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Chandys hypothesis, that the rapid onset of the repairing processes induced by B12 shots might overwhelm the system and temporarily cause a worsening in symptoms, similar to the Jarisch-Herxheimer reaction in those treated for Lyme disease

Because adequate, well-controlled studies in pregnant individuals are lacking, use should be limited to circumstances in which the potential maternal benefit clearly outweighs theoretical fetal risk-such as treatment of documented systemic carnitine deficiency

How This Works 5-Amino-1MQ (5-amino-1-methylquinolinium) is a synthetic small molecule not a peptide that selectively inhibits nicotinamide N-methyltransferase (NNMT) [1]