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[DOI] [PMC free article] [PubMed] [Google Scholar] 4.Gonzalez-Muniesa P, Martinez-Gonzalez MA, Hu FB, Despres JP, Matsuzawa Y, Loos RJF, Moreno LA, Bray GA, Martinez JA

Non-alcoholic steatohepatitis (NASH) , characterised by inflammation and hepatocyte injury, or advanced fibrosis and cirrhosis can disrupt normal liver function

Patients should be reviewed 812 weeks after commencing treatment to assess: Symptomatic improvement, particularly resolution of fatigue and neurological symptoms Haematological response (normalisation of haemoglobin and mean cell volume) Reticulocyte count typically rises within one week, indicating bone marrow response Repeat serum B12 testing is generally not useful after starting parenteral therapy, as levels remain elevated for months

For any protocol requiring multiple draws over weeks, bacteriostatic water is the standard and the safe choice