Coskun T, Sloop KW, Loghin C, et al
After 46 weeks of treatment: 0.6 mg dose: 6.2% mean body weight reduction 2.4 mg dose: 12.5% mean body weight reduction 3.6 mg dose: 13.2% mean body weight reduction 4.8 mg dose: 14.9% mean body weight reduction (all randomized) 4.8 mg dose: 18.7% mean body weight reduction (completers only) Placebo: 2.8% mean body weight reduction Among completers at the 4.8 mg dose, 68.8% achieved at least 10% weight loss, 67% achieved at least 15%, and 40% achieved at least 20% weight loss
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Methylene Blue What It Does: Methylene blue is a mitochondrial enhancer that acts as an electron carrier in cellular respiration, directly improving energy production at the mitochondrial level
Normal vital signs (blood pressure, heart rate, respiratory rate, temperature) and body mass index (BMI) between 18 and 30 kg/m 2 Suboptimal vitamin B12 status (deficient to borderline 200300 pg/mL), defined as serum B12 levels within the lower end of the reference range (234894 pg/mL) Able to provide informed written consent Able to comply with study procedures and follow-up visits as outlined in the protocol 2.2.2 Exclusion criteria Known hypersensitivity or allergy to oral vitamin B12 supplements or any of its components Known history of cobalt allergy or sensitivity Severe malabsorption syndromes, including pernicious anemia or intestinal disorders affecting vitamin B12 absorption Current use of acetaminophen, nonsteroidal anti-inflammatory drugs, antibiotics, antacids, proton pump inhibitors (PPIs), multivitamins, or nutritional supplements containing vitamin B12 History of gastric bypass surgery or other procedures that significantly alter GI anatomy or function Significant renal impairment (estimated glomerular filtration rate [eGFR] 0.05) Supplementary Table 1
