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Duration of treatment depends on the underlying cause: Lifelong therapy is required for pernicious anaemia or irreversible malabsorption (e.g., after gastrectomy) For dietary deficiency without malabsorption, treatment may be reviewed once deficiency is corrected and neurological symptoms have resolved Oral B12 supplementation is generally not recommended for patients with neurological symptoms, particularly when pernicious anaemia is the cause

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IV therapy may not be appropriate for athletes with: Severe kidney disease (impaired fluid and electrolyte handling) Congestive heart failure (fluid overload risk) Known allergies to any components of the infusion Active infection or fever Uncontrolled hypertension Always discuss your complete medical history and medication list with your clinician before your first IV therapy session

Other studies have shown issues with the ability of the enzyme dopamine beta hydroxylase which catalyzes dopamine into norepinephrine and the norepinephrine transporter enzyme which is involved in the reuptake of norepinphrine into the synaptic terminals (13, 14)

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Diagrammatic Representation: A bidirectional arrow connects the gut and the brain