If your condition allows, try to eat regular meals with protein and complex carbohydrates to support your metabolism

For patients with significant portal hypertension or ascites, deltoid or lateral thigh injection sites avoid the potentially altered abdominal vascular dynamics