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The recommended pharmacological treatments for fibromyalgia are antidepressants (eg, Serotonin and norepinephrine reuptake inhibitors (SNRI)) and antiepileptics (eg, gabapentinoids), which often cause side effects.4 In addition, opioid analgetics and NSAID (Non-Steroidal Anti-Inflammatory Drugs)/COX (Cyclooxygenase inhibitor) are often prescribed.10 Only a minority of individuals report a clinically relevant improvement from any of the treatments.11 Vitamin B 12 is sometimes used for symptoms other than those of vitamin B 12 deficiency, for example, different pain conditions such as backpain and neuropathic pain.1216 Vitamin B 12 nasal drops have been tested with positive results on patients with myalgic encephalomyelitis (ME)/chronic fatigue (CF)/fibromyalgia (ME/CF syndrome).17 A recent study showed that sublingual vitamin B 12 had positive effect on patients with fibromyalgia.18 In addition, there are vitamin B 12 studies that have shown good results in the therapy of aphthous ulcers19 and acute lumbago,20 as well as in studies concerning diabetic polyneuropathy.21 22 Moreover, studies examining methylcobalamin treatment in patients with lower back pain showed pain reduction and functionality gain.13 23 To summarise, it is not entirely clear how vitamin B 12 affects the human pain system

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